What to do if you suspect group B strep infection?

What happens if an inquest is listed after a baby dies because of suspected group B strep infection?

We were instructed to investigate the circumstances surrounding Baby Y’s development of sepsis in the neonatal period which led to his sudden deterioration and death whilst still in hospital after his birth.

Baby Y was born in good condition and didn’t have obvious risk factors for infection when he was born. However, over the first 24 hours of life, he developed breathing difficulties and became critically unwell. He had very noisy breathing, was very unsettled, and crying inconsolably.

Our instructions are that he was inadequately monitored during this period and opportunities may have been missed to treat him more quickly. When clinicians appreciated the severity of his condition, he was transferred to the neonatal intensive care unit but sadly, efforts to treat him were unsuccessful and he died of sepsis.

Investigations are at a very early stage; however, we know from the hospital’s own internal investigation report that one cause of death being considered is whether group B strep (GBS) infection was present.

A post-mortem report has been commissioned by the coroner and the case is being listed for inquest. Coroners will often hold an inquest if somebody dies within 24 hours of being admitted to hospital or undergoing surgery, or if there is a possibility that medical care in the hospital has caused or contributed to their death.

What’s the purpose of an inquest?

The purpose of an inquest is to find out where, when, and how someone died. It’s a ‘fact finding’ exercise. It isn’t intended to apportion blame to any individual or organisation and witnesses are not required to answer questions that may incriminate them. 

What happens at an inquest?

Prior to the inquest the coroner’s staff will interview witnesses and take statements. The coroner will request the family of the deceased attend the inquest along with anyone involved directly or indirectly with the death. The family of the deceased are allowed to have their own legal representation, sometimes this can be covered by legal aid or a No Win No Fee agreement as part of a medical negligence claim.

During the inquest hearing, which can last anything from 15 minutes to several days – depending on the complexity of the case – the coroner will call witnesses to give evidence under oath and will ask questions. The family or their legal representative will also be permitted to ask the witnesses questions.

Once the evidence has been heard, the coroner will record:

• The name of the deceased
• The place, time, and circumstances of the death
• The cause of death
• Their conclusion as to the death

There are a few potential conclusions that can be reached by a coroner at the conclusion of an inquest. In some cases, the coroner will use one of the more traditional, ‘short form’ conclusions, which include the following:

• Natural causes
• Misadventure
• Open verdict - where no definite cause can be determined
• Suicide
• Stillbirth
• Unlawful killing - an inquest cannot accuse a named person of any criminal liability, and this verdict is used when a criminal investigation has been concluded by the police

The coroner is also able to conclude a death has been caused or contributed to by neglect. In the case of a hospital inquest, this usually involves a very serious failure by healthcare professionals to provide effective basic care that could have prevented the death. However, findings of neglect are very rare.

Increasingly, coroners have started to use longer, more detailed conclusions to summarise the circumstances in which someone died. These are called narrative conclusions and provide a more detailed explanation of the circumstances surrounding the death than the traditional short-form verdicts above.

How can a solicitor help with an inquest?

It is not always possible for families to obtain legal representation for an inquest but where we are able to help, we will undertake the following:

• Prepare the family for the inquest and pose/answer questions as necessary
• Ensure appropriate witnesses are called
• Ensure appropriate documentation is considered and forms part of the evidence considered by the coroner
• Ensure the hearing is fair and as many answers as possible are obtained
• Recommend the coroner seeks assistance from independent experts if necessary (though the final decision will of course rest with the coroner)
• Liaise with the other parties to obtain further details
• Represent families at the inquest and ask questions of the witnesses and the coroner
• Assist you with consideration of the inquest conclusion and what it means in the context of the medical care that was provided

In this case, we will be providing representation to the family and seeking to find out what happened in Baby Y’s neonatal care and whether his deterioration was as a result of group B strep infection.

The work that Group B Strep Support (GBSS) is doing to raise awareness of the signs and symptoms of group B strep is vital. They focus on the need for more widespread screening and the warning signs medical staff should consider if there is a history of group B strep. All of this is to ensure the safety of new born babies and will hopefully prevent future cases like those of Baby Y from occurring.

If you or your baby has been affected by group B strep infection and you believe the care/treatment you received from your medical professionals may have been substandard, please contact Laura Preston on ljpreston@slatergordon.co.uk. Laura is a medical negligence expert with a special interest in GBS cases and sits on the GBSS legal expert panel.