Case involving death of baby settled for $2 million

2008 Trial Lawyers Report

Medical malpractice lawsuit involves the death of 20 month old baby and hypoxic ischemic encephalopathy at birth

This case involves the death of a 20 month old baby boy from consequences of Hypoxic Ischemic Encephalopathy inflicted at birth. The defendants are an obstetrical resident, two nurse midwifes and a staff nurse each of whom attended to the mother during labor and delivery in October 2003. The plaintiff’s claim is that each of them failed to summon an attending obstetrician in the face of hours of fetal distress and that as a result the child suffered brain damage and, ultimately, death.

The mother was 28 years old, expecting her first child in October 2003. There were no significant prenatal complications. On 10/9/03, at 40 6/7 weeks gestation, she went into spontaneous labor. Antenatal testing was non-reactive and she was sent to the hospital at approximately 11:30 a.m. where she was attached to a fetal monitor. The plaintiff’s contention is that the fetal heart rate pattern on the monitor was generally reassuring until approximately 10:00 p.m.

The plaintiff’s claim is that the fetal heart rate pattern was non-reassuring from approximately 10:00 p.m. until delivery. At 11:40 p.m. the mother had spontaneous rupture of membranes revealing meconium stained amniotic fluid, another sign of fetal distress. By 11:53 p.m., the mother’s cervix had only dilated to 5-6 cm. Throughout this time, the resident, the midwives and the staff nurse each failed to summon the attending obstetrician, despite the non-reassuring signs.

By approximately 12:25 a.m. (now 10/10/03), the fetal heart rate variability became and remained diminished—yet another worrisome sign. This non-reassuring fetal heart rate pattern, combined with the presence of meconium in the amniotic fluid, should have caused increased vigilance by the defendants. Throughout the rest of labor, none of the defendants applied a fetal scalp electrode for a more precise reading of the fetal heart rate, none measured a fetal scalp pH to determine well-being, and none summoned an attending obstetrician.

The mother’s cervix was finally fully dilated at 2:34 a.m. and she began to push. The baby would not deliver until 4:02 a.m. During much of that time, the fetal heart rate was difficult or impossible to discern due to frequent, repetitive loss of signal from the external monitor. Still, no one took steps to confirm fetal well being, and no one summoned an attending obstetrician until moments before delivery. The attending obstetrician eventually noted that he had been called, and then called again and told not to come.

The baby was severely compromised at birth with Apgar scores of 2/3/3. His umbilical cord pH was severely acidotic at 6.91. The pediatric ER attending was called and arrived at approximately 7-8 minutes of life. The baby had seizure activity on his first day of life, and was non-responsive with no reflexes. An MRI on day of life six (10/16/03) was consistent with a hypoxic brain injury. The child was blind, deaf and totally dependent for all activities. He died on 06/03/05 from complications of his severely compromised condition.

The plaintiff’s claim is that there were non-reassuring signs of fetal jeopardy for approximately six hours of the mother’s labor, that the defendants were required to recognize the signs and summon an attending obstetrician, and that compliance with the standard of care would have avoided both the brain injury and death of the child.

The case settled eight months before the first scheduled trial date.

Lubin & Meyer attorneys represented the plaintiff in this hypoxic ischemic encephalopathy lawsuit.

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