Keh v Homerton University Hospitals NHS Foundation Trust [2019] EWHC 548 (QB) (08 March 2019)

On 9 October 2013 Mrs Adeline Keh (“the deceased”), who had been born on 14 January 1973, died as a result of sepsis caused by an infection in the operation wound in her uterus. The operation wound related to a caesarean section carried out on 18 September 2013 when her child was delivered. [1]

There are three bases upon which it is said that D acted negligently so as to cause the deceased’s death. [4]

The first basis is that there was always a high risk that induction would be unsuccessful and that labour would result in an urgent C-section. It is said that the deceased should have been warned of the risk and offered a C-section at the outset. Had she been so warned, C says that the deceased would have elected to go straight to a C-section… [5]

As to causation C says that most C-sections do not result in infections. Relying on Chester v Afshar C submits that it is sufficient to establish that, had the C-section taken place at a different time to when it actually did, then infection would probably have been avoided, even if the risk of infection was unaltered by the timing of the operation. D’s case is that the microbiologists agree that the infective organism derived from the deceased’s skin “which was implanted into the deep surgical site during the caesarean section.” On that basis, a caesarean section carried out prior to 18 September 2013 would probably have caused the infection… [6]

The second basis is that the deceased should have been offered a C-section on 18 September 2013 an hour earlier than was the case, or at some stage earlier than that; also that the section negligently took 18 minutes longer than it should have done. The same issue as to causation arises as in the first basis of claim. [7]

The third basis is that between 22 September 2013 and 5 October 2013 there was a negligent failure to consider and perform a hysterectomy. [8]

…had deceased been properly advised, my finding is that she probably would not have chosen to have a planned section on 16 September. She would have followed the plan suggested by [her doctor]… [95]

…the evidence is insufficient to prove a breach of duty based on the difference between the target of 75 minutes and the actual time taken of 93 minutes… [112]

…it was not negligent to fail to carry out a hysterectomy at any stage. [173]

Claim dismissed