Sarah O'Sullivan, Author at Tees Law

‘No fault’ divorce law

Posted on 24 March 202218 May 2025 by Sarah O'Sullivan

What is no fault divorce?

A ‘no fault’ divorce is one in which the partner within a marriage – who is asking for the divorce – does not have to prove that the other partner did something wrong.

Now there is only one ground for divorce

Instead, your petition (now called application) will simply cite the irretrievable breakdown of the marriage as the ground for divorce. You will no longer be able to cite factors of adultery, behaviour or separation.

Legislation to bring about a no-fault divorce option, became available to couples on 6 April 2022, having been passed into law on 25th June 2020.

Eradicate the blame game

For people who’ve reached the conclusion it’s better to divorce, to be able to do so without having to wait and apportion blame, is a positive step. This will likely benefit any children of the family because of the focus on separation, instead of blame. The emotional impact of divorce is a huge challenge for many and it’s rarely taken lightly, particularly where children are involved.

Blame and fault as to the end of a marriage is now almost entirely irrelevant when resolving the financial issues which need to be addressed in the divorce. This is a very helpful change because in the past when blame was actively required to start the process, there was a tendency to bring questions of ‘blame’ into the financial negotiations.

Important changes to divorce law

The changes certainly do remove much of the emotional content of divorce applications. In summary, the changes:

remove the requirement to provide evidence of poor conduct or separation
fundamentally restrict the ability to contest divorce proceedings
remove the ability to defend the decision
allow applications to be made jointly if they wish, or solely if they do not.

Defending divorce proceedings

At the moment, a respondent (the receiver of the application for divorce) can defend proceedings if they do not wish to divorce. In which case, the court must assess whether the fact cited in the petition can be proven on a balance of probabilities. However, the new law, will (save for exceptional circumstances) only allow people to defend a petition on a very limited basis:

lack of jurisdiction
marriage is not valid (so annulment proceedings are required and not divorce)

Does this give too much power to the person who wants a divorce?

In order to balance this shift towards one person alone being able to get the divorce, the new legislation introduces a mandatory 20-week cooldown period which is called a period of reflection. This runs from application at the start, to the conditional order (currently termed ‘Decree Nisi’) which is the document that establishes that the divorce can go ahead. This is the point where couples can submit what is called a consent order, which deals with their financial claims relating to the marriage. The consent order is submitted to the court for approval and sealing. Once you have the conditional order, the applicant(s) will then have to wait six weeks and one day before applying for the final order (currently termed Decree Absolute).

Is no fault divorce a good thing?

The vast majority of family lawyers believed the laws surrounding divorce should be changed, to allow couples to separate without having to apportion blame to each other and without having to wait at least two years before they can divorce. Divorce is difficult enough without either party being blamed for causing the end of a relationship, particularly when couples have simply grown apart. The legal requirement (which has been the case to date) to assign blame can make it challenging for couples to reach an amicable agreement. It’s also true that it’s often been a distraction for legal professionals, whose focus is to resolve more important issues in a constructive way.

At Tees, the family law team is pleased with this new legislation because it will help people to deal with this difficult period without the added strain of apportioning blame. It will allow people to concentrate on being able to resolve matters in relation to finances and children, without adding upsetting reasons in the divorce application.

In addition, there is a consensus among family law professionals that the end of the archaic legal language of ‘Decree Nisi/Absolute’ and ‘Petition/Petitioner’ is very much welcomed and makes the process much more accessible and understandable.

Prior to this recent change in the law, the most recent legislation governing divorce was approaching 50 years old. The last divorce legislation was brought into effect in 1973 and was designed to reflect the society of the time and the disapproval of the breakdown of a marriage. No one could suggest that society has not significantly changed in this time and that what was once considered taboo or frowned upon is no longer the case.

Will no fault divorce impact me?

If you are already in divorce proceedings, then there will be no impact on your divorce or its progression. If you are about to start a divorce process, you need to bear in mind the court portal will close in order to prepare for the new divorce rules. You should therefore begin to prepare your divorce application on the basis of the new rules. Our specialist divorce lawyers can help you with your questions.

Financial arrangements in divorce

Couples who are divorcing often find themselves under increased emotional stress, and they often fail to fully consider the financial impact of their separation. As a result, decisions that are made can have a long-lasting impact on the opportunity for financial security in the future.

Now that no-fault divorce has passed into law, this offers hope for couples who have decided to separate that they can to do so with less conflict and stress. This we hope will help with the process of making important financial decisions about major financial assets, most notably pension arrangements, which can turn out to be detrimental – more often negatively affecting women rather than men.

Pension funds are key to establishing a ‘fair share’

Assets held in pension funds are of vital importance when calculating a ‘fair share’ between couples. These funds are often the second most significant assets owned in a relationship after the family home – and can sometimes be the largest. And yet, they are all too often overlooked when it comes to establishing a financial settlement. Often couples put greater focus on splitting tangible assets, like property, with many under-estimating the impact of mismanaging the split of a pension in divorce.

The law gives the courts wide powers to vary on divorce the way in which pension funds are held by the parties so that fairness can be achieved. This may well involve a varying of the shares held by each party in the capital value of the funds, as well as how the income derived from the funds will be distributed.

The importance of seeking independent financial advice

It is alarming that very few people actively seek specialist independent financial advice on divorce. The impact of this is that many people are missing out on vital pension benefits, with the risk more likely to impact women than men given they often have a less sizeable pension of their own.

If you are going through a divorce, make sure you seek professional advice, both legal and financial as the importance in planning your finances for life after your divorce has been completed cannot be over-emphasized.

At Tees we combine independent financial advice with expert legal advice so you get a fully-joined up view. Our independent financial advisers are experienced in dealing with pensions as part of advising on the settlement of the overall financial arrangements on divorce. Sometimes the pension arrangements involved in divorce settlements can be complex depending on your circumstances and that’s where our experts can provide you with guidance to ensure that your interests are fully protected.

Medical negligence: Cauda Equina Syndrome claims

Posted on 28 January 202219 May 2025 by Sarah O'Sullivan

Tim Deeming, Partner in Tees’, Top Tier Legal 500 Medical Negligence and Personal Injury team, highlights ‘red flag’ symptoms and signs, and the importance of urgent medical intervention for patients showing symptoms of Cauda Equina syndrome. Sadly, if the warning signs are missed, it can have life changing impacts for the patient and their family and lead to a medical negligence claim.

In August 2021, the Healthcare Safety Investigation Branch (HSIB) reported their results of a national investigation into the timely detection and treatment of non-malignant spinal cord compression (cauda equina syndrome). The investigation was launched after HSIB identified an event where a patient had several GP and hospital presentations before CES was diagnosed. Once an MRI scan identified the cord compression, there were further barriers to receiving timely emergency surgery to alleviate the compression. This investigation focused on: assessing the resilience, consistency and reliability of the pathway(s) for patients experiencing potential red flags for CES; seeking to understand the context and contributory factors influencing the pathway for patients with CES from their first presentation reviewing the national context surrounding the timely detection and treatment of spinal nerve compression (CES) in patients with back pain.

What is Cauda Equina Syndrome (CES)?

Cauda Equina Syndrome, or CES, is a potentially devastating condition caused by compression of the group of sensitive nerves located at the base of the spinal cord involved in lower limb sensation and pelvic function known as the Cauda Equina. It can result in bowel, bladder and sexual dysfunction as well as lower limb weakness, numbness and pain as the nerves which are often damaged supply such areas.

CES occurs more often in adults than in children. But it can occur in children who have a spinal birth defect or have had a spinal injury.

What are the risks of delayed diagnosis or misdiagnosis of Cauda Equina Syndrome?

The most significant issue is that it is a surgical emergency to release the pressure on the spinal cord to prevent permanent damage. Delayed diagnosis or misdiagnosis of symptoms can mean this condition can progress to an irreversible stage. Research carried out by the Medical Protection Society (MPS) in 2016 found that failure or delay in diagnosis of CES was one of the top five errors leading to the most ‘expensive’ claims against GPs.

The study led to the MPS working with the National Institute for Health and Care Excellence (NICE) to produce revised ‘red flag’ guidelines that were published in 2018. The intention was to help healthcare professionals diagnose the condition and increase referrals for urgent investigation and medical intervention.

It is still too early to say whether the new guidance has made a significant difference to practice. However, it is hoped GPs are becoming more risk averse when providing advice to patients who may be at risk of CES, by referring them to hospital for detailed investigations.

What are the ‘red flag’ symptoms and signs of Cauda Equina Syndrome?

The National Institute for Health and Care Excellence (NICE) lists the following red flag symptom and signs:

Bilateral sciatica – occurs in both legs together. This type of sciatica is rare and may occur due to degenerative changes in the vertebrae and or the disc at several spinal levels or from Cauda equina syndrome
Severe or progressive abnormal function of the legs, such as major motor weakness with knee extension, ankle and or foot movement
Difficulty passing of urine and incontinence
Loss of rectal sensation which if untreated can lead to irreversible incontinence
Loss of feeling, tingling or numbness
Weakness and or numbness in the anal sphincter

What are the most common causes of cauda equina syndrome?

A severe ruptured disk in the lumbar area (base of the spine)
Narrowing of the spinal canal (stenosis)
A spinal lesion or malignant tumor
A spinal infection, inflammation, hemorrhage, or fracture
A complication from a severe lumbar spinal injury such as a car crash, fall, gunshot, or stabbing
A birth defect such as an abnormal connection between blood vessels

The potential long-term effects of Cauda Equina Syndrome (CES) can have a life-changing impact on patients and their families. Some patients with persistent back problems, neurological symptoms or concerns that something has gone wrong with their treatment, often do not realise that they are suffering from Cauda Equina Syndrome. It is therefore important to seek urgent medical advice if you have any of the warning signs.

How is Cauda Equina Syndrome treated?

If you have Cauda Equina Syndrome (CES), it is vital you receive immediate treatment to relieve pressure on the affected nerves. Surgery must be done quickly to improve recovery and prevent permanent damage, such as paralysis of the legs, loss of bladder and bowel control, sexual function, or other problems.

It is often best if this occurs within 48 hours of the onset of symptoms, but this depends on the cause of the compression and severity of the symptoms. Depending on the cause of your CES, you may also need high doses of corticosteroids which can reduce some swelling. If you are diagnosed with an infection you may need antibiotics. If a tumor is responsible, radiation or chemotherapy may be needed after surgery.

Common medical negligence claims relating to Cauda Equina Syndrome

Unfortunately, there are still common themes in compensation and settlement case studies such as:

Patients not being advised of the ‘red flag’ warning signs or presenting with worsening lower back pain radiating into their legs being dismissed as sciatica
Failure to pay sufficient attention to a relevant medical history leading to patients not being referred for an emergency MRI scan and emergency surgery
Delay, misdiagnosis and poor treatment in A & E departments
Delay in hospitals performing an MRI scan of the lumbar spine, causing irreversible damage
Following an MRI scan which demonstrates cauda equina nerve compression, an avoidable delay in transferring the patient to a hospital where the required spinal surgery could be carried out, again causing irreversible damage
Substandard medical care – spinal operations such as a lumbar discectomy and decompression being performed in an inappropriate manner
A haematoma (collection of blood) developing during surgery, creating pressure on the nerve roots and causing CES, even where the patient had no CES symptoms prior to surgery

Even with treatment, some patients may not retrieve full function, it depends on how much damage has occurred both given the length of time and severity of the compression. If surgery is successful, you may recover some bladder and bowel function

How we can help

If negligently treated, Cauda Equina Syndrome could ultimately lead to lifelong paralysis and the need for full time support. This in turn may have consequences on mental health, relationships and cause financial hardship.

In these circumstances, the law seeks to award compensation to help you deal with any continuing problems and to maximise your potential rehabilitation and quality of life. While no sum of money can compensate the difficulties you may face, our specialist team are here to help.

We have specialist lawyers within the team including Tim Deeming who has successfully pursued cases on behalf of clients who have suffered CES and often obtained compensation of six/seven figures that will provide the help needed for the client and family’s future.

No win, no fee

We work on a no win, no fee basis, so there’s no need to worry about costs. Plus, our specialist solicitors provide an initial free assessment of your claim.

Ectopic pregnancy: Medical negligence claims

Posted on 22 January 202218 May 2025 by Sarah O'Sullivan

Failure to diagnose, or misdiagnosing an ectopic pregnancy can be very distressing for an expectant mother. If left untreated, an ectopic pregnancy can tear or rupture the fallopian tube, which is not designed to accommodate a growing embryo. An ectopic pregnancy can sometimes lead to severe, life-threatening internal bleeding.

National incident data from the NHS shows that between April 2017 and August 2018 there were 30 missed ectopic pregnancies leading to ‘serious harm’. The Healthcare Safety Investigation Branch (HSIB) carried out a national investigation into the diagnosis of ectopic pregnancy which considered referral from emergency departments to early pregnancy services; the provision of early pregnancy services to diagnose and manage ectopic pregnancy; the information that women receive on discharge from the emergency department and made four safety recommendations.

Caring and sensitive support with Tees

Whatever your situation, our legal specialists are here to help guide you. Our expert clinical negligence lawyers can handle your ectopic pregnancy misdiagnosis claim from the initial consultation through to financial settlement.

Ectopic pregnancy misdiagnosis medical negligence claim

Doctors owe a duty of care to diagnose ectopic pregnancies and provide treatment in a professional and timely manner. An ectopic pregnancy misdiagnosis claim may arise whenever this duty is breached and the patient suffers injury as a result. Here are some examples of events that may give rise to a claim for ectopic pregnancy misdiagnosis:

misinterpretation of pregnancy test results such as blood tests and scans
misdiagnosis, for example, mistaking an ectopic pregnancy for a uterine miscarriage
failure to diagnose the condition when a woman presents with symptoms pointing to a possible ectopic pregnancy
a delay in diagnosing the condition causing a woman to undergo more invasive surgery than would have been necessary.

Gwyneth Munjoma, solicitor in Tees’ clinical negligence team, looks at the risk factors and associated symptoms – and what to do if you suffered from an ectopic pregnancy and believe that the condition could have been managed better by the doctors or nurses who attended to you.

What is an ectopic pregnancy?

An ectopic pregnancy occurs when a fertilised egg (embryo) implants and grows outside the cavity of the uterus (womb). Where an ectopic pregnancy occurs within the fallopian tube it is called a tubal pregnancy. A tubal pregnancy is the most common type of ectopic pregnancy. This happens when a fertilised egg gets stuck in the fallopian tube on its way to the uterus.

Normally, a fertilised egg travels down the fallopian tube to the uterus where it embeds itself and grows. An embryo stuck in the fallopian tube will not develop into a baby and your health may be at risk if the pregnancy continues.

In the UK, around 1 in every 90 pregnancies is ectopic. This is around 11,000 pregnancies a year. Depending on the stage at which the ectopic pregnancy is diagnosed, it can be treated using a drug called methotrexate or by an operation to remove the fallopian tube.

What problems can occur with an ectopic pregnancy?

Fallopian tubes can be damaged by inflammation or can be misshapen. Once an egg is fertilised it starts to grow rapidly. If a fallopian tube is damaged or misshapen, the rapidly growing embryo is unable to continue its journey to the uterus and gets stuck within the fallopian tube.

An embryo stuck in the fallopian tube cannot progress to a successful pregnancy, because it is restricted by the lack of space within the fallopian tube. As the embryo grows, the tube stretches and eventually may rupture; this can cause life-threatening internal bleeding, if not treated promptly.

Sometimes, an ectopic pregnancy will occur in other sites of the abdomen such as in the ovary, in the abdominal cavity or in the cervix.

What are the symptoms to look out for?

In most cases of an ectopic pregnancy, a woman will experience the early signs or symptoms of pregnancy, i.e. misses a period, breast tenderness and nausea. A pregnancy test will be positive. The first sign of an ectopic pregnancy may be pain in the pelvic area sometimes accompanied by light vaginal bleeding. Where there is internal bleeding the woman may feel shoulder pain as the pooling blood irritates the nerves. Symptoms may be variable, and a high index of suspicion should be exercised.

When should I seek help?

Seek emergency medical help if you think you are pregnant and experience any of the following:

severe abdominal or pelvic pain
vaginal bleeding
extreme lightheadedness or fainting
other concerning symptoms, especially if you have risk factors for an ectopic pregnancy.

What doctors have to consider

Ectopic pregnancy must be excluded for all women presenting with abdominal pain in early pregnancy. Successive reports into maternal deaths have highlighted the perils of not excluding an ectopic pregnancy in the circumstances.

Some things that make you more likely to have an ectopic pregnancy are:

Previous ectopic pregnancy. If you’ve had this type of pregnancy before, you’re more likely to have another.
Inflammation or infection. Sexually transmitted infections, such as gonorrhea or chlamydia, can cause inflammation in the tubes and other nearby organs, and increase your risk of an ectopic pregnancy.
Fertility treatments. Some research suggests that women who have in vitro fertilization (IVF) or similar treatments are more likely to suffer an ectopic pregnancy.
Tubal surgery. Surgery to correct a closed or damaged fallopian tube can increase the risk of an ectopic pregnancy.
Choice of birth control. The chance of getting pregnant while using an intrauterine device (IUD) is rare. However, if you do get pregnant with an IUD in place, you may be at increased risk of suffering an ectopic pregnancy. Tubal ligation, a permanent method of birth control commonly known as “having your tubes tied,” also raises your risk, if you become pregnant after this procedure.

Cigarette smoking just before you get pregnant can increase the risk of an ectopic pregnancy. The more you smoke, the greater the risk.

What is the treatment for an ectopic pregnancy?

The management of ectopic pregnancies has shifted towards medical rather than surgical intervention. The drug methotrexate has been successfully used for many years now. Methotrexate kills the pregnancy cells and any pregnancy tissue is then progressively absorbed.

In the event that it is too late to use methotrexate, the affected fallopian tube can be removed through keyhole surgery (laparoscopic surgery). However, in cases where it is not possible to successfully remove the fallopian tube through keyhole surgery, the abdomen is opened (laparotomy) and the tube is removed.

Family mediation: A complete guide

Posted on 13 January 202225 June 2025 by Sarah O'Sullivan

Family mediation can be a practical and effective way to resolve disputes when a relationship breaks down. It provides a structured environment for couples to reach an amicable agreement, often avoiding the stress and expense of a lengthy court battle.

Understanding family mediation

Family mediation is a voluntary process where a neutral mediator helps couples negotiate and resolve issues arising from separation or divorce. It’s designed to promote respectful communication, enabling both parties to find mutually agreeable solutions.

When is family mediation helpful?

Family mediation can assist when couples face challenges agreeing on matters such as:

Division of assets and finances
Property arrangements
Child custody and visitation schedules

It’s a preferred alternative to court proceedings, often resulting in quicker and more cost-effective resolutions.

How does family mediation work?

Step 1: Initial assessment (MIAM)

Your mediation journey typically begins with a Mediation Information and Assessment Meeting (MIAM). This one-on-one session allows the mediator to understand your situation, explain the mediation process, and determine whether it’s a suitable option.

Step 2: Joint mediation sessions

Once both parties agree to proceed, joint mediation sessions commence. The mediator facilitates discussions, helping both individuals communicate effectively. Key areas of focus may include:

Finances: Dividing savings, pensions, and debts fairly
Property: Deciding on ownership, sale, or buy-out arrangements
Children: Establishing custody schedules and parental responsibilities

Step 3: Resolution and documentation

After productive discussions, the mediator will draft a Memorandum of Understanding detailing the agreements reached. While this document isn’t legally binding, it can be converted into a consent order by a solicitor, making it enforceable by law.

Benefits of family mediation

Choosing mediation offers numerous advantages, including:

Cost-effective: Typically more affordable than court litigation
Faster resolution: Agreements can often be reached within weeks
Control over decisions: You remain in control rather than relying on a judge’s ruling
Reduced conflict: Encourages respectful dialogue and compromise

Is mediation legally required?

In most cases, couples must attend a MIAM before pursuing court action. However, exceptions apply in instances involving:

Domestic abuse or safety concerns
Child protection issues
Bankruptcy
International jurisdiction matters

Costs of mediation

The cost of mediation varies depending on the complexity of your case and the number of sessions required. However, it remains significantly cheaper than court proceedings.

What happens if mediation fails?

If mediation doesn’t lead to an agreement, you can explore alternative dispute resolution options such as arbitration or proceed to court. Seeking legal advice from a specialist family law solicitor is recommended.

Family mediation case study

Case overview: Abigail and Graham faced disagreements over child custody, financial settlements, and property division after their separation. Mediation was recommended to avoid court intervention.

Resolution: Through five mediation sessions, both parties identified their priorities. The mediator facilitated financial disclosure, ensuring transparency. Ultimately, a fair financial arrangement allowed Abigail to remain in the family home while Graham accessed liquid savings to purchase a new property. Child custody arrangements were also amicably agreed upon.

Outcome: Mediation enabled Abigail and Graham to reach a mutually beneficial agreement without resorting to court, reducing stress and legal costs.

Conclusion

Family mediation is a constructive way to navigate the challenges of separation or divorce. By fostering communication and collaboration, it offers a path toward amicable resolutions that prioritise the well-being of all parties involved. If you’re considering mediation, contact a qualified family mediator to explore your options.

ROP Retinopathy of prematurity – delayed diagnosis claims

Posted on 7 January 202218 May 2025 by Sarah O'Sullivan

Premature babies are at risk of an eye disease called Retinopathy of Prematurity (ROP), which may, in serious cases lead to blindness. This is why premature babies should be regularly screened in line with the 2008 National Guidelines.

In most cases, even if a baby does develop ROP, it will resolve spontaneously and treatment will not be needed. For a small number of babies, ROP worsens, often very rapidly, but with timely treatment the prognosis is good.

What is retinopathy of prematurity?

Retinopathy of prematurity (ROP), also called retrolental fibroplasia (RLF) and Terry syndrome is where the blood supply to the retina does not develop normally as a consequence of being born prematurely. The retina is the layer of tissue that lines the back of the eye and makes it possible to see.

Your baby’s eyes begin to develop around the 16th week of pregnancy. If he or she is born very early, this process is cut short. The blood vessels in the inner retina do not develop a blood supply until much later in the pregnancy and this process does not complete until the end of the pregnancy. Therefore, if your baby is born prematurely, the inner retina has an incomplete blood supply. The more premature the birth, the less complete the blood supply present.

In most cases, the premature baby’s eyes will develop normally. However, in some cases, the blood vessels in the inner retina do not grow normally. They may grow into other parts of the eye such as the clear gel that fills the space between the lens and the retina of the eyeball and cause bleeding/leaking. The vessels may also change physically, to pull the retina, and, if extensive enough, cause the whole retina to detach from the eye.

Over time, these blood vessels and the associated scar tissue can cause other serious vision problems, such as:

Crossed eyes (strabismus)
Increased eye pressure (glaucoma)
“Lazy eye” (amblyopia)
Near-sightedness (myopia)

The good news is that with early diagnosis and treatment, most babies will retain a normal structural eye, with good vision.

Retinopathy of prematurity medical negligence claims

Sadly, ROP occasionally gets missed and by the time it is detected, the baby has suffered permanent visual loss. Janine Collier, Head of the Medical Negligence team at Tees, has specific expertise in helping families whose child has suffered permanent visual impairment because of a failure to detect and treat ROP. If your baby has suffered visual loss as a result of late diagnosis you may be eligible for compensation. Read on to find out more about this condition or click below to speak to a specialist solicitor.

What are the risk factors for ROP?

The risks increase with increased prematurity and the smaller your baby is at birth, the greater the chance of her or him having ROP. There are other factors which contribute to the risk including:

Ventilation
Bronchopulmonary dysplasia
Chronic lung disease
Other inter-current illnesses such as infections, cardiovascular instability
Poor post-natal weight gain

How do I know if my baby has ROP?

All infants who are at risk for it should be screened in line with the 2008 National Guidelines. The timing of the first screening examination will depend on your baby’s gestational age at birth.

The baby is given eye drops to make her or his pupils larger ahead of the examination. This helps the doctor see all the parts of the eye better. It doesn’t hurt.

As the screening is not an especially comfortable examination, local anaesthetic eye drops are usually used alongside comfort care techniques, such as swaddling, oral sucrose or expressed milk, a dummy / pacifier. Experienced ophthalmologists can usually undertake the examination in 2-3 minutes. Each eye is fully examined to check for ROP.

Screening is usually carried out two-weekly, and, if no cause for concern, stops at around 36 weeks gestational age.

If the ophthalmologist identifies early signs of ROP, the interval may be shorter as the doctor will watch to see if the condition requires treatment, or if it resolves spontaneously. Most babies with ROP will resolve spontaneously.

If my baby has ROP, what treatment will he or she need?

In the UK, approximately 4% of cases require treatment. The purpose of treatment is to preserve the anatomy of the retina, by preventing retinal detachment.

If the doctor recommends treatment, this is usually given within 48-72 hours and most commonly, it is treated with laser to the affected part of the retina.

Your baby may suffer some side effects, including inflammation (typically treated with a short course of steroid eye drops and pupil dilating eye drops for 1 to 2 weeks). Rarely, other side effects may occur. Your baby’s doctor should explain these to and discuss these with you prior to treatment.

I am worried about the care my baby is receiving – what should I do?

You might already have tried to talk to doctors about your baby’s condition but sometimes it can feel like you’re on your own. With Tees by your side, you are not. We understand what you’re going through, and we’re here to give you a voice.

We’ve handled many medical claims and have a particular expertise in supporting families with babies and young children, so our team of lawyers really do have the practical experience to support you. We’re persistent, and we’ll fight to get answers for you and you may be eligible for compensation.

Retinopathy of prematurity: Case studies

Baby A: Rentinopathy of prematurity due to inadequate care

Baby A was born prematurely at 25 weeks and 4 days gestation by caesarean section. He suffered respiratory distress, was intubated and transferred to the NICU for a period of intensive care and specialist support. He remained ventilated for 9 days, spent 22 days in Intensive Care and 7 days in the high dependency unit. During his admission, he received antibiotic treatment for sepsis, insulin for hyperglycaemia and two blood transfusions.

Baby A’s parents understood that he was at risk of ROP. However, his parents also understood that their baby would be regularly screened, so that if there were signs of ROP, he could receive treatment, significantly reducing the risk of loss of vision.

Five weeks after birth, Baby A had his first screening for ROP. At the time of the exam, Baby A was still small and in an incubator. When screened, each eye examination took around 10 minutes. Parents were advised that he would be screened every two weeks.

Baby A was transferred to a Special Care Baby Unit at a local hospital. Parents felt that the care at the local hospital was very different to what they had experienced at the previous hospital. They felt the staff treated them as over anxious young parents and did not encourage them to be a part of their baby’s care, which was unlike their experience at the previous hospital.

Whilst at the local hospital, Baby A was screened twice for ROP over a six-week period. Prior to being discharged, the Ophthalmologist spent an extended period of time examining Baby A’s eyes. During the exam the Ophthalmologist cut the white part of Baby A’s eye. After a time the despite the Ophthalmologist being unable to get a clear view, Baby A was discharged from hospital.

At a paediatric follow up the following month, Baby A’s parents told the Paediatrician that they were worried about his eyes as he would not look, follow or track. The Paediatrician said that it was just because he was a young premature baby and that they should not worry.

One month later, Baby A was referred to Great Ormond Street (GOSH) for assessment. Baby A’s parents were told that he had suffered significant and severe visual loss, equivalent of Stage 5 ROP / retinal detachment in the left eye and Stage 4a ROP in the right eye.

Baby A had surgery on the right eye at GOSH. The estimate is that post-operation he may have 2% vision in his good right eye since having the operation. It was not possible to offer Baby A any treatment for his left eye.

The outcome

The hospital that treated Baby A has admitted that the diagnosis of ROP should have been made several weeks earlier and that laser treatment should have been offered within 48-72 hours of diagnosis. Now that liability has been admitted, we are seeking an interim payment to put in place some immediate support for Baby A and his family (aids, appliances, accommodation, educational support).

As a result of a review, the hospital has changed their process and procedure for ROP screening. The Ophthalmologist no longer undertakes ROP screening and the Paediatrician no longer reviews premature babies.

Baby C: Late diagnosis of retinopathy of prematurity

Baby C was born at 24 week’s gestation, weighing c. 600 grams. She suffered several complications because of her extreme prematurity including Respiratory Distress Syndrome, Chronic lung disease, Hypertension, a patent ductus arteriosus, sepsis, hyperglycaemia and necrotizing enterocolitis.

Due to her prematurity and low birth weight, C was at high risk of suffering from ROP.

Baby C was examined by an ophthalmologist at, 7 weeks old, 8 weeks old, 9 ½ weeks old

On all occasions, it was noted that there was no ROP.

At ten and a half weeks of age, Baby C was again examined. The ophthalmologist found and recorded a “definite progression of ROP stage 3 zone 2 in both eyes, + disease”.

Treatment by both laser and cryotherapy was undertaken, but, the disease being so extensive now, was unsuccessful.

ROP behaves in a highly predictable manner and, we were, therefore, able to infer that at the time of the examination when C was 9 ½ weeks of age, it is implausible that there was no ROP present. The examination must, therefore, have been substandard. With a competent examination, C would have been referred for urgent laser treatment and, on the balance of probabilities, she would have retained good functional vision in both eyes.

Baby C lost all vision in her left eye, and has a shrunken eye. She has lost most useful vision in her right eye. She is at risk of retinal detachment, retinal degeneration, the need for surgical treatment of the band keratopathy, glaucoma and shrinkage of the right eye.

C also suffers from learning, behavioural and social difficulties because of her extreme prematurity. Her visual impairment has compounded her other developmental problems.

This case has now settled for a six figure sum.

Birth injuries to mothers: Medical negligence claims

Posted on 21 December 202118 May 2025 by Sarah O'Sullivan

Birth related injuries to mothers can be absolutely devastating, and can have long-term effects. They can affect personal relationships, careers and mental health.

Some childbirth injuries are unavoidable, and they can be a natural part of having a baby. Childbirth injuries can have an impact on the psychological and/or physical well-being of a woman. Injury can occur during any pregnancy, even if the mother has no risk factors and the pregnancy is deemed to be normal. Sadly, some injuries are caused, or made worse, when midwives and doctors make mistakes during a mother’s pregnancy, labour or delivery.

Medical negligence claims for maternal birth injury

If you believe that you may have suffered a birth injury, or think that your labour and delivery may have been mismanaged or a mistake made during your care caused the problem, you might have a medical negligence claim.

Doctor or midwife negligence can cause birth injuries which affect mothers and their families for the rest of their lives. The effects of childbirth injuries are very personal and individual, but possible consequences include:

physical symptoms which affect your quality of life, such as incontinence
mental health problems, such as postnatal post-traumatic stress disorder or depression
relationship breakdown
problems bonding with your new baby
being unable to return to work because of your symptoms

If you suffered a birth injury, are worried about the care you received, and think it might have caused a problem you may be eligible for birth injury compensation. Our maternal birth injury claims solicitors understand what you’re going through, and we can help you get answers about your care.

Find out more about childbirth injuries claims.

Common types & causes of birth injuries to mothers:

Vaginal tears during childbirth

About 9 in 10 women suffer perineal tears when the perineum (the skin between the vagina and anus) stretches as the baby is born. Most perineal tears are quite minor and should heal naturally within a short time after the baby is born. However, more serious tears can also extend to the vulva (external genitals) and muscles in the anus (back passage). These require repair, take longer to heal and may have long-term effects.

Types of tears during childbirth

First degree tears are skin-deep and only affect the outermost layer of skin around the vagina and perineum. You may need a few stitches, but normally they heal quickly. First degree tears have the best chance of quick recovery with minimal pain. Normally, there is no long term damage. Your midwife will decide in consultation with you, whether it is necessary to stitch your first degree tear or not.

Second degree tears are deeper tears, involving the muscles of the vagina and the skin around the anus. Stitches are normally required to help the tear to come together and heal. Dissolvable stitches are usually used, so that the mother doesn’t need to have them removed. Second degree tears can be quite painful and recovery normally takes a few weeks. Your midwife will examine the tear from time to time to ensure that it is healing well. You should report any signs of unusual discomfort or signs of infection to your midwife.

Third and fourth degree perineal tears are the most serious form of tears during childbirth. These types of tears are typically deeper and more serious. Third degree tears damage the anal sphincter (the muscle which controls the anus). Fourth degree tears also involve the lining/muscles of the anus. Third and fourth degree tears are unpredictable. The Royal College of Obstetricians and Gynaecologists (RCOG) lists the following as risk factors:

the mother’s first vaginal delivery
the second stage of labour is particularly long
shoulder dystocia during delivery
the baby is large (over 8 pounds 13 ounces)
labour is induced
an assisted delivery (for example, if forceps or ventouse are used).

If you are concerned about suffering a serious tear during birth, you can talk to your or midwife or doctor about it during your antenatal care. They may be able to recommend measures to help reduce the risk of a serious tear, such as perineal massage. Perineal massage helps the perineum to be more elastic and can help reduce the risk of it tearing as your baby is born. Another option is an episiotomy, a procedure designed to reduce the risk of a serious tear.

What is an episiotomy?

An episiotomy is a surgical incision made by a doctor or midwife during childbirth. It is a deliberate cut designed to expedite delivery and help reduce the risk of uncontrolled tearing of the perineum. This incision makes the opening of the vagina wider, so there’s more room for the baby to pass through.

There are two types of episiotomy you might hear about:

midline episiotomy – a cut from the vagina directly towards the anus (rarely done)
mediolateral episiotomy – a cut from the vagina, but angled off to one side of the perineum. Mediolateral episiotomies are more common in the UK.

Midwives and doctors should only recommend an episiotomy if there is a medical need, or the mother specifically requests one. It may be the best course of action if your baby is in distress and needs to be born quickly, if they are in a difficult position or if you are having an instrumental delivery using forceps or ventouse.

Some women may prefer an episiotomy over a spontaneous (natural) tear. Spontaneous tears can cause serious, lasting damage to the muscles around the vagina and anus but are said to heal better. Studies show that episiotomies reduce the risk of suffering a serious tear. Your doctor should explain the risks and benefits of an episiotomy to you before performing one.

Failure to identify and repair tears following childbirth

If you suffer a perineal tear, your caregivers should identify the tear at delivery and manage it appropriately. You can also find more information and support regarding perineal tears from the charity MASIC (Mothers with Anal Sphincter Injuries from Childbirth).

Following delivery and for the rest of your postnatal care, your midwife will ask you about the condition of your perineum and where necessary examine the perineum. Care of your perineum forms part of your post-natal midwifery follow up. Serious tears and episiotomies can, unfortunately, cause a great deal of suffering if they are unnoticed and not repaired at the time of delivery or if they’re repaired poorly. For example, they can cause complications such as:

incontinence – lack of control to pass faeces (stool) and/or wind
rectovaginal fistula – a serious tear can cause a hole in the wall between your vagina and your anus, which can cause faeces to pass through into the vagina
pain and soreness – the tear may make it difficult for you to sit for a long time, or be very active
stinging pain when passing urine
pain during sexual intercourse.
scarring.

It may also mean you need another procedure to correct the damage (secondary repair), causing further pain and distress.

If you suffered a third or fourth degree tear, if this was not identified and repaired at the time of delivery, and if you suffer continuing problems as a consequence, please contact our Obstetric Anal Sphincter Injury experts, Janine Collier and Gwyneth Munjoma for compensation advice.

Post-natal depression (PND) and post-natal post-traumatic stress disorder (PTSD)

A negative experience before, during or shortly after childbirth (‘birth trauma’) can affect mental health and wellbeing. Negative experiences during childbirth are highly personal, and everyone reacts differently. However there are some common signs and symptoms, for example:

difficulty bonding with the baby
a sense of ‘failure’ – that the circumstances surrounding baby’s birth were somehow their fault
feeling isolated or guilty
avoiding situations reminiscent of the birth (going to hospital, seeing birth depicted on television).

Many mothers suffer in silence. However, post-natal PTSD and post-natal depression needs the right treatment and support. Get further information about psychological damage after childbirth.

If you suffered post-traumatic stress disorder or post-natal depression following a traumatic delivery contact our experts Gwyneth Munjoma or Janine collier for advice.

Post-partum haemorrhage (PPH)

Women experience some blood loss after giving birth. Vaginal bleeding is normal for about 2 to 6 weeks after the baby is born. The bleeding is normally heaviest in the days immediately after delivery, becoming gradually lighter over time.

However, some women experience abnormally heavy bleeding, which can be dangerous. This is called a post-partum haemorrhage (PPH). There are two types of PPH:

primary or immediate PPH – heavy bleeding within 24 hours of the baby’s birth
secondary or delayed PPH – heavy bleeding after 24 hours, and up to 6 weeks after the baby’s birth.

Primary PPH happens in about 5 in 100 pregnancies. Normally, about 500ml (1 pint) of blood may be lost. However, in very rare cases, a particularly severe haemorrhage can lead to blood loss of around 2L (4 pints) or more.

Secondary PPH is rarer and affects less than 2 in 100 women. It normally happens if the mother suffers an infection following delivery. A major bleed can be life threatening. Midwives and doctors are trained to recognise situations where a mother is at high risk of suffering a PPH. They should take the necessary steps in order to reduce the chance of a haemorrhage – or prevent it altogether. And, if a haemorrhage does occur it is important to treat it quickly. Doctors and midwives are trained in controlling heavy bleeding.

If you suffered a post-partum haemorrhage and are concerned about the medical care you received contact Janine Collier or Gwyneth Munjoma for advice.

Ruptured uterus

A ruptured uterus is a serious complication during pregnancy. It happens when the wall of the uterus (womb) tears during pregnancy. It’s more common in women who have previously had a caesarean section, at the site of their caesarean section scar.

It is very important that doctors and midwives diagnose and treat a uterine rupture promptly. A ruptured uterus is considered a medical emergency because it can be life-threatening to both the mother and the baby and cause serious damage to the health of the mother and baby.

First line treatment is urgent caesarean section and uterine repair if possible (hysterectomy if not). Usually, the mother loses a lot of blood and needs a transfusion and antibiotics to reduce the risk of infection. It can take a little time to recover from losing so much blood and the surgery itself. Women who have more children in the future will need a caesarean section.

If you suffered a ruptured uterus and are concerned about the medical care you received contact our maternal birth injuries experts, Janine Collier or Gwyneth Munjoma for advice.

Prolapsed uterus

Childbirth can also cause pelvic organ prolapse. This is where one of more of the pelvic organs bulges into the vagina. It’s quite common, and the NHS states that up to half of mothers are affected by some level of prolapse.

Pelvic organ prolapse is more likely in cases where labour was particularly long or difficult, or the baby was particularly large.

A prolapse of the uterus (womb) happens when the uterus slips out of its normal position and down into the vaginal canal. Most of the time, a prolapsed uterus or other pelvic organ isn’t life-threatening. However, it can affect the mother’s quality of life and general wellbeing significantly. Possible symptoms include:

urinary incontinence
pain during sex
a feeling of heaviness in the vagina and/or perineal area.

Many cases of a pelvic organ prolapse can be managed through pelvic floor exercises, treating any constipation and weight loss (if appropriate). However, if you suffer a serious prolapse it might require more invasive treatment such as a hysterectomy (removal of the womb, which means the woman cannot have any more children) or surgical repair of the pelvic floor muscles.

If you suffered a prolapsed uterus and are concerned about the medical care you received talk to our maternal birth injuries experts, Janine Collier or Gwyneth Munjoma.

Medical negligence claims for maternal birth injuries

physical symptoms which affect your quality of life, such as incontinence
mental health problems, such as postnatal post-traumatic stress disorder or depression
relationship breakdown
problems bonding with your new baby
being unable to return to work because of your symptoms

Cerebral palsy medical negligence cases: How Tees can help

Posted on 17 December 202128 March 2025 by Sarah O'Sullivan

Babies can be born with cerebral palsy despite the highest level of antenatal and obstetric care. Unfortunately, in some cases, severe injury results from medical negligence, where healthcare providers fail to ensure the safety of mothers and babies during pregnancy and delivery. One major cause is the failure to recognize signs of fetal distress, leading to delays in critical situations.

Cerebral palsy medical negligence cases at Tees

At Tees, our medical negligence lawyers are supporting two severely disabled children and their families, striving to ensure they receive the lifetime security they need.

Liam Baker and Kayleigh Smith were both born in 2006 at separate hospitals.
Both children have severe physical disabilities (classified as GMFCS Level 5) and brain damage.
Liam is tube-fed and fully dependent on others, while Kayleigh also has limited vision.
Both experience severe epilepsy and seizures, managed with anticonvulsant medications.

Cerebral palsy during labour: Negligence in healthy pregnancies

Hannah Baker was experiencing her first pregnancy, which was deemed unremarkable.
Tracy Smith had a history of recurrent miscarriages and a previous emergency caesarean section.
Both mothers attended regular antenatal check-ups and raised concerns about limited fetal movement. Despite reassurance from normal CTG readings, problems arose during labour.

Medical experts identified failures in monitoring and timely intervention, resulting in preventable brain damage.

The importance of fetal heart monitoring

Monitoring the baby’s heart rate is critical during pregnancy and labour. A normal fetal heart rate ranges between 110 and 160 bpm.

Bradycardia refers to a heart rate below 110 bpm.
Tachycardia refers to a heart rate above 160 bpm.

Abnormal heart rates can signal fetal distress and oxygen deprivation. In both Liam’s and Kayleigh’s cases, medical experts concluded that fetal heart monitoring was insufficient.

Monitoring failures

Continuous electronic fetal monitoring was discontinued for both mothers after 30 minutes, against best practice guidelines.
NICE guidelines recommend that, without continuous monitoring, midwives should conduct auscultations every 15 minutes for at least 60 seconds.
In Hannah’s case, auscultations were conducted at half-hourly intervals, despite her experiencing severe abdominal pain – a potential sign of placental abruption.
For Tracy, with a history of miscarriage and traumatic birth, continuous monitoring should have been prioritized. Her initial abnormal CTG trace was disregarded, and it took two hours before medical staff intervened.

Detecting cerebral palsy and brain damage after birth

After birth, both Liam and Kayleigh had low Apgar scores, indicating distress.

Kayleigh was floppy and struggling to breathe.
Liam required immediate resuscitation and was placed on a ventilator.

Both children were diagnosed with acute hypoxic ischaemic encephalopathy (HIE), a form of brain damage caused by oxygen deprivation.

The court process for cerebral palsy medical negligence cases

After gathering extensive evidence from independent medical experts, our solicitors instructed a barrister to represent the families. The court process involved:

Statements from the families.
Medical evidence evaluating the timing and cause of brain damage.
Determining whether earlier intervention could have prevented the injuries.

Cerebral palsy compensation

Although neither case has concluded, liability has been resolved. The next step involves determining the compensation amount, expected to reach multi-million-pound settlements to provide lifelong care and support for Liam and Kayleigh.

Free expert medical negligence advice

At Tees, our experienced medical negligence solicitors are dedicated to supporting clients and their families.

If you have concerns about your medical care, we offer free, confidential, and no-obligation consultations. Contact us via our enquiry form or arrange for a home visit if preferred. We’re here to help you through every step of your journey.

Caesarean Section Requests

Posted on 9 December 202124 April 2025 by Sarah O'Sullivan

A report on the variations in practice and procedure across NHS Trusts in the UK

At Tees, we are increasingly supporting women who, despite requesting a caesarean section or raising concerns about vaginal delivery, have been counselled in a way that steers them toward a vaginal birth.

Many of these women are unaware that nearly 40% of births in the UK involve either instrumental assistance or a caesarean section. For first-time mothers, this figure rises to 50%. Furthermore, around 4% of women experience third or fourth-degree perineal tears during childbirth, which can result in life-changing, long-term issues with bowel control and incontinence.

Sadly, many go on to endure traumatic births, often leading to serious and lasting physical and/or mental health problems. In some cases, their babies also suffer injury.

Read Tees Law’s own report

The copyright in this report belongs to Tees Law. Tees Law gives permission for extracts from the report to be used provided a suitable credit to Tees Law is given and a link to the full report published.

In 2018, Birthrights – a charity dedicated to promoting women’s rights in childbirth, published a report into Maternal Request Caesarean (MRCS). These are planned caesarean sections requested by pregnant women without a medical indication.

The report revealed that, despite NICE Guideline CG132, nearly 75% of NHS Trusts did not have written policies supporting a woman’s right to choose a caesarean.

It concluded that “the majority of Trusts in the UK made the process of requesting a caesarean lengthy, difficult or inconsistent, adding anxiety and distress to women at a vulnerable time.” The report called for greater transparency around the variation in policies and procedures between NHS Trusts.

Three years have passed since the Birthrights report was published. With no further research on this issue that we were aware of—and with our Medical Negligence team continuing to support women like Niamh and Anna, who have faced disempowerment and difficulty when giving birth—we undertook our own investigation in May 2021. Our goal was to assess whether practices and procedures regarding MRCS had changed across NHS Trusts since 2018.

Trust failed to advise woman on risks and benefits of vaginal delivery vs. caesarean

Posted on 9 December 202128 March 2025 by Sarah O'Sullivan

Ensuring informed birth choices: The importance of understanding risks.

Childbirth is a significant life event, and while most experiences are positive, complications can arise. Informed decision-making during the antenatal period is crucial to ensure the safety and well-being of both mother and baby.

The need for informed choices

Expectant mothers should receive comprehensive, unbiased information about the potential risks and benefits of various birthing options, including Caesarean sections, vaginal births, and other interventions. This empowers them to make decisions aligned with their individual health needs and preferences.

However, in practice, the risks of vaginal births are often underrepresented compared to those of Caesarean sections. Many women remain unaware that in the UK:

Nearly 40% of women undergo instrumental delivery or Caesarean section.
50% of first-time mothers experience these interventions.
4% of women suffer third or fourth-degree tears, leading to long-term bowel control issues and incontinence.

Lack of comprehensive counseling

At Tees Law, our Medical Negligence team has supported numerous women who faced traumatic childbirth experiences. Despite expressing concerns or requesting a Caesarean section, some were advised against it without a full understanding of the risks of vaginal delivery.

Anna’s story: A preventable trauma

In 2018, Anna (not her real name) suffered a third-degree tear during vaginal birth. Despite having pre-existing bowel difficulties, including slow transit and severe constipation, her concerns about vaginal delivery were repeatedly dismissed. Her visual impairment added to her vulnerability.

Missed opportunities

Throughout her pregnancy, Anna consistently raised concerns:

She was advised to stop taking stimulant laxatives without thorough discussions on alternative options.
Her repeated questions about Caesarean delivery were met with reassurances that vaginal birth was “safest for the baby.”
Risks associated with vaginal delivery were not communicated, despite her history of bowel issues.

When her baby was positioned “back-to-back,” increasing delivery risks, she was still discouraged from a Caesarean.

Traumatic delivery and lasting impact

Anna endured two days of contractions, leading to an instrumental delivery using forceps without an episiotomy. Following the birth, she was informed of her third-degree tear and its consequences, which severely impacted her quality of life.

Despite her long-standing bowel condition, appropriate postnatal care and medication were delayed. She continues to experience bowel urgency, incontinence, and symptoms of Post-Traumatic Stress Disorder (PTSD).

The fight for justice

Anna’s experience is not isolated. NICE guidelines state that if a vaginal birth remains unacceptable to a mother after counseling, a Caesarean section should be offered. However, a 2018 Birthrights report revealed that only 26% of Trusts adhered to this best-practice guidance.

At Tees Law, we are committed to holding healthcare providers accountable for failures in maternal care. Our experienced Medical Negligence solicitors support clients in pursuing justice, ensuring their voices are heard and their rights upheld.

Contact us

If you or someone you know has experienced medical negligence during childbirth, our dedicated team is here to help. Reach out to Tees Law today for expert legal support and compassionate guidance.

Woman suffers severe injuries and PTSD after denied caesarean request

Posted on 9 December 202128 March 2025 by Sarah O'Sullivan

Most women who give birth vaginally do so safely and without any long-term health issues. However, according to NHS data, around 4% of women suffer third- or fourth-degree tears during childbirth. In some cases, complications can result in severe and life-changing maternal injuries.

Sadly, Tees Law’s specialist Medical Negligence team knows only too well the devastating impact of such cases. One example is Niamh who experienced a third-degree tear following a vaginal birth. This was despite Niamh having expressed a preference for planned caesarean section. Her claim against Kingston Hospital NHS Foundation Trust is based on breaches of duty before, during and after delivery.

Lack of informed consent

Niamh became pregnant in early 2018.

At 16 weeks, she met with a male registrar and explained that she expected she would need to have a C-section because all the women in her family had given birth that way. In addition to her family history, Niamh’s very slight build further suggested that C-section would be the best method to deliver her baby. Niamh recalls: “the registrar looked me in the eye and said that ‘we would very much support a vaginal birth at this stage’. lt felt to me from the outset like it was going to be a battle to get a c-section and that I was being told that I didn’t need one, despite my family history. To be told so early on that I would need to have a vaginal delivery, made me really anxious.”

Later on at her booking appointment, Niamh also explained her family history of c-sections to the midwife. The midwife referred Niamh to Birth Options to discuss the mode of delivery. There, she was told that a vaginal birth would be much better for the baby. She was also informed that a vaginal birth would allow her to get back to her daily routine sooner. Additionally, she was warned of the risks of having a C-section, including the potential to lose a lot of blood.

Throughout the antenatal process, Niamh repeatedly asked about having a C-section. At 26 weeks, it was noted that she felt “very anxious about [the] birth and uncomfortable within the hospital”. She expressed doubts about her ability to give birth vaginally but was nevertheless encouraged to pursue this route. In the end, based on the medical assurances she had received, Niamh agreed to proceed with a vaginal birth.

An assisted delivery

A week before Niamh went into labour, an ultrasound scan revealed that her baby was back-to-back, a position that increases the risk of complications during delivery. At this point, Niamh asked again if this meant she should have a C-section. She was told that the baby would likely turn around and there would be no problem.

In October 2018, Niamh went into labour spontaneously at 40 weeks. The baby remained back-to-back, and Niamh could not deliver so she was taken to theatre for assisted delivery. A C-section was not offered to Niamh. Instead, the baby was delivered after three pulls of the ventouse and four pulls of the forceps. Her daughter, Darcey, was born safely, but the instrumental delivery caused Niamh to sustain a Grade 3 tear, along with significant and irreparable muscle damage.

Postnatal negligence

Niamh bled heavily for 16 days after giving birth. She suffered faecal urge symptoms and abdominal distension, and her haemoglobin levels fell to 52 grams per litre. On day 5, she was given an X-ray but was refused a CT or MRI scan. The X-ray didn’t reveal anything and despite her symptoms, Niamh was told there was nothing untoward. Niamh pressed for a CT or MRI scan but continued to be refused. Finally on day 9, after having to wait a full weekend and only after continuing to press further, an ultrasound was performed, which failed to detect any medical issue.

Finally, a CT scan was arranged and Niamh was subsequently diagnosed with a pelvic haematoma requiring surgery.

After this, she was unable to pass urine. Several attempts at trial without catheter failed, but instead of being referred to uro-gynaecology, she was discharged with a catheter.

Niamh was in and out of hospital several times during November 2018 to attempt a trial without catheter (TWOC). Eventually, Niamh sought her own private consultant and on the consultant’s medical advice, went back to the NHS to request a suprapubic catheter.

Niamh was re-admitted in late November 2018 and underwent further surgery to insert the suprapubic catheter into her stomach, a procedure which she found extremely distressing.

Niamh’s catheter was not removed until the start of January 2019. During this time, she experienced coccyx, groin and deep pelvic pain, as well as faecal urgency. Since then, Niamh has continued to suffer from psychiatric injury. She has been diagnosed with PTSD and also suffers chronic coccyx pain, which causes her to wake up in pain. She also suffers urgency of continence and has not been able to return to work.

Failures at every stage

There were medical failures at every stage in Niamh’s story. In antenatal meetings, she was not properly counselled as to the pros and cons of C-section compared to vaginal delivery. Having expressed concern regarding the risks of giving birth vaginally, specifically in relation to her family history of C-sections, Niamh was assured that this was the best method of delivery. At no point was she presented with a balanced picture of the benefits and risks of each option. If she had been warned of the risks associated with vaginal delivery, she would have chosen a C-section.

Although she knew there was a small risk she could tear, Niamh was not warned this could lead to difficulties with continence. Moreover, she was warned of the dangers of C-section and the potential disruption this could cause to her recovery, but she was not provided with an equivalent risk assessment of vaginal delivery. For example, she was informed that she could suffer excessive bleeding with a C-section but was never told that this could also happen with a vaginal delivery. Niamh was also not informed about the risk of requiring instrumental assistance.

During labour, there was an opportunity to perform a C-section yet Niamh was not offered the option of a C-section. Furthermore, once assisted delivery with ventouse and forceps had been chosen, there was a failure to manage the delivery in such a way as to avoid the tear.

Finally, Niamh experienced negligent postnatal treatment. There was a delay in escalation, imaging, identification and treatment of the haematoma. Had the haematoma been diagnosed and treated earlier, the extent of the infection would have been less severe. Because of the failure to treat in a timely manner, her episiotomy wound broke down twice and wasn’t able to heal properly which has resulted in the formation of extremely painful scar tissue.

An all-too-common problem

Ultimately, had Niamh been able to go ahead with her preference for a planned C-section, she would have avoided the third-degree tear, haematoma and the rest of the consequences that have resulted from her instrumental delivery. Unfortunately, Niamh is not alone in suffering injury and long-term complications from a vaginal birth that should have been avoided.

Official NICE guidelines state: “For women requesting a caesarean section, if after discussion and offer of support… a vaginal birth is still not an acceptable option [Trusts should] offer a planned caesarean section.” Yet a report by Birthrights in 2018 revealed that only 26% of Trusts offered C-sections in line with NICE best-practice guidance.

Here to help

Our Medical Negligence solicitors are devoted to achieving the justice our clients deserve. If you have been affected by medical negligence, we can support you on your journey to justice, looking out for your needs and priorities every step of the way.

What is a child arrangements order during divorce or separation?

Posted on 2 December 202118 May 2025 by Sarah O'Sullivan

A child arrangements order is a legal document that formalises childcare agreements between parents who are going through a divorce or separation. It determines critical aspects such as where the children will live and how much time they will spend with each parent.

This type of court order is typically necessary when parents cannot reach a mutual agreement on childcare arrangements. Ideally, parents should try to resolve these issues amicably, often with the assistance of a mediator. However, if disputes remain unresolved, applying for a Child Arrangements Order through the court may be the best option.

Why might you need a child arrangements order?

You may require a Child Arrangements Order if:

You are unable to agree on custody or visitation arrangements.
One parent is not adhering to a previously agreed-upon schedule.
There are concerns about a parent neglecting their responsibilities.
Mediation has failed to resolve disagreements.

If both parents are cooperating and the existing arrangements are working, a court order is typically unnecessary.

How to apply for a child arrangements order

Attempt mediation first:
- Before applying for a child arrangements order, you are legally required to attend a Mediation Information and Assessment Meeting (MIAM) unless there are valid reasons not to do so, such as instances of domestic abuse.
Seek legal advice:
- A solicitor can guide you through the process, helping you prepare your application and submit it to the court.
Attend court hearings:
- Both parents will need to attend a court hearing, where a judge or magistrate will assess the situation.
- A representative from the Children and Family Court Advisory and Support Service (CAFCASS) may also provide input by producing a safeguarding report and making recommendations.
Decision making:
- The court will prioritise the child’s welfare, considering factors like their wishes, feelings, and overall needs.
- If an agreement cannot be reached during the initial hearing, further evidence may be required before a final decision is made.

Specific issue orders and prohibited steps orders

In addition to Child Arrangements Orders, the court may issue:

Specific issue orders: For resolving specific disputes, such as which school a child should attend or whether they should follow a particular religion.
Prohibited steps orders: To prevent a parent from taking certain actions, like relocating a child abroad without consent.

Child arrangements orders vs. special guardianship orders

A Special Guardianship Order (SGO) grants parental responsibility to someone other than the child’s parents, often in cases where parents are unable to provide proper care. Unlike a Child Arrangements Order, an SGO allows the guardian to make decisions without requiring parental approval, although some significant decisions still require consent.

Can grandparents apply for a child arrangements order?

Yes, grandparents or other relatives can apply for a Child Arrangements Order, although they need the court’s permission first. This may be relevant if they have been acting as the child’s primary caregivers or if they wish to establish visitation rights.

How to change a child arrangements order

While Child Arrangements Orders are intended to provide long-term stability, circumstances can change. If significant changes occur, such as a parent relocating, remarrying, or experiencing financial difficulties, you can apply to modify the order. The court will reassess the child’s best interests before making any adjustments.

Expert legal support for child arrangements orders

Navigating the complexities of child custody during a separation can be challenging. Seeking the advice of our specialist family law solicitor can ensure that your child’s best interests remain the priority. Professional legal support can help formalise arrangements and provide clarity and reassurance during this difficult time.

For further guidance on child arrangements orders, contact our experienced family law team today.

Aortic dissection medical negligence claims

Posted on 18 November 202130 June 2025 by Sarah O'Sullivan

Aortic dissection is a serious condition that can impact at any age. It is essential that aortic dissection is detected early, as when treated quickly there is a very good chance of survival. Sadly, when delays in diagnosis happen it can lead to catastrophic outcomes.

Jacob Hassan was a father of two, who died after having an aortic dissection aged 62.

Jacob, a keen cyclist who regularly cycled 100 miles a week, had worked as a GP for over 30 years before taking early retirement. He lived in Cambridge with his wife, Sharon, and loved visiting his grandchildren in Indonesia and Australia.

His death followed a trip to A&E after Jacob had experienced intense chest pain. He was discharged with a diagnosis of “non-specific chest pain” without being offered the scan that would have saved his life.

What is aortic dissection?

Aortic dissection occurs when there is a partial tear in the aortic wall. The aorta is the main artery that carries blood away from the heart. If a tear develops, it can allow blood to leak into the aortic lining, which can create a false channel between the inner and outer layers.

Many of the symptoms of aortic dissection are similar to those of other heart problems like heart attacks. Usually, the first sign of an aortic dissection is abrupt and severe chest, back or abdominal pain. The sensation is often described as ripping or tearing.

How is aortic dissection diagnosed?

Aortic dissection is not common and it can also be difficult to diagnose. That’s why it’s so important to have a specialist CT scan. In Jacob’s case, this could have been performed on-site to provide a quick and definitive diagnosis. When diagnosed and treated quickly, the survival rate for aortic dissections is better than 80%.

According to the Aortic Dissection Charitable Trust, however:

33% of sufferers are misdiagnosed
2,000 people die each year from aortic dissection in the UK

Like Jacob, most patients with aortic dissection suffer sudden severe chest pain, which can settle completely after a few hours. Routine tests carried out in the Emergency Department can come back normal. Only a specialist CT aortogram can conclusively say one way or the other whether a patient has an aortic dissection.

Case study of failure to diagnose aortic dissection

Jacob’s story is tragic and his death avoidable.

On a cycle ride from Cambridge, Jacob had to pull over because he was breathless. For an experienced cyclist like Jacob, this was an unusual occurrence. That same evening, he complained of chest pains, telling his wife Sharon to call an ambulance.

By the time he arrived at Addenbrooke’s Hospital’s A&E Department his chest pain was intense. The triage nurse noted the pain was stabbing in nature and radiated to the back – both classic symptoms which should have alerted staff to the need for a CT scan.

Jacob was given painkillers and a chest X-ray but was discharged without being offered a CT scan. A common scenario with aortic dissection is that it can be dismissed because patient doesn’t seem ill enough.

The pain subsided but Jacob continued to lack energy over the next few days. Then, one evening, his wife Sharon returned home to find Jacob collapsed and unresponsive. He died later that night.

Classic signs of aortic dissection missed

The decision to discharge Jacob without offering him a CT scan, despite his unexplained chest pains, was a tragic mistake. According to the coroner, a CT scan would have led to a diagnosis of aortic dissection and saved Jacob’s life.

The Coroner’s Record of Inquest noted that “The presentation of chest pain being severe, sharp, and radiating to his back was indicative of acute aortic syndrome… and should have triggered CT aortography at the hospital which would have confirmed the presence of such a dissection.

“This would have necessitated emergency cardio thoracic surgical intervention and on balance, Jacob would have survived such a procedure.”

Cambridge University Hospital NHS Foundation Trust failed to offer a CT scan and there was also a communication issue with the A&E department not being able to access to the electronic notes of the ambulance crew.

Seeking justice and raising awareness

With the help of Partner Tim Deeming in our medical negligence team, Sharon Hassan is proceeding with her case.

Once the Coroner commenced the inquest investigations, independent experts confirmed Jacob’s death could have been avoided if the cause of severe chest pain had been thoroughly investigated.

Through the case we aim to raise awareness of the effectiveness of CT scans in identifying aortic dissection.

As Sharon said: “Unless the Health Authority has a system to offer a scan to all those presenting with chest pain that cannot be explained by a heart attack, pneumothorax or pulmonary embolism, tragedies will continue” she said. “I just want to ensure no family has to go through what mine has.”

Tim Deeming, Partner acting for the family added: “It’s vital we raise awareness through shared knowledge. As a lawyer supporting families who have had such challenging circumstances, it is through shared experiences we can improve services and learn.”

“It’s about systems and it’s about support… we hope wider training can be provided about Jacob’s circumstances and we want to create a legacy so that CT investigations for aortic dissection are considered basic and fundamental to rule out.”

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