Case details
Mother claimed delivery delay led to infant’s cerebral palsy
SUMMARY
$6000000
Amount
Mediated Settlement
Result type
Not present
Ruling
KEYWORDS
brain, brain damage, brain injury, cerebral palsy, cognition, impairment, mental, psychological
FACTS
In the early morning of March 27, 2009, a pregnant 24-year-old part-time administrative worker with preeclampsia was administered Pitocin at a medical center and was seen by a physician. The pregnant woman originally was hospitalized on March 25, 2009, after her preeclampsia became severe and required an induction of labor at almost 37 weeks gestation. The following day, at 3 p.m., there was a spontaneous rupture of the woman’s membranes, but the progress of labor was slow. As a result, Pitocin was prescribed on March 27, 2009. At 2:30 p.m., after the patient was administered the Pitocin, the physician determined that the woman was 6 centimeters dilated and 100 percent effaced. As a result, he concluded that progress was being made and returned to his office, which was less than a five minute walk from the medical center. Shortly after he left, the patient developed uterine hyperstimulation and fetal distress. The labor and delivery nurse responded by shutting off the Pitocin at 2:45 p.m., and placing the patient on oxygen. At 2:59 p.m., there was a deceleration into the 80’s and the nurse recognized that there was an emergency. At 3 p.m., she notified the physician of the decreased fetal heart rate, the increase in intrauterine pressure, and the increased intensity and frequency of contractions despite the discontinuance of Pitocin. When the fetus’ condition continued to deteriorate, the nurse called the physician back at 3:25 p.m. and asked him to come back to see the patient. The physician arrived at 3:35 p.m. and spent 20 minutes in the labor room trying to rescue the fetus by elevating the fetal vertex and encouraging breathing, relaxation and position changes. However, the woman was ultimately brought to the operating room at 3:55 p.m., and delivery was accomplished with vaginal forceps at 4:02 p.m. When the infant plaintiff was born, he did not breathe, had no heart rate, and was limp and pale. His APGARs were 0, 0 and 2 at one, five and 10 minutes. A diagnosis of placental abruption was confirmed when the placenta was delivered, accompanied by 1 liter of blood and a large clot. Thus, the infant was diagnosed with metabolic acidosis, respiratory failure and coagulopathy. He was subsequently transferred to another medical center to receive brain cooling, and an MRI performed at four days of age confirmed that the infant had brain damage due to asphyxia. The infant’s mother, acting individually on behalf of her infant son, sued the physician, the medical center and the obstetrical group. She alleged that the defendants failed to timely treat her condition and deliver her baby, and that this failure constituted medical malpractice. The plaintiffs’ experts were prepared to testify that the physician breached the standard of care in failing to see the mother at the time of the initial call at 3 p.m. on March 27, 2009, and further breached the standard of care in failing to perform an emergency delivery when the physician finally returned to the medical center at 3:35 p.m. Plaintiffs’ counsel contended that the nurse breached the standard of care in failing to ask the physician to see the mother at the time of her initial call at 3 p.m., and that the nurse should have gone up the chain of command when the physician did not arrive within 10 minutes of her initial telephone call. Counsel also questioned whether the labor and Pitocin should have been continued when there was an increased risk of placental abruption with the preeclampsia and uterine hyperstimulation. Plaintiffs’ counsel anticipated that defense counsel would have argued that the physician took reasonable steps to expedite the delivery and once the physician arrived, delivery was accomplished within 30 minutes. Plaintiffs’ counsel also anticipated that the nurse would have been defended on the basis that she provided the physician with the necessary information for him to determine whether or not there was an emergency, and that she did not breach the standard of care in failing to go up the chain of command when the physician did not promptly arrive after the first telephone call., The infant plaintiff suffers from truncal and cervical hypotonia, which is low muscle tone to his torso and neck. He also suffers from cerebral palsy, resulting in spastic quadriplegia, severe global delays, a seizure disorder and a failure to thrive. The infant remained hospitalized after birth until April 27, 2009, and has been living with his parents since that time. According to the plaintiffs’ experts, the infant, who is now 3 years old, will likely require a gastrostomy at age 6, which will affect the level of his attendant care if obtained through an agency. It is also anticipated that there would be issues concerning the infant’s life expectancy in evaluating damages. Plaintiffs’ counsel contended that the special damages for the mother and infant were medical liens totaling $86,298. Counsel also estimated the present value of the infant’s lost earning capacity as being $2,537,000. In addition, counsel contended that the present value of the infant’s recurring future medical and attendant care was $6,400,149, and there were one-time future medical costs of $376,713. There was no dispute that the infant will require round-the-clock care for the rest of his life and that there is a total loss of earning capacity. According to plaintiffs’ counsel, there was an indication that the defense’s experts estimated a present value of between $3 million to $4 million for the infant’s past and future medical and attendant care needs, and would have argued a loss of earning capacity of $645,708.
COURT
Superior Court of San Mateo County, San Mateo, CA
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INJURIES:
- anxiety
- brain
- brain damage
- brain injury
- cognition
- depression
- epidural
- extradural hematoma
- face
- facial bone
- fracture
- head
- headaches
- hearing
- impairment
- insomnia
- loss of
- mental
- nose
- psychological
- scapula
- sensory
- shoulder
- skull
- speech
- subdural hematoma
- tinnitus
- traumatic brain injury
- vision
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