She was 41 weeks along when she went into labour in November 2006.
As planned she called her midwife.
Her labour was strong, and when her midwife arrived at her house she detected foetal heart sounds of between 140 and 158 beats per minute.
She trusted this midwife.
It was just as she wanted – in her home – a place of calm of peace.
A place of trust.
By 2pm she was fully dilated. Her soon to be born son’s head high.
For the next four-and-a-half hours she laboured.
The legal term, in the Supreme Court judgement, for this four-and-a-half hour period has been coined “protracted and complex”.
You can only imagine what the ‘non-legal’ phrases used would have been.
A protracted and complex labour ensued.
To stick with the legalese the “plaintiff’s head” (that would be the newborn baby) descended slowly and, apparently, in a variety of positions.
Louise Hall, covering this story for Fairfax, writes that he was delivered at 6pm, when “thick meconium was noted.”
The Supreme Court judgment goes on “There was considerable difficulty releasing the plaintiff’s shoulders, and eventually the plaintiff was born at 6.50pm.”
To break from the legal jargon now – this was when things went to shit.
This is when the trust – so important in this birth was shattered.
The baby was flat, unresponsive, oxygen was given to him.
He was slow to respond, he had a ruptured umbilical cord and a persistent low temperature.
For more than fifteen hours this midwife failed to care properly for the newborn boy.
This tiny baby – just about to embark upon his life was finally transported by air ambulance to the Royal Hospital for Women.
The very place his mother had tried to avoid.
The very situation the ‘defendant’ had obviously not accounted for.
The very institution that, had he been there in the first place, probably would have changed the course of his life.
Baby Will Pattison was admitted to the Neonatal Intensive Care Unit, diagnosed with a diffuse hypoxic brain injury.
A brain injury that could have been avoided if it wasn’t for this woman, the midwife, Akal Khalsa.
In a devastating blow for his parents he developed cerebral palsy.
At the age of six his diagnosis read like this:
Mr Patterson’s diagnosis consists of quadriplegic cerebral palsy, low gross motor function and upper limb function, moderate intellectual disability and functional dependence significantly below able-bodied peers. Furthermore, it is likely that Mr Patterson’s condition will worsen over time and he will need lifelong support in his daily activities, including managing his finances, paying bills or purchasing equipment or services.
After years of hospitals and treatments and therapies and equipment and medical intervention his mother sued the midwife for the botched home birth on his behalf.
Early last year they were successful with their lawsuit.
The NSW Supreme Court upholding a civil claim against Akal Khalsa brought by Will’s mother.
Justice Peter Garling found Akal Khalsa had been negligent in both recommending and carrying out the home birth.
But just to make matter’s worse for Will’s family she then elected not to defend the claim, stating in a letter to the judge that she was unable to fund her own defence.
In a move which could only be described as cowardly she then disappeared, failing to attend a hearing set down to determine how much she was required to pay to Will and his mother, or to freeze her assets as ordered by the court.
And again another blow – she was uninsured.
In June a warrant was issued for her arrest.
Last October, nearing the time of Will’s 7th birthday Justice Garling ordered her to pay $6.6 million to Will and his mother for future care.
The young boy has an intellectual disability as well as cerebral palsy. He will never earn an income; he will never care for himself. He will never live the life he was meant to live.
His life was stolen from him by Akal Khalsa.
Until yesterday there were serious doubts over whether the mother and son would see any of the money they are owed.
But things are now looking more hopeful with Khalsa finally arrested, trying to board a flight at Sydney airport to Wellington, carrying an Italian passport in a different name.
She held a one way business class ticket.
She was taken from the airport and brought before a judge who remanded her in the custody of the Department of Corrective Services for failing to comply with a series of court orders.
Louise Hall reported for Fairfax that the judge said the two passports in Ms Khalsa’s possession showed she had been to Malaysia, Myanmar, New Zealand and India in the past six months. He said she was a “serious flight risk” as documents she was carrying showed she had organised a house in New Zealand, future travel to Fiji and had $35,000 in cash in her possession.
Her application for release until her next appearance in court was refused.
As it should have been.
We will keep you updated as we hope for justice for Will Pattison and his mother.
Top Comments
The midwife may have acted negligently in not correctly informing the mother of the risks/benefits associated with a homebirth or in failing to attain transport to a hospital at an earlier stage when the labor "failed to progress".
However, the notion that Cerebral Palsy (CP) is largely caused during intrapartum hypoxia and that it is preventable is incorrect. More and more, recent studies have shown that the increase in emergency caesareans have done nothing to reduce the rates of CP. An eminent Adelaide professor and obstetrician has confirmed this in a recent meta analysis, see:
http://journals.lww.com/gre...
Thus, regardless of whatever negligence the midwife may have committed she almost certainly didn't cause the Cerebral Palsy. There is hypothermic treatment that can be used on neonates to reduce encephalopathy, but it's efficacy at reducing/preventing CP has yet to be established, so even if Khalsa had provided this in a timely fashion it would have been unlikely to do anything.
Instead the difficult and protracted birth was probably more a symptom of the earlier causes, such as infection during pregnancy or genetic abnormalities, that had compromised the placenta and this became evident once birth commenced.
Khalsa was uninsured for homebirth services as no insurer will provide insurance for homebirths due to the market failure that persists in actuarials having to look to legal risk rather than modern science (the legal community still thinking CP is preventable with our present technology). APRHA is somewhat alive to this insurance market failure issue and that is why there is a moratorium on the requirement for health professionals having insurance covering intrapartum homebirth services (all other health care professions require insurance for all aspects of their service).
Without insurance funding behind a defence, Khalsa, being a midwife who made a relatively meagre living supporting women in their right to chose a birth setting, could not afford to pay an expert witness to argue the above causation fallacy I have just set out. No wonder she saw she had no hope in court.
Self represented litigants never win. She panicked, she ran. Understandable. In no way a demon, just a midwife doing what she thought best for women and although I don't agree with advocating homebirths for high risk women or first time mothers I can understand how this all came to be.
Just to put a different spin on matters, we had a horrible experience with a Ob.. with our first child and 3 beautiful experiences with Akal who delivered 3 of our children at home.
This case is a real sham because Akal was ultra professional and provided wonderful care.
She definately had no insurance and this was because none was available. We knew she was uninsured.
Akal provided a great service to those of us that were failed by the system.
Its just horrible for this family that this injury happened.