Wednesday, May 3, 2017

Hospital & OB-GYN fail to order a c-section; Cerebral Palsy

Case Name: Baby Girl v Hospital and OB/GYN. Settlement: $3.25 Million with the assistance of facilitation. This is a claim of medical negligence in the management of the birth and delivery of Baby Girl at Defendant-Hospital. At 40 weeks gestation, mom presented to the hospital with spontaneous rupture of membranes. Amniotic fluid was ample and clear. Pre-natal management was unremarkable. A physician examined the patient. Fetal heart tones on fetal monitor were noted as good and reassuring. At approximately eight hours later, a pattern began to emerge on the fetal monitoring strip of one of minimal to absent variability and prolonged and late decelerations. There was an under appreciation by the Defendants, including the OB/GYN and the Hospital nursing staff that changes were occurring. The ominous pattern continued to progress, yet, no action was taken towards delivery or discussions regarding Cesarean section. Approximately another hour and a half later, the infant was born without spontaneous respiration. Resuscitative personnel had to be called into the delivery room, at which time the baby was intubated for a short period of time. The baby remained floppy, pale and limp with a cord blood gas of 6.82. Blood cultures were drawn, which later revealed negative findings. Blood work at the time revealed normal white blood count. Also at the time, the baby had a normal temperature. The baby was transferred to another hospital for intensive care management, at which time during that hospital stay, the baby developed rhythmic movements potentially a seizure. A CT scan at approximately 38 hours of age revealed cerebral edema, consistent with hypoxic ischemic encephalopathy. Claims against the Defendants were: in failing to recognize and appreciate the signs and symptoms of a non-reassuring fetal heart tone and to order timely Cesarean section. That the labor and delivery nursing staff failed to appreciate the signs and symptoms of fetal distress and to call this to the attention of the Defendant-OB/GYN in a timely manner. Given testimony provided by the Defendant-OB/GYN at the time of deposition, the Defendant, too, did and would have failed to appreciate the signs and symptoms of fetal distress and, therefore, the nursing staff would have had the responsibility to go up the chain of command to see that the interests of the infant were being met within the standard of care. Plaintiffs relied on the expertise of physicians in various specialties: obstetrics and gynecology, neonatology, neuro radiology, pediatric neurology, placental pathologist, life-care planning and an economist. The Defendants set forth a defense that the fetal monitoring strips did not reveal ominous signs and symptoms of fetal distress (although testimony was inconsistent between their own experts). The main defense was one of placental and fetal infection, in which they engaged two placental pathologists, one that had been disqualified as an expert on causation in the State of Michigan, in another case. The Defendants’ pediatric neurologist and neonatologist relied on the opinions of their placental pathologist, opining that the most likely cause of the child’s brain damage was infection and in doing so, they merely played a game of statistics, totally disregarding the evidence of fetal distress and hypoxic injury. The Defendants did not have a neuro radiologist to refute Plaintiffs’ neuro radiologist’s opinions. This baby has been diagnosed with cerebral palsy, is spastic, is quadriplegic, precocious puberty, blind, is fed by a feeding tube, is in need of 24-hour care and is being taken care with unconditional love by her mom, dad and younger sister. The settlement was reached through the assistance of a facilitator with a non-disclosure agreement.

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