FETAL DISTRESS CAUSED BRAIN INJURY: $13.9M
DURING THE LAST 2 HOURS OF LABOR, the mother was febrile, the baby's heart rate rose to over 160 bpm, and fetal monitoring indicated fetal distress. Oxytocin was administered to hasten delivery, but the mother's uterus became hyperstimulated. After nearly 17 hours of labor, the child was born without respirations. A video of the vaginal birth shows that the child was blue and unresponsive. The baby was resuscitated, and was subsequently found to have cerebral palsy, epilepsy, and mental retardation. At the time of trial, the 10-year-old had the mental capacity of a 3-year-old.
PARENTS' CLAIM The child suffered brain injury due to hypoxic ischemic encephalopathy. A cesarean delivery should have been performed as soon as fetal distress was evident. The doctors and nurses misread the baseline heart rate, and did not react when the baby did not recover well from the mother's contractions. Brain imaging did not show damage caused by infection or meningitis.
PHYSICIAN'S DEFENSE The girl's condition was caused by an infection or meningitis.
VERDICT A confidential settlement was reached with the midwife before the trial. The ObGyn was dismissed because he was never alerted to any problem by the labor and delivery team. A $13.9 million Georgia verdict was returned against the hospital system.
UTERINE ARTERY INJURED DURING CESAREAN DELIVERY
AFTER A SCHEDULED CESAREAN delivery, the 29-year-old mother had low blood pressure and an altered state of consciousness When she returned to the OR several hours later, her ObGyn found a uterine artery hematoma and laceration. After the laceration was clamped and sutured, uterine atony was noted and an emergency hysterectomy was performed
PATIENT'S CLAIM The mother was no longer able to bear children. The ObGyn was negligent in lacerating the uterine artery, failing to recognize the laceration during cesarean surgery, failing to properly monitor the patient after surgery, and failing to repair the artery in a timely manner. The patient's low blood pressure and altered state of consciousness should have been an indication that she had severe blood loss. The hospital's nursing staff failed to properly check her vital signs after surgery, and failed to report the abnormalities in blood pressure and consciousness to the ObGyn.
DEFENDANTS' DEFENSE The ObGyn claimed that a uterine laceration is a known risk of cesarean delivery; it can occur in the absence of negligence. The hospital also denied negligence.
VERDICT A Texas 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.versictslaska.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.