A showjumping star with spina bifida is suing a GP for allegedly failing to tell her mother to take a crucial supplement that could have warded off the condition before getting pregnant.
Evie Toombes, 20, wants millions in damages from Dr Philip Mitchell, claiming that he did not advise her mother Caroline Toombes to take folic acid, leading to the child being ‘born in a damaged state’.
Evie, from Skegness, Lincolnshire, claims that if Dr Mitchell told Caroline that she had to take the supplements to minimise the risk of spina bifida affecting her baby, she would have delayed getting pregnant until she had done so.
Caroline, 50, had gone to see Dr Mitchell in February 2001, but despite discussing folic acid during the consultation, she claims she was not told of its importance in spina bifida prevention.
Dr Mitchell, who at the time was working at the Hawthorn Medical Practice in Skegness, ‘comprehensively denies’ liability, claiming he gave Caroline ‘reasonable advice’.
Evie, who has forged a career in showjumping and met the Duke and Duchess of Sussex in 2018 when she won the Inspiration Young Person Award at a Wellchild charity event, is now the centre of a ‘wrongful conception’ claim at the High Court to cover the increased cost of living a disabled life.
Evie Toombes, 20, was born suffering from spina bifida but has forged a career in showjumping, competing against both disabled and able-bodied riders
Evie, pictured with her mother Caroline Toombes. Evie claims that, had the doctor told her mother that she needed to take folic acid supplements to minimise the risk of spina bifida affecting her baby, she would have put off getting pregnant until she had done so – meaning Evie would never have been born at all
Prince Harry, Duke of Sussex and Meghan, Duchess of Sussex with Evie Toombes and her brother Rocco during the annual WellChild awards at Royal Lancaster Hotel on September 4, 2018 in London
Medics routinely advise prospective mothers of the benefits of taking folic acid supplements before conceiving and throughout the first 12 weeks of their pregnancy to ward off the risk of spina bifida.
What is spina bifida?
Spina bifida is a fault in the development of the spine and spinal cord that leaves a gap in the spine.
About 1,500 babies are born with spina bifida each year in the US, according to the CDC. In the UK, approximately 1 in 1,000 babies are born with the condition.
Most cases are detected before birth, at the 20-week scan.
The most serious form of the disease is called myelomeningocele. In myelomeningocele, the spinal column remains open along the bones making up the spine.
The membranes and spinal cord push out to create a sac in the baby’s back.
This sometimes leaves the nervous system vulnerable to infections that may be fatal.
In most cases surgery is carried out to close the gap in the spine after birth. But damage to the nervous system will usually already have taken place, resulting in:
The court heard that 50-year-old Caroline Toombes – who is also a keen horsewoman – had gone to see Dr Mitchell at the Hawthorn practice to discuss her plans to have a first baby in February 2001.
‘This was a very precious decision to start a family, because she herself had lost her parents when she was young,’ her daughter’s barrister Mrs Rodway told the judge.
‘They had been refraining from sexual intercourse until after they had received advice at this consultation.’
But despite discussing folic acid during the consultation, Caroline claims that she was not told by Dr Mitchell of its importance in spina bifida prevention.
‘He told me it was not necessary,’ she told the judge. ‘I was advised that if I had a good diet previously, I would not have to take folic acid.’
Mrs Rodway said that, had Caroline been properly advised by Dr Mitchell, she would not have gone on to conceive as quickly as she did.
She would have paused her pregnancy plans, started a course of folic acid treatment and then attempted to conceive, she claims.
‘It is her evidence she would have read up on it and wouldn’t have attempted to become pregnant until she was satisfied that she had protected herself as much as possible,’ she said.
If she had indeed put off getting pregnant, she would have had a ‘normal, healthy’ baby – but one who was a ‘genetically different person’ to Evie, the QC added.
After her birth in November 2001, Evie was diagnosed with a lipomylomeningocoele (LMM), a form of neural tube defect to the spine leading to permanent disability.
Her mobility is said to be ‘very limited’ and she will depend more and more on a wheelchair as she grows older, while she also suffers with bowel and bladder issues, the court heard.
She has previously spoken about her issues on ITV show ‘Hidden Disabilities: What’s The Truth?’
After her birth in November 2001, Evie was diagnosed with a lipomylomeningocoele (LMM), a form of neural tube defect to the spine leading to permanent disability
Evie, from Skegness, Lincolnshire, claims that had Dr Mitchell told Caroline Toombes that she had to take the supplements to minimise the risk of spina bifida affecting her baby, she would have delayed getting pregnant until she had done so
However for Dr Phillips, Michael De Navarro QC denies liability for what happened.
He told the judge that it is the doctor’s defence that he gave ‘reasonable advice’ about the desirability of folic acid supplements being taken.
It was his usual practice to tell prospective parents that 400 micrograms should be taken by those preparing for pregnancy and all through their first trimester once pregnant.
He says he would have said that if the mother had a good diet and so good folic acid levels anyway, supplements would be less important, but denies saying they were not necessary.
According to her own website, Evie describes her motto in life as: ‘Find a way, not an excuse.’
As well as competing in showjumping, nationally and internationally, she educates children about invisible illnesses and works at Nottingham University.
She writes: ‘I was born with a form of spina bifida…but having a passion in life gives me purpose and direction.’
In 2018, she met the Duke of Sussex and Megan Markle when she won the Inspiration Young Person Award at a Wellchild charity event.