Equivocal Court Cardiotocography Weighting in Cerebral Palsy Litigation

The article cones on one aspect of cerebral palsy court litigation, namely the ubiquitous non reassuring CTG tracing interpretation and the jurisprudential weighting allotted to it. Such litigation contributes to a massive financial drain of National Health budgets and may inflict crippling financial punishments on doctors. The author delves into a number of UK court cases, where medical malpractice is alleged to be the cause of the cerebral palsy and analyses these weightings which, overall give the impression of equivocity in such CTG weighting. Due consideration is given to the fact that the court hearing may have taken place decades after the actual birth management being analyzed, and this may have a bearing on the case e.g. decision as to prefer caesarean section or vaginal delivery in breech presentation. Two cases center around such breech delivery while a third case analysis the possibility of unconscious court misdirection by the plaintiff ’s counsel, himself wrongly over-weighting the importance of a possibly non-reassuring CTG when much bigger issues were at stake. One case of clear, jurisprudential non equivocity is concluded. The author stresses that court litigation should be wary, not only of the inherent defects associated with CTG (such as the low sensitivity and high interand intra-observer error rates of interpretation), but also of the very weighting to be allotted to the CTG itself. Only then, would the role affected by CTG in cerebral palsy litigation help in the fair swing of the scales of justice.