A Court of Appeal judge has expressed “profound concern” about aspects of litigation centred on a critically ill baby girl who was the focus of a life-support treatment fight.
Lord Justice Peter Jackson said on Friday that doctors caring for eight-month-old Indi Gregory, and other critically ill children, at the Queen’s Medical Centre in Nottingham had been put in an “extremely challenging” position.
He told a Court of Appeal hearing that the hospital’s governing trust had shown “proper sympathy and understanding” for Indi’s parents and said “manipulative litigation tactics” would not be tolerated.
The judge also asked whether a trainee solicitor advising Indi’s father was “out of control”.
He aired concerns as Indi’s parents, Dean Gregory and Claire Staniforth, lost a Court of Appeal argument over where the little girl should be when doctors withdraw treatment.
Indi’s parents, who are both in their 30s, want specialists to withdraw treatment at their home in Ilkeston, Derbyshire.
Specialists caring for Indi at the Queen’s Medical Centre in Nottingham say treatment should be withdrawn in a hospice or hospital.
A High Court judge has ruled against Indi’s parents and concluded that withdrawing treatment at home would be “too dangerous”.
Indi’s father on Friday challenged that ruling by Mr Justice Peel at an online Court of Appeal hearing.
But Lord Justice Jackson, and two other London-based appeal judges, dismissed the challenge.
Lord Justice Jackson said the appeal was “entirely without merit” and Lady Justice King and Lord Justice Moylan said they agreed.
Judges have heard that Indi, who was born on February 24, has mitochondrial disease – a genetic condition that saps energy.
Specialists say she is dying and bosses at the hospital asked for a ruling that doctors could lawfully limit treatment.
Medics say the treatment Indi receives causes pain and is futile.
Her parents disagree.
They want specialists to keep providing life-support treatment.
But Mr Justice Peel has already ruled that specialists can lawfully limit treatment.
He has concluded such a move would be in Indi’s best interests.
Indi’s parents have failed to persuade Court of Appeal judges and judges at the European Court of Human Rights in Strasbourg, France, to overturn that treatment decision.
Lord Justice Jackson said on Friday, when ruling on Indi’s father’s appeal, that the little girl had been on “full life support” since early September.
The judge said evidence showed that “invasive” treatments caused her daily “significant pain and distress”.
He said she showed “no purposeful interaction” with the “world around her”.
“The trust, it seems to me, has had proper sympathy and understanding for the parents’ position,” he said.
“The judge’s (Mr Justice Peel) approach has been fair and sensible, with decisions based on strong evidence.”
He said there had been a number of hearings since Mr Justice Peel ruled that withdrawal of treatment was in Indi’s best interests, following challenges by the youngster’s parents.
Those hearings had required “significant preparation” and had distracted medics, he said.
Lord Justice Jackson said he wished to express his “extreme concern” and added: “Attempts to change position by the parents have been extremely challenging for clinicians, who not only have to look after Indi but … other critically ill children on the ward.
“The court will not tolerate manipulative litigation tactics designed to frustrate orders which have been made after anxious consideration.”
Lady Justice King and Lord Justice Moylan said they agreed.
Barrister Emma Sutton KC, who represented Nottingham University Hospitals NHS Foundation Trust had told appeal judges that two doctors involved in Indi’s care were also looking after between 12 and 14 other “critically ill” children.
Mr Justice Peel has overseen private hearings in the Family Division of the High Court in London.
But he has allowed journalists to attend and ruled that Indi can be named in reports.
Court of Appeal hearings have been staged in public.
Indi’s parents are being supported by campaign organisation Christian Concern and its sister organisation the Christian Legal Centre.
Mr Gregory said after Friday’s appeal hearing, in a statement issued through Christian Concern: “Claire and I are again disgusted by another one-sided decision from the judges and the trust.
“The whole world is watching and is shocked at how we have been treated.
“Claire and I have always wanted what is in Indi’s best interests.
“She has human rights and we wanted her to have the best treatment possible.”
He added: “This feels like the latest kick in the teeth, and we will not give up fighting for our daughter’s chance to live until the end.”
Indi’s parents have also failed in a bid to transfer her to a hospital in Rome.
Mr Justice Peel ruled that a move to Italy would not be in Indi’s best interests and Court of Appeal judges backed that decision.
The Italian government recently intervened in Indi’s case by granting her Italian citizenship.
That move came after Indi’s parents failed in their bid to move her to the Rome hospital.
Appeal judges were told on Friday that an Italian consular official had recently written to Mr Justice Peel, asking him to “cede his jurisdiction”.
Lord Justice Jackson said such a jurisdiction application was “wholly misconceived”.
Appeal judges were also told by Ms Sutton that during a break in Friday’s appeal hearing, Pavel Stroilov, a trainee solicitor based at Andrew Storch Solicitors and part of Mr Gregory’s legal team, had contacted Mr Justice Peel’s clerk.
Ms Sutton said Mr Stroilov had been seeking to “reopen issues”.
Barrister Bruno Quintavalle, who led Mr Gregory’s legal team, told appeal judges his understanding was that Mr Stroilov passed a medical report to Mr Justice Peel.
He said he was unaware of any bid to reopen issues.
Appeal judges asked Mr Quintavalle why he had not told them what had happened.
Lord Justice Jackson suggested to Mr Quintavalle that either appeal judges were not been given the full picture or “your trainee solicitor is out of control”.
He said when giving his ruling that he was “not sure” what Mr Quintavalle knew about what had happened and “not sure what control is being exercised over the trainee solicitor’s actions”.
In 2018, a High Court judge overseeing a life-support treatment case centred on another child – Alfie Evans – criticised Mr Stroilov.
Mr Justice Hayden criticised the “malign hand” of Mr Stroilov, then a law student, after hearing he had been party to Alfie’s father, Tom Evans, lodging a private prosecution of hospital doctors, allegedly for murder.
The Christian Legal Centre, which represented Alfie’s family, hit back and said the judge’s criticism was “unfair” and “detrimental”.