What happens when the hospital fails to manage your labor & delivery?

$1,500,000.00 Settled at ADR mediation Baby decedent died at six days of age secondary to hypoxic ischemic encephalopathy. His labor and delivery was managed at defendant hospital by a midwife, an obstetrician/gynecologist and nursing staff. Objective evidence on fetal monitoring strips revealed a baby that was not tolerating labor during his last hours in utero. Adding insult to injury, pitocin was administered during this intolerance period, augmenting contractions. The pitocin was turned off shortly thereafter, but not without inflicting additional damage. Baby decedent was born blue, floppy and without respirations. Resuscitation and intubation was accomplished and the baby was transferred to another hospital for neonatal interim care and attention. Baby decedent succumbed to the severity of his brain injury at six days post-birth. The prenatal course was uneventful. The mother presented to defendant hospital. A fetal monitor was placed. The fetal monitor is the best tool available to monitor fetal well-being. Initially, the fetal monitor strips were categorized as a Category I, which means normal heart rate, accelerations and variability. Category II means there are some abnormalities, decreased variability or evidence of decelerations or dips in the heart rate below baseline. Category II tracings need to be monitored closely for the very reason of what happened in this case. The idea is to intervene before the strips progress to a Category III level, which requires immediate emergent intervention. The fetal heart rate monitor revealed variable decelerations which were appropriately designated early in the labor, and the baby responded to resuscitative measures appropriately taken by the nursing staff. What began to occur is the decelerations became more frequent and baby decedent lost his ability to compensate. He did not respond to resuscitative measures in utero. Adding insult to injury during this time of intolerance, pitocin, a contraction augmentation drug, was administered. Recognizing the instant intolerance of the fetus, the pitocin was turned off 4 minutes later and a cesarean section was called. Baby decedent was born by cesarean section approximately 21 minutes later, meconium-stained with tight nuchal cord times 1. He was limp and blue with no respiratory effort. He was administered chest compressions for 20 minutes, epinephrine given, intubated, and cord gases were performed. His APGARs were 2 at 1 minute, 1 at 5 minutes, 10 minutes and 15 minutes respectively. At delivery, meconium was noted. Meconium is, in essence, the baby’s first bowel movement. The amniotic fluid at time of the rupture of membranes earlier in the labor was clear. Meconium presence is generally secondary to stressors on the baby. The cord was also noted around the neck. This is a common finding, the significance being that a cord, whether wrapped around the neck or a body part, can easily be compressed while in utero. Variable decelerations noted were related to cord compression. Pediatricians were present at the time of delivery and initiated resuscitation. Baby decedent was successfully intubated at approximately 20 minutes of life and was transferred to another hospital for neonate intensive care attention. At the second hospital, Phenobarbital was given as a seizure preventative as well as cool-capping, which is hypothermic treatment. MRIs of the brain confirmed the diagnosis of HIE. Ultimately, baby decedent expired secondary to severe hypoxic ischemic encephalopathy. Pathology was performed, which was consistent with said diagnosis. Plaintiff brought the action of medical malpractice in the failure to properly manage the labor and delivery, resulting in the death of baby decedent. Plaintiff relied on the expertise of numerous specialists, including obstetrics/gynecology, midwifery, maternal-fetal medicine, nursing, pediatric neurology, neuroradiology and placental pathology. The hospital’s defense was that fetal monitoring strips were appropriately interpreted and labor was appropriately managed. After the death of baby decedent, the relationship of the parents unraveled. As a result of this death, their lives were changed forever. They were parents for a moment. Submitted by: Co-Counsel: CHARFOOS & CHRISTENSEN, P.C. DAVID W. CHRISTENSEN P11863 MARY PAT ROSEN P34992 26622 Woodward Avenue, Suite 100 Royal Oak, MI 48067 (248) 399-0350 or (313) 875-8080 Fax: (248) 399-0351 dwchristensen@c2law.com mprosen@c2law.com CONYBEARE LAW OFFICE, P.C. MICHAEL D. MARRS P25117 519 Main Street Saint Joseph, MI 49085 (269) 983-0561 Fax: (269) 983-5327 mike@conybearelaw.com

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.