The physician contended the neuropathy resulted from the woman’s preexisting diabetes and noncompliance with her diabetes therapy.
- The surgeon settled with the plaintiff for a confidential sum before trial; the jury returned a defense verdict.
Were maternal and fetal danger signs ignored?
<court>Nassau County (NY) Supreme Court</court>
A 33-year-old woman in the late stages of pregnancy presented to a hospital with nausea and abdominal pain. The examining physician concluded she had dehydration, and released her. The women delivered an infant about 6 weeks later who had severe brain damage, cerebral palsy, cognitive disability, cortical blindness, and seizures.
In suing, the woman alleged the physicians failed to provide proper monitoring during delivery. Specifically, she claimed the fetal monitor revealed nonreassuring, distressed heart rates that were not recognized, resulting in a hypoxic event that caused brain damage.
The woman also asserted the defendants failed to consider that her 2 prior pregnancies were complicated by hypertension and gestational diabetes, so that this pregnancy should have been treated as high risk. According to the plaintiff’s expert, the episode of nausea and abdominal pain should have led to blood, glucose, and urine tests that would have revealed fetal and maternal distress and would have led to immediate cesarean section.
The physician claimed the brain damage occurred before delivery and was unrelated to his actions or inactions. He asserted that the infant had prebirth prolonged protein-S deficiency that caused a dural-sinus thrombosis and hemorrhage. The defense also claimed the infant had prebirth vascular abnormalities and a vascular lesion resulting in disruptions of the circulatory system that led to the brain damage.
- The case settled for $3.7 million.
Was injury due to large infant or inexperience?
<court>Harris County (Tex) District Court</court>
A woman with gestational diabetes gave birth to an infant with a brachial plexus injury. At the time of delivery, some questions were raised about macrosomia and whether the infant would easily pass through the birth canal. Several physicians of varying levels of experience participated in the delivery after the infant became stuck in the birth canal, using various standard manipulations. The shoulder injury was described as a “three-level avulsion,” and the child is unlikely to ever have much use of the arm.
- The case settled for a confidential sum.
Fetal heart rate “sufficiently reassuring”
<court>Unknown Massachusetts venue</court>
Several weeks before she delivered, a pregnant woman fell, requiring hospitalization. Irregular contractions were noted, although no preterm labor or abruption occurred. Three weeks after discharge, at 37 weeks’ gestation, the parents presented to the defendant physician for a regularly scheduled visit. Ultrasound revealed the fetus was in the category of less than 10% for weight. A decision was made to induce labor.
The woman initially had variable decelerations to 90 with recovery to the 140s with moderate beat-to-beat variability. After 20 minutes of the mother pushing, decreased long-term variability during the recovery phase led to a decision to proceed to operative delivery. A vacuum extractor was applied 3 times for 60 seconds each time, bringing the head to +4 station. The fetal heart rate became more reassuring and the mother continued to push.
The infant was delivered with Apgar scores of 2, 6, and 7. The infant was limp with no respiratory effort and poor color. Cord blood arterial pH was 7.1. The infant was placed on CPAP and given bicarbonate. In the NICU the infant had apneic episodes that did not respond to stimulation, and his oxygen saturation levels fell to the 50s with a heart rate of 100.
A CT scan revealed occipital/parietal and subarachnoid blood, along with subdural bleeding. MRI confirmed the bleeding with possible parenchymal ischemia. The infant was eventually diagnosed with gastroesophageal reflux disease, encephalomalacia, and severe developmental delays.
In suing, the mother faulted the defendant for attempting to induce delivery and failing to properly monitor the delivery.
The physician denied any deviation from the standard of care and asserted the fetal heart rate pattern was sufficiently reassuring to allow labor to continue.
- The case settled for $1.7 million.
ObGyn was negligent, but didn’t cause injury
<court>Fayette County (Ky) Circuit Court</court>
A 33-year-old woman with major vaginal bleeding was scheduled for an outpatient dilation and curettage. During the procedure, the physician switched to ablation of the uterus. The physician allegedly did not immediately advise the woman of the change. Complications developed, and ultimately she required a hysterectomy.
In suing, the woman contended the physician mutilated her uterus, in effect sealing the cervix so menstrual flow could not escape. She claimed the physician performed the ablation of the uterus without her consent and did so negligently.