Did mother’s allergic reaction cause fetal injury?
When a mother was admitted to the labor and delivery unit, she had strep throat; ampicillin was administered. She experienced anaphylactic symptoms that were attended to. The baby, delivered vaginally 3 hours later, was severely distressed and showed signs of asphyxia. He was found to have a permanent brain injury.
PARENTS’ CLAIM:
The ObGyn and hospital nurses failed to properly manage the mother’s anaphylactic reaction to ampicillin. Fetal heart-rate tracings indicated fetal distress. Standard of care required prompt intervention with epinephrine and/or emergency cesarean delivery. Brain injury occurred because these procedures were not performed.
DEFENDANTS’ DEFENSE:
The nurses denied fault and explained that they appropriately and immediately responded to mild anaphylactic symptoms in the mother. They could not administer epinephrine because the ObGyn did not order it.
The ObGyn denied violating the standard of care that included minimizing the mother’s allergic reaction. Because the mother didn’t have a rash, it was not necessary to order epinephrine. The baby sustained an unknown injury earlier in the pregnancy that was unrelated to labor.
VERDICT:
A Tennessee defense verdict was returned.
Resident blamed for shoulder dystocia
A mother presented to a federally funded health center in labor. A first-year resident managed labor and delivery under the supervision of the attending physician. Shoulder dystocia was encountered and the baby suffered a permanent brachial plexus injury.
PARENTS’ CLAIM:
Negligence occurred when the resident used excessive force by pulling on the infant’s neck during delivery. The resident, who had just received his medical license, was poorly supervised by the attending physician.
DEFENDANTS’ DEFENSE:
Suit was brought against the resident, the attending physician, the federal government, and the hospital’s residency program. The resident denied using excessive force. As soon as delivery became complex, the attending physician completed the delivery. The baby’s injuries were unpredictable and unavoidable.
VERDICT:
A $290,000 settlement with the federal government was reached before trial. A Pennsylvania defense verdict was returned for the other parties.
Related Article:
Tackle the challenging shoulder dystocia emergency by practicing delivery of the posterior arm
What caused brachial plexus injury?
An experienced midwife delivered a baby who sustained a brachial plexus injury resulting in flail arm syndrome.
PARENTS’ CLAIM:
The midwife mismanaged the delivery causing permanent injury. The child has gained little improvement with surgery and physical therapy.
DEFENDANTS’ DEFENSE:
The injury was caused by the natural forces of labor. The midwife used appropriate techniques during the birth.
VERDICT:
A Washington defense verdict was returned.
These cases were selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska ( www.verdictslaska.com). The information available to the editors about the cases presented here is sometimes incomplete. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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