Page bhnf Page v Gold Coast Hospital and Health Service (No 2) [2026] NSWSC 603 | Case summary

Page bhnf Page v Gold Coast Hospital and Health Service (No 2) [2026] NSWSC 603 | Case summary | Zoe

The Defendant is the Gold Coast Hospital and Health Service. It is a statutory health district established under Queensland legislation with management and control of the Gold Coast University Hospital (the Hospital) located at 108 Nerang Street, Southport. The Defendant is vicariously liable for the acts and omissions of its employees, servants and agents, including the midwives and medical practitioners who treated Ms Page on 16–17 November 2011.
Ms Page was pregnant with Benjamin in 2011. She booked the Hospital as the venue for her antenatal care and confinement on or after 22 September 2011, when she was approximately 27 weeks pregnant. Her antenatal records document her relevant obstetric history, which included the following high-risk factors:
pre-eclampsia (2006): a serious hypertensive disorder of pregnancy associated with maternal and foetal morbidity;
placental abruption during birth (2008): a premature separation of the placenta from the uterine wall, which is a life-threatening condition for mother and foetus;
uterine perforation (2009): a significant structural complication of the uterus, relevant to the management of subsequent pregnancies; and
gestational diabetes: associated with increased risk of foetal macrosomia, complicated delivery, infection and perinatal complications.
This history was available to hospital staff when Ms Page presented on 16 November 2011. One of Benjamin’s experts, Dr Catherine Adams, clinical midwife, categorised the pregnancy as “high risk” on the basis of these records and opined that the Hospital’s failure to treat Ms Page’s pregnancy as such from her first presentation that morning constituted a departure from acceptable peer professional practice.
The Defendant filed a Defence on 14 August 2025. It admitted that Ms Page’s obstetric history included pre-eclampsia, a placental abruption during childbirth in 2008, uterine perforation in 2009, and a diagnosis of gestational diabetes: Defence at [6]. The Defendant did not admit, but also did not specifically contest, that these factors collectively constituted high-risk status requiring heightened clinical management.
A synthesis of the matters contained in the Statement of Claim, the Amended Statement of Particulars and Counsel’s confidential advice (which I address below) identifies the following relevant facts.
On 16 November 2011, Ms Page was 39 weeks pregnant and experienced a spontaneous premature rupture of membranes at home at approximately 5.30 am. She telephoned the Hospital’s delivery suite to report the rupture. Spontaneous premature rupture of membranes at 39 weeks in a high-risk patient with her obstetric history is a clinical event warranting urgent assessment and careful management, including assessment for group B streptococcus (GBS) colonisation and consideration of antibiotic prophylaxis. The Defendant admits that Ms Page contacted the Hospital at this time: Defence at [7].
At 7.30 am that morning, Ms Page presented at the Hospital’s delivery suite. She was assessed by staff. A cardiotocography (CTG) trace was taken at this point. Her temperature and blood pressure were recorded as within normal limits. Staff administered a GBS screen at 8.35 am.
Ms Page was scheduled for induction the following morning at 5 am. She was advised to go home to await onset of labour and was given the option to return if she had any concerns. No prophylactic antibiotics were prescribed. No instruction was given to return when the pending GBS results were known. There was a contest as to whether the decision to discharge Ms Page was made by the midwife alone (as the Plaintiff contended) or by an attending medical practitioner (as the Defendant contended). The Defendant denied that her discharge was negligent in circumstances where it asserts that the CTG, temperature and blood pressure were normal at this time.
At 11 am that morning, Ms Page telephoned the Hospital delivery suite reporting that she was feeling clammy and cramping, with swelling of hands and feet that had come on suddenly, unlike anything she had experienced in prior pregnancies, as well as flu-like symptoms. The midwife who took the call did not use the Hospital’s designated question form for telephone assessment of patients. The midwife dismissed the symptoms as normal and likely attributable to weather conditions. Dr Adams expressed the opinion that the failure to use the designated question form resulted in the absence of thorough questioning, a failure to recognise the deterioration of Ms Page’s health, and a failure to verify her GBS status at this critical juncture.
The GBS screen returned a positive result at 11.42 am that morning. This was clinically significant for a patient with premature rupture of membranes (PROM), as GBS colonisation in the context of ruptured membranes dramatically increases the risk of infection, chorioamnionitis and neonatal sepsis. The Hospital did not inform Ms Page of the positive result. It did not recall her, and it did not administer antibiotic prophylaxis, namely, penicillin with a dosage of 5 million units (as per the recommended protocol for GBS-positive patients, according to the Plaintiff’s expert). There was no escalation of care.
By 1.30 pm that day, Ms Page’s contractions were 20 minutes apart. She contacted the Hospital again. The evolving pattern of symptoms remained unrecognised. By 3.30 pm her contractions were 10 minutes apart. Her skin had become sensitive and sore, and her joints felt very tender. She was experiencing hot and cold sweats which were further symptoms consistent with developing infection.
By 4.40 pm that afternoon, Ms Page and her husband decided that her condition warranted attending the Hospital. En route they telephoned the delivery suite and reported her symptoms. The Hospital staff advised them to turn around and return home because the contractions were not frequent enough. The Plaintiff contends that that advice was given without any clinical assessment, without reference to the positive GBS result on file, and without any appreciation of the deteriorating systemic picture. The Defendant admitted the telephone call at approximately 4.40 pm but did not admit the content of the advice given or that the advice to return home was inappropriate.
At 8 pm that evening, Ms Page became pale. Her husband, who had recognised the seriousness of her condition, called the Hospital delivery suite and was forced to repeat the description of his wife’s symptoms three times before the staff allowed her to return to the Hospital. At 9 pm Ms Page was readmitted. Staff noted the following significant findings:
meconium-stained amniotic fluid running down her legs when she used the delivery suite bathroom. This indicated foetal distress and increased the risk of meconium aspiration syndrome in the neonate;
the GBS screen, which was again noted to be positive. This was the first time that Ms Page was informed that her GBS result from that morning was positive, despite the result having been available since 11.42 am; and
temperature at 38 degrees, consistent with intra-amniotic infection.
The Plaintiff contended that the combination of PROM, meconium-stained liquor, pyrexia and a positive GBS result in a high-risk patient should have prompted immediate escalation including urgent induction or emergency caesarean section and high-dose IV penicillin. I note that the Defendant admitted the fact of Ms Page’s readmission and the significant findings set forth above but otherwise denied this allegation: Defence at [18].
Between 10.30 pm and 11 pm, antibiotics were administered intravenously, although significantly below the recommended contemporary protocol of 5 million units for GBS-positive patients. The Plaintiff’s expert, Dr Mike O’Connor, obstetrician, specifically identified this as a departure from the recommended regime. A vaginal examination at approximately 10.30 pm revealed that the cervix was dilated 4 centimetres. At 11.45 pm, a CTG was performed which revealed a severe foetal tachycardia of 200 bpm with occasional decelerations. This indicated significant foetal compromise and is a recognised obstetric emergency. Despite this, the Hospital did not perform an emergency lower uterine segment caesarean section, and a vaginal delivery proceeded. Dr Adams opined that the failure to perform an emergency caesarean section was a further departure from acceptable peer professional practice.
Between 12.30 am and 12.47 am on 17 November 2011, Ms Page commenced involuntary pushing. Benjamin was born at 12.47 am.
On 17 November 2011, following delivery, Benjamin was diagnosed with GBS sepsis and meconium aspiration syndrome, being inhalation of meconium-stained amniotic fluid into the lungs causing respiratory distress and hypoxia. He also failed a newborn hearing screen.
Between 2011 and 2022, Benjamin experienced a cascade of developmental and neurological difficulties including delayed speech development, hearing loss, asthma, recurrent febrile convulsions, recurrent acute otitis media, and developmental delay. He was diagnosed with cerebral palsy in 2022. This was subsequently characterised as spastic diplegia at Level 2 of the Gross Motor Function Classification System. A cognitive and neuropsychological assessment confirmed executive functioning impairment, specific learning disorder and severely delayed language and communication skills.

The Statement of Claim, at paragraph [37], and the Amended Statement of Particulars plead the following particulars of negligence against the Defendant, its servants and agents, namely that it:
failed to properly treat Ms Page;
failed to admit Ms Page once the diagnosis of PROM was made on the morning of 16 November 2011, notwithstanding her high-risk obstetric history;
failed to recognise and treat Ms Page as a high-risk patient despite her documented history of pre-eclampsia, placental abruption, uterine perforation and gestational diabetes;
discharged Ms Page on the morning of 16 November 2011 although she was of high-risk status;
discharged Ms Page prior to receipt and validation of the GBS test results;
did not perform additional investigations warranted by Ms Page’s high-risk status;
did not recall Ms Page to the Hospital on 16 November 2011;
did not recall Ms Page although the GBS test results returned positive at 11.42 am, and did not commence IV antibiotics;
did not immediately inform Ms Page of a positive GBS result upon receipt;
failed to provide a prophylactic antibiotic at the time of discharge, despite the pending GBS result and PROM; and
failed to provide proper facilities for the care of Ms Page and Benjamin in light of her high-risk status, or to transfer her to a location with such facilities.
There were also particulars concerning the telephone consultations at 11 am and 4.40 pm on 16 November, and failures to properly treat Ms Page when she was readmitted on the evening of 16 November 2011.
An Amended Statement of Particulars was filed on 25 March 2026, shortly before the mediation, providing a detailed schedule of Benjamin’s injuries and continuing disabilities. The primary diagnosis has been set out above. The particulars identified disabilities in relation to mobility/physical function, fine motor self-care, continence, speech/language/communication, cognitive/learning, psychological disorders, educational/employment opportunity, ear/hearing difficulties, and orthopaedic issues involving Botox injections (to relax calf muscles), tendo-achilles lengthening surgery (completed) and likely further orthopaedic surgery for deformities with ongoing pain in the calf muscle region.
The Plaintiff relied on the following expert evidence in respect of liability and causation:
Dr Catherine Adams, clinical midwife (report dated 17 October 2025);
Dr Mike O’Connor, obstetrician and gynaecologist (reports dated 12 January 2024 and 1 December 2024);
Dr Michael Harbord, paediatric neurologist (reports dated 31 July 2024 and 1 August 2024); and
Dr Ken Maclean, paediatrician and clinical geneticist (report dated 8 May 2025).
As to quantum, the Plaintiff relied upon seven experts, namely:
Dr Stephen Buckley, consultant physician in rehabilitation medicine (report dated 31 March 2025);
Dr James O’Sullivan, orthopaedic surgeon (report dated 16 February 2026);
Ms Susie Mullen, occupational therapist (report dated 29 April 2025);
Ms Joan Hacken, assistive technology/mobility equipment (report dated 8 February 2025);
Ms Kate Perlstein, orthotist (report served February 2026);
Ms Evelyn Keng, architect (report dated 10 March 2026); and
Mr Morteza (Morry) Akbarian, automotive engineer and mobility consultant (report dated 4 February 2026).
There were also further experts concerning speech, language and cognitive functions as well as psychiatric/psychological experts.

The principles which inform the Court’s assessment of a proposed settlement are well established. It will not enforce a compromise against the opinion of the tutor for the person under legal incapacity and his or her legal adviser: Re Birchall (1880) 16 Ch D 41; Permanent Trustee Company Ltd v Mills (2007) 71 NSWLR 1; [2007] NSWSC 336 (Mills) at 4 [19] (Hammerschlag J, as his Honour then was). The Court “must form the view that it is beneficial to his or her interests”: Mills at 5 [29]. Considerations relevant to the compromise include matters such as litigation risk, the desirability of early finality, and the avoidance of the risk of further distress: Brown v Western NSW Local Health District [2026] NSWSC 51 at [22] (Chen J).
Counsel who appeared for the Plaintiff, Mr Philip Beale, is immensely experienced, practising now for 45 years predominantly in medical negligence. Mr Beale authored an extremely comprehensive and incisive confidential opinion which I have considered in detail.
Appendix A to the confidential advice sets forth a summary of the various heads of damage, namely, non-economic loss, past out-of-pocket expenses, future out-of-pocket expenses, past domestic assistance/attendant care, future domestic assistance/attendant care, equipment costs and assistive technology, house claim, future economic loss/loss of earning capacity, and funds management.
Of the total amount claimed, plus costs and disbursements, I am satisfied that the settlement sum of $XXXX plus costs is a satisfactory reflection of the litigation risks identified by Counsel in his expert advice. During oral submissions, Mr Beale expressed the opinion that the Plaintiff’s case on liability was relatively strong. Without disclosing the substance of that advice, I note that it covers, in addition to assessments of liability, causation and quantum, a detailed analysis of reasons supporting a settlement sum of $XXXX. In recommending the approval of the proposed settlement, Mr Beale advances ten grounds which commend the settlement sum. They are persuasive.
There is a significant disparity between the amount claimed by the Plaintiff and the settlement sum. At the hearing, Mr Beale described the total amount claimed as somewhat of a “wish list”, which I take to mean an ambitious claim whose prospects of success were remote. Factoring in the many considerations that Mr Beale addressed in his comprehensive opinion, he stated that the settlement sum was reasonable and prudent.
Ms Page affirmed an affidavit dated 7 May 2026. She deposes that the contents of the expert reports have been explained to her by her solicitors and Counsel. She indicates that she has been advised of and understands the risks associated with proceeding to hearing. Ms Page states that, having considered those matters, she is satisfied with the settlement proposed and requests that the Court approve it.
On the basis of the above analysis I am content to do so.

Page bhnf Page v Gold Coast Hospital and Health Service (No 2)

At a glance

Court

Decision date

Before

Catchwords

Source

Catchwords

Judgment

JUDGMENT

Facts

Particulars of negligence alleged and evidence in support

The Defence

Consideration

Parties

Legislation Cited (6)

Cases Cited (3)