XM (By His Father and Litigation Friend FM) v Leicestershire Partnership NHS Trust [2020] EWHC 3102 (QB) (23 November 2020)

C was born on 27 June 2012. D provided health visitor services… C says that he sustained catastrophic permanent brain injury as a result of D failing to identify and act upon the fact that his head was growing at an abnormally fast rate. C had a very rare and benign brain tumour, a choroid plexus papilloma, from birth until he was treated in January 2013. The tumour caused overproduction of cerebrospinal fluid (CSF) which accumulated in the ventricles of his brain causing C’s head to grow abnormally fast. Because of elasticity in a baby’s skull, C was able to compensate for the rapid increase in the size of his head. In late December 2012 raised intracranial pressure began to cause symptoms. His parents took him to an emergency walk-in centre on 30 December 2012. He had massive hydrocephalus. On 3 January 2013 CSF was drained and the tumour successfully removed. However, it was too late to prevent injury and he sustained permanent catastrophic brain damage. [1]

Whilst C was in utero his head circumference was recorded on 17 May 2012 as being below the 5th centile and on 1st June 2012 as a little above the 5th centile… No measurement was taken of the head circumference at birth. [2]

On 10 July 2012 (aged 13 days) … C’s head circumference was on the 25th centile. [4]

On 8 August 2012 C was exactly 6 weeks old… The head circumference was by now on or just over the 50th centile. [6]

On or about 22 August 2012, the Claimant missed his 6-8 week GP appointment. [7]

On 30 December 2012 C went to the emergency walk-in centre. His head circumference was 99.6th centile on 30th December 2012 [12]

My findings in favour of C are:

i) D was in breach of duty of care when she failed on 8 August 2012 to arrange for C’s head circumference to be remeasured and/or failed to refer him for medical opinion.

ii) D was in breach of duty of care in not recommending to the C’s parents that he undergo the 6-8 week GP check, albeit late.

iii) D was in breach of duty of care by not appreciating that there was disproportion in C’s head size which should have led her to have his head remeasured and/or checked by a medical practitioner. [442]

…it is common ground based on these findings that there is no issue as to causation [443]