Monday, July 18, 2011

Brain Damaged Baby



J. Douglas Peters, Ann Mandt and local counsel negotiated a 2.5 million ($2,500,000) Dollar settlement against the defendant doctor and defendant hospital in this case involving failure of labor to progress, an unsuccessful attempt at delivery using a vacuum extractor for 13 pulls, and a failure to timely deliver the fetus in the face of fetal distress. This case was not litigated in Michigan.

Mother, a 34 year-old gravida-1 at 40 weeks gestation with good clinical dating and ultrasound, presented herself to the hospital at the onset of contractions at about 5:30 p.m. There was no bleeding or rupture of the membranes. Mother's pre-natal course was uncomplicated. She was rubella negative, blood type A+ and her alphafeto-protein had been normal. An infectious disease workup was negative and the mother did not use cigarettes or alcohol during her pregnancy.

Mother was admitted to labor and delivery and watched overnight. In the early morning her contractions began occurring every 2-5 minutes, were mild in intensity and lasted 50-70 seconds. There was good beat-to-beat variability. At about 8:00 a.m., mother's membranes ruptured spontaneously with clear fluid. Her blood pressure rose to 150/90's. In the first few hours following the rupture of her membranes there was a failure of the labor to progress. The labor was augmented by IV Pitocin and over the course of the next few hours, she dilated to six (6) cm. Mother was noted to have some coupling and poor relaxation on her contraction pattern so her Pitocin was discontinued. Contractions then decreased to about one every five to six minutes lasting approximately 40-80 seconds. They were moderate to strong in intensity. Over the next hour there was no progress so the IV Pitocin was restarted at a lower level. Mother again failed to progress and an internal fetal monitoring probe was placed. At this point mild variable decelerations were noted.

Over the course of the next hour, mother progressed to 8 cm. and then fully dilated at approximately 9:30 p.m. Mother was encouraged to push but her pushing effort was noted to be poor and she had difficulty relaxing her legs.

After approximately an hour and a half of such pushing, mother having made only a small amount of progress, a telephone conversation with the obstetrician was obtained. Shortly thereafter, he arrived at the hospital and explained various options to the mother including the selected choice of a vacuum extractor. After 13 pulls of the vacuum extractor, with two to three pop-offs, the vacuum extractor did bring the head down to bring the head down to crowning. It took several more pushes after that for the mother to push the baby out.

Following the delivery, the baby had APGAR scores of 1, 3 and 3 at 1, 5 in 10 minutes after birth. During the last 20 minutes of the second stage, the fetal heart tones ranged from about 150 to 180 and decelerations appeared. Delivery was finally effectuated at approximately midnight.

Upon delivery, the baby was described as being severely depressed, color was pale blue and there was no respiratory effort and the muscle tones were flaccid. After resuscitation, including intubation, the baby was transferred to a Children's Hospital in a University Center. Neonatal seizures occurred within the first 24 hours. The records showed the baby was hypoxic and acidotic with massive subglial hematomas, all of which resulted in moderate/severe cerebral palsy.

This case was settled prior to trial with a non-disclosure agreement.

J. Douglas Peters & Ann Mandt
(313) 875-8080

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