Sunday 22 April 2018

Mother of tetraplegic girl (10): 'HSE's fight in our damages case was aggressive and ruthless'

File photo: Alex Butler with parents John and Sonya. Photo: CourtPix
File photo: Alex Butler with parents John and Sonya. Photo: CourtPix
File photo: Alex Butler. Photo: CourtPix.
Geraldine Gittens

Geraldine Gittens

The mother of a ten-year-old girl who is tetraplegic after injuries she received at birth has described her family’s fight for damages against the HSE as “aggressive” and “ruthless”.

Through her mother Sonya, Alex Butler of Kilmacleague, Dunmore East, Co Waterford, sued  consultant obstetrician at Waterford Regional, John Bermingham; locum consultant obstetrician Mahmud Khbuli who now practises at University Hospital Galway,  and the HSE, as a result of the management of her birth on April 12, 2005. The case was against Khbuli and Bermingham was previously struck out.

The final settlement of Alex Butler's case brings to €10.4million the total she has received in relation to her legal action over her birth at Waterford Regional Hospital in 2005.

Two years ago, she received a €1.4million interim payout along with an apology from the hospital.

The final settlement came on the second last day of a long running hearing on the child's future care needs which had already gone on for 18 days.

This morning, Sonya told RTE Radio’s Brendan O’Connor: “We’re happy that the litigation side of things is over and that in a way that you can move on, you can start to build a life that she deserves.”

“Those barristers are there fighting tooth and nail, being as aggressive as they can, being totally ruthless, but it’s for the benefit of the State Claims Agency and it’s someone in an office up there is pulling their strings and telling them what they can agree to and what they can’t agree to.”

“They fought tooth and nail, down to whether tissues should be provided, down to what type of shower or bath seat she may need, whether or not she’s entitled to outside the State on holidays, or should it be sufficient that she takes a hotel weekend break for the rest of her life as her annual holiday.”

“We were told yesterday that the State Claims Agency were on a lose/lose basis at this stage, that they’d fought our case so hard that the costs were going to be astronomical, that basically it was a case of ‘settle it now, this is just getting way out of hand’.

She said they were also told that “all of the extra witnesses that they were introducing left right and centre, that they were just adding to the bill constantly,” she said.

“Yesterday someone finally in their office basically allowed them to settle.”

 “They send these people out to do a report on your child. They might spend two hours with your child and think then that they know what she needs for the rest of her life.”

“I just feel that the situation needs to change.”

In response, the State Claims Agency released a statement to “The State Claims Agency recognises that clinical negligence cases involve patients who have suffered enormous trauma and pain. The Agency is acutely conscious that it has a duty to act fairly, ethically and with compassion in all its dealings with these patients and their families."

The Agency is required by law to ensure that, where negligence has caused injuries, the patient who has been injured receives an appropriate and fair amount of compensation. The complexity of these cases means that it is necessary to obtain expert medical and care-related evidence, which can often require multiple witnesses."

"The Agency does everything in its power to keep things less adversarial and as simple as possible for the families involved in cases of this nature."

"The Agency has frequently stated that the current legal system for resolving medical negligence cases is not fit for purpose and has been to the forefront in introducing reforms to make the process easier for the families involved.”

Yesterday, Liam Reidy SC, for the family, told the court that Alex is a bright personality with a huge intelligence.

As a result of intensive physiotherapy treatment in the US, the girl, who is normally confined to a wheelchair, can now manage to walk a few paces.

The court was told previously that had Alex been born 10 or 12 minutes earlier, she would not be physically disabled.

Waterford Regional apologised saying it "sincerely regrets the tragic consequences their failings have caused to both Alex and to her parents John and Sonya Butler".

Today, Sonya said: “I felt that they didn’t have the upper hand, that we got what we were looking for, and they had to agree to it basically.”

“We had an occupational therapist give a statement basically to say that she’d done a transfer with Alex in my home that it was so easy that A wouldn’t need a second person until she was way in her 30s and that she’d probably never ever need a hoist.”

“They fought tooth and nail. They basically want Alex to have an existence, not a life. They want her to scrape by with the bare minimum rather than her having the life that she should have had.”

“It was actually suggested by someone that if there wasn’t a second person when Alex was older to go to the bathroom with her that she could wear incontinence pants, for someone that was completely continent, they felt that this was acceptable,” she said.

Sonya described the legal battle by the HSE as “disgusting”.

She described how problems emerged during Alex’s birth. Everything was fine until ten minutes before her birth, she said, and a casaraean section should have been performed.

“Labour progressed quite quickly. I was told I’d have a baby in a couple of hours. Everything was fine and as soon as it came to 10cms (dialated), I was told to start pushing. My daughter’s heart rate started to drop and after the second drop, the midwife came to help.”

“A more senior midwife came out and said I’m going to call out for assistance. She put out an emergency bleep to Dr Mahmud Khbuli. He is the one who was in charge that night,” she said.

 “When he came he asked for a surgical kit and we proceeded to push. He decided to use a suction cup and the suction cup was on Alex’s head for about 28 minutes in total. The maximum amount of time that that was meant to be used was ten minutes, or three pop offs. So if it pops off a third time it’s not meant to be reapplied.”

“It was constantly popping off and he continued to use it in the region of 28 minutes, so Alex’s head was being damaged even before it was delivered.”

Alex was born “blue and lifeless” with the umbilical cord wrapped around her neck, Sonya said.

“She wants to be out there in the thick of the fun and she wants to have a life. This was my point... we were in Tayto Park at the weekend and she wanted to do that rollercoaster. She just loves the adrenaline of it.”

“She absolutely loves life. She loves being able to do things. She loves being active, she loves horse riding, swimming, we go ice skating every year when it comes to Waterford. She goes in on her walker and she just gets stuck in.”

Alex’s father John has trained as a physiotherapist to help his daughter, and she can walk with the aid of special equipment.

“There’s a really stiff corset with certain tensions on it that enables her to get extra trunk control. She can stand on a treadmill holding the bars and she can take up to ten steps.”

“She’s driven, we’re driven. I think for kids like Alex to be left sitting in a chair without the right intervention is a no-no. Whereas if you have them out and physically active, it adds years to their lives.”

“Therapies do help. Physiotherapy is essential in these kids’ lives and basically that’s what early intervention will do for kids like Alex.”

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