Overdose of Dilantin at Birth Leads to $6 Million Settlement
2010 Medical Malpractice Trial Report
Already brain damaged baby receives overdose of dilantin, suffers from cognitive impairment, autism
The minor plaintiff was born by C-section at Cooley Dickson Hospital on 9/7/02 at 38 weeks gestation, after 3 days of labor induction, due to cephlaopelvic disproportion, variable decelerations, and fetal intolerance of labor. On 9/9/02, day of life two, the baby developed seizure with episodes of apnea, and was transported to Baystate Medical Children’s Hospital’s Neonatal Intensive Care Unit.
Over the next two days he continued to have multiple seizures with tongue rolling, lip smacking, jerky uncoordinated movements of all extremities, and apnea, despite treatment with Phenobarbital. Thus, it was decided to give the baby a second seizure medication, Dilantin, in hopes of controlling the seizures.
On 9/11/02, day of life four, at 5:07 p.m., a physician ordered Dilantin to be administered intramuscularly. This was an appropriate order. At 6:00 p.m., the defendant nurse administered the medication to the baby by vein rather than intramuscularly as had been ordered. During or shortly after the infusion the baby developed apnea and mild bradycardia with a heart rate of 85. He had distant heart sounds, weak peripheral pulses, poor tone, poor perfusion, and cold extremities. He was intubated and placed on a ventilator, his arterial blood gases reflected moderate metabolic acidosis. The chest and abdominal x-rays were unremarkable. He received boluses of normal saline for his hypovolemia and hypo perfusion and medications to increase his blood pressure. He responded with an increase in his heart rate and blood pressure. His color, perfusion, and oxygen saturation improved as well.
Blood tests showed an elevated level of Dilantin which gradually subsided over a few days. The baby was taken off the ventilator and was able to breath on his own, and he was noted to have normal heart, kidney, liver and lung function.
Over the course of the next seven years, the child went on to demonstrate residual cognitive impairment, and was diagnosed with autism. The plaintiff claimed the injury was a result of the Dilantin overdose. The defense conceded the baby had been given too much Dilantin but contended that it cleared quickly and the baby suffered no harm as a result. The defense further contended the baby was brain damaged long before the Dilantin episode, as evidenced by abnormal head studies prior to the overdose, and that his current condition is entirely unrelated to the Dilantin.
The case settled a month before trial for $6,000,000.
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