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David W. Christensen published in 2017 Leading Lawyers Magazine, Michigan Edition. Top 10 in Michigan in ALL areas of law, Top 10 Consumer, Top 10 Plaintiff Personal Injury. David W. Christensen has been practicing in Michigan for 44 years. Congratulations to All the lawyers published.

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

Apprentice Tradesman Burned to Death at Industrial Company

Personal Representative of the Estate of a 21-year old Deceased vs Defendant Industrial Corporation and Defendant Trades. Settlement: $4.25 Million Dollars, February 2012. Plaintiff’s Decedent was an apprentice tradesman working at Defendant Industrial Company, as were Defendant Trades. All parties were present at Defendant Industrial Company for the purposes of unblocking a gas washer. Defendant Industrial Company developed a plan and sequence utilizing all of Defendant Trades and Plaintiff’s Decedent’s Trade to unblock the gas washer. At the date and times these events were to take place, Defendant Industrial Corporation eliminated the safest access to address the blockage. Defendant Industrial Corporation altered the plan so that Defendant Trades would attempt to unblock the gas washer by attempting to vacuum or water jet out the clean out lines and/or replace a 40-inch clean out pipe at the bottom of the clogged gas washer. If these attempts were unsuccessful, Plaintiff’s Decedent’s Trade would remove a flange attached to the bottom of the gas washer. Defendant Trades were unsuccessful in their attempts at unclogging the gas washer. All Defendants were aware that any material in the gas washer was known to be super heated. After Defendant Trades were unable to unclog the gas washer, Defendant Industrial Corporation advised Plaintiff’s Decedent to proceed in removing the flange. The flange was located at the bottom of the gas washer in an area that subsequently was defined as a confined closed space, meaning there was limited ingress and egress. Plaintiff’s Decedent was standing in front of the flange removing every other bolt as instructed by Defendant Industrial Corporation in preparation for its removal. After completing the task of removing every other bolt, Plaintiff’s Decedent was instructed to begin removing the rest of the bolts. With one bolt left, the flange opened, engulfing Plaintiff’s Decedent in hot steam water and mud. Plaintiff’s Decedent was burned over 95 per cent of his body. Plaintiff’s Decedent expired the following morning.

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.

Family Doctor Fails to Notice Limp Limb in Infant. Hip Dysplasia

Minor Plaintiff vs. Defendant Family Practitioner State of Michigan $127,500.00 settlement. This is a medical malpractice action based on defendant family practitioner’s failure to timely diagnose congenital hip dysplasia in minor Plaintiff. Minor Plaintiff was born with congenital hip dysplasia (“CHD”) that was not diagnosed until 14 months of age. Surgery ensued, casting, immobility and medical attention followed. As a result of the delay, minor Plaintiff was subjected to additional and more invasive surgeries, required additional medical follow-up and experiences disfiguration, has an abnormal gait, has increased risk of avascular necrosis and will likely need hip replacement when older. Defendant pediatrician saw minor Plaintiff routinely during her first year for well visits. During these visits defendant should have diagnosed hip dysplasia and did not. Congenital hip dysplasia occurs when a child is born with an unstable hip due to abnormal formation of the hip joint during the early stages of fetal development. Another name for this condition is developmental dysplasia of the hip. The ball and socket joint in the hip may sometimes dislocate. Statistics show one out of every 1,000 infants is born with a dislocated hip. The cause is unknown. The standard of care is to screen for congenital hip dysplasia from birth and throughout the first year of the child’s life. The most common screening method is a physical examination where the pediatrician will gently maneuver the child’s hips and legs while listening for clicking or clunking sounds that may indicate a dislocation. These tests are generally utilized for children up to three months of age. The instability worsens with age. Older babies’ findings that indicate CHD include limping, limited abduction and a difference in leg lengths if they have a single hip affected. Imaging tests can confirm a CHD diagnosis. If detected early enough, a child may be placed in a harness which abducts the hip by securing their legs in a frog-leg position. The baby may wear this harness for 6 to 12 weeks depending on their age and the severity of the condition. Also, the baby may need to wear the harness full time or part time. If the harness application is unsuccessful, surgery is generally indicated. After the baby’s hip is placed into position, their hips and legs will be casted for at least 1-2 months in a SPICA cast. In this case, minor Plaintiff was not afforded treatment at an early age, and therefore extensive open reduction surgery was necessitated. It is estimated that between 80 and 95 percent of cases identified early receive successful treatment, depending on the severity of the condition. The complicated and more invasive treatment is less likely to be necessary when the doctor identifies the CHD early and provides appropriate treatment. Once treated, the child will likely continue regular visits with an orthopedic specialist to insure the hip is growing normally. In this case, defendant pediatrician examined minor Plaintiff at 9 days, 14 days, 8 weeks, 4 months and 6 months. By the age of six months, the minor’s parents observed asymmetrical folds in her right thigh and buttocks area and informed defendant doctor of the same at the six month visit. There is no mention by defendant physician of the concerns conveyed to her. The abnormalities in skin folds were still present again at the nine month visit, and then the 12 month visit. Again, no mention was made in the record. Shortly thereafter, minor Plaintiff began to walk and had an obvious limp, was walking like she had one high heel on and noticed one leg was longer than the other. Plaintiff mother knew an orthopedic doctor and discussed the minor’s condition with him. An x-ray revealed “suggestive of congenital right hip dysplasia.” A physical examination revealed that the right leg was externally rotated with a mild limp. The note indicates that the parents noted asymmetric thigh folds approximately six months ago, and that this was brought to the attention of the pediatrician, who told them there was nothing to be concerned about. Surgical consultation was recommended. The procedure performed was a femoral shortening, right abductor tenotomy with right hip open reduction. Minor remained in a SPICA cast for the next 6 weeks and underwent physical therapy thereafter. At 18 months, minor could stand but not walk. Minor presented again with hip dislocation and further surgery was recommended, with a Salter or Dega osteotomy to obtain better coverage for the right femoral head. Minor underwent therapy and today continues to exhibit a limp when walking and gallops when running. Plaintiff relied on experts in family practice medicine, and a treating orthopedic surgeon. Defendant violated the applicable standards of care by failing to carefully evaluate the range of motion and flexibility of minor Plaintiff’s hips and legs during her well visits. Defendant failed to recognize that asymmetrical folds in the buttocks and/or thigh of the minor were suggestive of hip dysplasia and warranted further evaluation, early diagnosis of hip dysplasia and treatment. Had defendant performed the appropriate evaluation with careful detail as per the standard of care towards hip range of motion and flexibility, performing certain maneuvers, congenital hip dysplasia would have been diagnosed, an ultrasound or x-rays should have been performed, and a referral to a pediatric orthopedic surgeon should have been made. Defendant claimed that thorough examinations were done within the standard of care, and that the condition only presented itself at 6 month of age or later and surgery at that point would have been the same, with the same outcome. As a direct and proximate result of defendant’s negligence, minor Plaintiff had an undiagnosed and untreated hip dysplasia which worsened significantly as she got older. Her risk of avascular necrosis, additional surgeries, abnormal growth of the femoral head, future delayed socket development and leg length discrepancy are all continued risks. Hip replacement surgery is most likely in the future, with revisions as she ages.