Cox v The Secretary of State for Health [2016] EWHC 924 (QB) (26 April 2016)

On 30 May 1986 Mrs Sandra Cox gave birth to twins at the Jessop Hospital in Sheffield. The first twin was born by vaginal delivery at 06:20 hours. About five minutes later it was noted that the umbilical cord of the second twin had prolapsed. Thereupon the decision was taken to move the mother to the operating theatre where twin 2 was delivered by Caesarean section at 06:45 hours. Sadly, as a consequence of the prolapse, twin 2 was deprived of oxygen and suffered serious brain injury. (paragraph 1)


There are essentially two issues in this case. First, C alleges that D failed to ensure that the delivery of S was conducted in a safe environment [immediate section in emergency]… It is C’s case that the failure to perform the delivery within such an environment meant that 20 minutes elapsed between the cord prolapse being detected and her delivery by Caesarean section. It is said that those 20 minutes included “an unacceptable delay of at least 10 minutes by comparison to the likely timeframe if delivery had taken place within a safe environment”. (paragraph 4)

Second, it is alleged that delivery could and should have been by means of a vaginal breech extraction which would have been markedly quicker. It is said that the failure to deliver by this means also amounted to a breach of duty. (paragraph 5)

D denies any breach of duty. (paragraph 6)

It is common ground that had C been delivered 10 minutes earlier than in fact she was, she would in all probability have been spared damage. It follows that I am called upon to decide only the question of breach of duty. (paragraph 7)

There was detailed consideration of evidence:

There was in 1986 no well-established practice in hospitals without integral operating theatres to maintain in the delivery suite in a room which could rapidly be converted so that it could be used for Caesarean sections in emergency cases… There was no breach of duty in the decision not to attempt vaginal breech extraction. (paragraph 164)

The claim failed. (paragraph 165)