13 April 2018
Sri Lankan wins lawsuit against NHS as midwives fail to explain why she needed to feed her son due to language barrier
A Sri Lankan refugee who could not speak English has won a legal battle against the NHS after her child was brain damaged after hospital staff did not explain the importance of feeding a newborn.
Nilujan Rajatheepan was in good condition when he was delivered by caesarean section at King George Hospital in Goodmayes, Essex in July 2009.
His parents are Tamil refugees from Sri Lanka and his mother, Sinthiya, was 21 when Nilujan was born and spoke only very few words of English.
When the community midwife visited the family at home after the birth, Nilujan was pale and lethargic, having not been fed for more than 15 hours.
His hypoglycemic state resulted in catastrophic brain injuries. Nilujan, now eight, has cerebral palsy with severely impaired physical and cognitive function.
On Friday in London, Judge McKenna ruled that Barking, Havering and Redbridge NHS Foundation Trust was liable.
He ruled midwives failed to hire an interpreter to tell her to feed her baby and the eight-year-old is now in line for multi-million-pound NHS compensation because midwives were negligent in failing to tackle the language barrier.
Judge McKenna said medics at King George's Hospital ended up "effectively ignoring" Sinthiya Rajatheepan's concerns about her crying baby.
Because she only knew a few basic words of English, she was never given proper instructions about how to feed her son.
The mother and baby were discharged home too early and, due to poor feeding, Nilujan suffered irreversible brain damage, the judge added.
Mrs Rajatheepan, 29, and her husband Sivarajah, came to Britain from their native Sir Lanka as refugees in 2008.
The judge said the young mother was "certainly unable to understand anything but the simplest of instructions" and only when accompanied by hand gestures.
He added the brain damage he suffered was "caused as a result of poor feeding".
Midwives were adamant that they were well used to patients with language difficulties and had properly instructed Mrs Rajatheepan how to feed her baby.
But the judge said: "The overwhelming weight of the evidence is that Mrs Rajatheepan had very little ability with the English language.
"She was certainly unable to understand anything but the simplest of instructions and only then when accompanied with appropriate hand gestures."
He added: "The sad reality is that Mrs Rajatheepan did not, in fact, ever get any instruction on how to feed properly.
"Still less did she receive any instruction on what to look out for and what to do if feeding was unsuccessful".
The King George Hospital in Barley Lane, Goodmayes, Essex, where the Sri Lankan family were given medical attention
Because of the language barrier, she "did not and could not reasonably have been expected to have understood" the advice she was given.
She was anxious that Nilujan was "crying continuously", but the judge said: "Her attempts to draw attention to her concern in this regard were effectively ignored."
The ward was busy and Mrs Rajatheepan, of Lavender Place, Ilford, had "a propensity simply to smile at people when she caught their eye."
She had, "albeit timidly", approached the midwive's station in a bid to draw attention to her concerns, but the judge said she was "ignored".
Midwives had given her "false reassurance" by "repeating the mantra that it is perfectly normal for new born baby's to cry."
The hospital's midwifery team should have contacted the NHS "language line" for help, or called for an interpreter, he ruled.
The judge added: "The reality is that no one ever in fact gave Mrs Rajatheepan a clear and understandable explanation of the importance of feeding.
"Because of the language barrier, she had been unable to communicate her concerns to hospital staff."
The end result was that Mrs Rajatheepan was discharged home too early and, had she been kept in hospital overnight, Nilujan would have escaped injury.
"In the circumstances, I would enter judgment in favour of the claimant with damages to be assessed," the judge concluded.
Nilujan's NHS compensation award has yet to be assessed, but is likely to be a multi-million-pound sum, given the extent of his disabilities.
Wendy Matthews, director of midwifery, Barking, Havering and Redbridge University Hospitals NHS Trust, said later: "We would like to say sorry again to Nilujan and the Rajatheepan family and express our sincere sympathies to them.
"We are considering the judgment and the implications of the judge's ruling in this case.
"Although we have made huge improvements since this incident occurred in 2009, we will take the opportunity to review it closely and see if there are any more lessons about our post-natal care that we can learn."