Neonatal Hypoxic Ischaemic Encephalopathy: Demolishing the Cerebral Palsy Myth and Enlightening Court Litigation

The article sheds medico-legal light on jurisprudence based on the two original tenets of the great Cerebral Palsy myth, namely 1. The misconception that intra-partum hypoxia underlies most cases of neonatal Cerebral Palsy. 2. The role played by misapplied intra-partum cardio-tocography (I-P CTG) in “diagnosing” intra-uterine hypoxia. Both concepts, originated by medicine, were eagerly embraced by the legal system seeking liability damages in Cerebral Palsy litigation. Although, these misconceptions have been largely rectified in medical practice, they still form the conscious or sub-conscious basis of much Court litigation, across both sides of the Atlantic. UK Court case law is referred to, in a number of instances, to illustrate various points referred to. In the light of Hypoxic Ischaemic Encephalopathy (HIE) being the true pathological hallmark of hypoxia – induced Cerebral Palsy, the article highlights the medico-legal need, existing pre-2003, to formally accentuate the connection. In this context, reference is made to the ACOG's initiative in setting up the relevant workshops, the reports of which led to the 2003 – 2014 ACOGAAP Criteria for diagnosing HIE. The milestone relevance of these criteria in illuminating Cerebral palsy litigation is evaluated, again with references to relevant UK Court cases.