$23.8M award in childbirth lawsuit

By Scott Allen, Globe Staff
Boston Globe, May 11, 2005

2 doctors faulted at Mass. General; girl born with cerebral palsy

In one of the largest malpractice verdicts in state history, a Suffolk County jury has awarded $23.8 million to the family of a girl born with cerebral palsy after a traumatic delivery at Massachusetts General Hospital. Jurors took less than four hours Monday to find two Mass. General obstetricians negligent in the delivery in 1996 of Julia McLaughlin, who was born suffering from large bruises on her head and bleeding on the tissue around her brain.

Lawyers for the McLaughlins argued that the obstetricians, Mary Ames Castro and Alessandra Peccei, neglected Maria Lynn McLaughlin while she struggled to deliver her first child and failed to recognize that Julia’s head was tipped so that she could not fit through her mother’s pelvis. After 17Æ hours of labor, the lawyers charged, Ames Castro pulled the baby out with a vacuum extractor without telling the parents about the risk of brain damage.

''They weren't paying close enough attention to this patient, and they didn't take the time to discuss the situation and warn the parents," said lead lawyer Andrew C. Meyer, Jr. of the law firm Lubin & Meyer.

Mass. General defended the doctors, among the first hired when the hospital started its obstetrics program in 1994. Mass. General said Julia’s disabilities were unrelated to complications at her birth.

''Despite the best efforts of providers . . . complications sometimes can arise during a pregnancy, and tragically, not all outcomes are perfect," said a statement from the hospital. ''In this case, the physicians worked very hard to manage what was an extraordinarily complex and difficult situation. "

George E. Wakeman, Jr., whose firm represented the Mass. General doctors, promised to appeal the decision to the Massachusetts Court of Appeals, contending that the jury acted hastily.

''All the court personnel that I spoke to after the case . . . were stunned at how quickly this jury came back," said Wakeman, of the law firm Adler, Cohen, Harvey, Wakeman & Guekguezian. He said the doctors did nothing wrong and kept the parents informed about their care.

The verdict, which includes $12.9 million in damages and $10.9 million in interest since the lawsuit’s filing in 1998, appears to be the third largest overall award in state history. The top verdict was $30 million awarded a Randolph mother and her paralyzed child in 1992.

The $12.9 million in damages would be the fourth most in state history, according to Massachusetts Lawyer’s Weekly magazine.

All of the biggest verdicts involve young children because the damage they suffer from a doctor’s mistake lasts a lifetime: Julia’s verdict included $2.6 million in future lost wages, as well as $3.7 million in healthcare costs.

For Lynn McLaughlin, the long-awaited verdict only begins to compensate for the suffering and worry since Julia’s birth. The 9-year-old attends second grade, but requires an aide with her at all times and has to be pulled out of class half the time for special instruction and therapy. Julia, who suffers seizures, can walk with braces, but needs a stroller for longer distances.

''It’s not going to change my life," said McLaughlin, who lives in Lexington. ''It takes the financial burden off with Julia that she is going to be taken care of. That’s what we needed. "

No one disputed that Julia suffers serious disabilities at the two-week trial, which centered on whether the obstetricians were liable. Half a million Americans have cerebral palsy, a chronic condition that often causes difficulty walking and speaking, but doctors do not know why most patients develop the condition. However, specialists for the McLaughlins testified that brain trauma could cause the disorder and her seizures.

According to Meyer, Lynn McLaughlin and her husband, Kevin, came to Mass. General on Jan. 18, 1996, so that Lynn could try for a second time to deliver Julia. At 6:30 a.m., the overnight obstetrician started Lynn on Pitocin to cause contractions.

Peccei, a year and a half out of her medical training, was supposed to take over McLaughlin’s care at 7 a.m., but there is no record that she checked in on McLaughlin until 11:50 a.m.

Wakeman said that is because McLaughlin’s labor was going so routinely that Peccei took no notes, but the McLaughlins said they did not see the doctor during a period when the nurses were steadily increasing her dose of Pitocin for more powerful labor contractions.

''We didn't think things were going well in the level of attention we were getting," McLaughlin said. ''But they weren't giving me any sense that something was wrong. "

McLaughlin labored all day, but the baby scarcely moved toward delivery, despite escalating doses of Pitocin and other steps. At 4:45 p.m., Peccei had McLaughlin lie on her side and put on an oxygen mask and then signed out for the night, Meyer said.

Meyer contended that Peccei should have offered McLaughlin a caesarean section and that continuing to give the mother labor-inducing drugs harmed the baby.

Ames Castro was supposed to take over McLaughlin’s care at 5, but the family said she did not appear in her room until 7:30 that evening and took no action to end the stalled labor until 9:30, when the doctor began preparation to use a suction device, called a vacuum extractor, to pull Julia out.

'’she basically came in and said we've got to get this baby out," said McLaughlin, who said she was so tired that she simply did whatever the doctor said. ''The atmosphere was very intense. There was no discussion" of the risks from suction or the alternatives, she said.

Ames Castro’s lawyer countered that the doctor did not visit with McLaughlin because she was asleep from 5 until after 7 p.m., and after the mother awoke, she checked on McLaughlin frequently. By the time Ames Castro decided to extract the baby, Julia had come too far down the birth canal for a caesarean section, leaving suction as the best alternative.

Meyer said that the suction did not work, despite five tries over 11 minutes. Eventually, Lynn McLaughlin pushed out the baby, who was initially unresponsive and had bruises on her head. A subsequent brain scan showed bleeding around the brain, though Wakeman, the doctors' lawyer, stresses that none of the bleeding was inside the brain.

But Meyer said Mass. General’s records describe Julia’s birth as traumatic, adding ''There’s no question that one can sustain brain damage from trauma. "

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