Can you bring a claim for medical negligence against a health visitor?
Health Visitors are part and parcel of having a baby, but how much medical knowledge should they have? In a recent case this question was considered.
How much responsibility does a health visitor have?
When babies are born various measurements are taken. These are then repeated regularly during the babies early month and years. This is for the purpose of monitoring for health concerns and critically, triggering action if there is a problem. Sadly, sometimes those caring for babies or children forget the reason behind the measuring and therefore fail to act on a problem.
A child born in June had his head circumference measured at 2 weeks old by his Health Visitor. His head was on the 25th centile. (meaning ¾ of babies that age have bigger heads). 4 weeks later at age 6 weeks the Health Visitor measured his head again, as she was supposed to do. This time his head was on the 50th centile (i.e. a half of babies that age would have a bigger head). The baby’s weight had remained on the 25th centile throughout. In that four week period the baby’s head had grown significantly relative to his weight. He was seen again at four months but his head circumference was not measured. Crossing two centile lines within a six-week period is a red flag necessitating referral to a medical practitioner.
In December the baby became ill and was admitted to hospital and his head circumference was measured. It was on the 99.6th centile. (the very largest of all babies of that age) whilst his weight remained on the 25th centile. He was diagnosed with hydrocephalus and treated immediately, but sadly had already suffered brain damage. The medical experts in the case accepted that had he been treated before his head circumference reached the 99.6th centile he would have avoided brain damage.
Health visitors are trained to take a child’s weight and head circumference and plot them on the chart. They do this so that they can spot potential developmental problems and refer, when appropriate, for medical assessment.
What errors did the Health Visitor make?
In this case the Health visitor took the measurements four weeks apart and only one centile had been crossed but she failed to recognise that the baby’s head was growing too rapidly. She should either have measured again 6 weeks after the first measurement to monitor the baby or she should have referred him for medical assessment at the time of the second measurement when it was clear that his head was growing disproportionately.
The missed measurement at four months was also negligent. The Health Visitor failed to note that the baby had not attended a six week GP check and failed to notice that visually the baby’s head was disproportionately large.
Health visitors need to understand the work they are doing
The Judge concluded that whilst a Health Visitor is not required to diagnosis hydrocephalus it was her duty to measure and to understand the implications of the measurements so that a medical referral could be made for any abnormalities noted.
This case is a timely reminder that whist Health Visitors are becoming less and less hands on and there is talk of ‘the red book’ which is a diary of a baby’s progress going digital, the basic medicine remains the same. Babies need to be monitored and that responsibility falls to the Health Visitor in the community. When an abnormality is recorded there must be a referral for a medical review.
Do you need more information about health visitor negligence?
If you feel that your midwife, health visitor or GP has missed a problem with your baby or child get in touch with our legal team who are specialists in claims for injuries to children.