Articles Posted in Birth Injury

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At the moment of birth, the most objective method of assessing a newborn’s metabolic condition is by analyzing umbilical cord blood gas. To be specific, arterial cord pH and base deficit can determine perinatal hypoxia and be an insight into causes of fetal distress.

Umbilical cord blood gases are most likely interpreted in situations of high risk pregnancies when there are abnormal fetal heart rate patterns, when there is an intrapartum fever, emergent C-section for a fetal compromised, low Apgar scores (less than 3) or when there are multiple fetal births.

There are three most common causes of neonates hypoxia or asphyxia, which are when the mother is oxygen compromised, when there is preeclampsia, chronic hypertension, hypotension, hypovolemia or cyanotic heart disease. Another type of condition that causes hypoxia or asphyxia is when the oxygen flow from the placenta to the fetus is obstructed or impaired. This could be caused by a placental abruption, a cord prolapse, or repetitive cord blockage.
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A federal district court judge in Harrisburg, Penn., has entered a judgment for $42 million to the parents of a Pennsylvania boy left disabled because of brain injuries. In the federal lawsuit, it was alleged that the brain injury was caused by a doctor who used forceps during the delivery process of the child.

The judgment came after a six-day trial in September on claims by a Chambersburg, Penn., couple, Christiana Late and Nathan Armolt. Their 5-year-old son, identified only as D.A. in court documents, understands language but cannot speak, read or write.  He will eventually have to use a motorized wheelchair in order to move about.

The family sued the federal government for errors allegedly made by an obstetrician for Keystone Women’s Health Center, a federally supported facility. Dr. Thomas Orndorf, who was not sued, delivered the child Feb. 21, 2012, at Chambersburg Hospital. Under the law, when a federally financed clinic has been alleged to be negligent causing injury to a patient, the remedy is a claim against the United States under the Federal Torts Claim Act.
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According to the World Health Organization (WHO), the United States maternal mortality ratio has increased between 1990 and 2013 by 136%. Between 2003 and 2013, there were 7,210 maternal deaths in the U.S., according to the Center for Disease Control’s (CDC) database. The rise in maternal deaths is stunning compared to the rest of the world where the maternal mortality rates have decreased by 45% between 1990 and 2013. Compared to other developed regions of the world, the U.S. is lagging far behind in this area. In developed regions of the world, the maternal mortality ratio was down 38%.

Furthermore, neonatal deaths between 2003 and 2013 numbered 277,886 in the U.S. That number of neonatal deaths compared to Sweden, Iceland and the United Kingdom was significantly higher. The birth trauma injuries for neonates for the year 2004, for example, were 1.1-7.5/1,000 births.

Also alarming is the fact that in the U.S., the likelihood of maternal death in high-poverty areas of the country are twice as high as other areas. The maternal mortality rates per 100,000 live births by race or ethnicity was highest among non-Hispanic black women. The next highest, which was less than half, were of American Indians/Alaska native Americans. In short, African-American women are three times more likely to die from pregnancy-related causes than white women.

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Vonshelle Brothers received her prenatal care, including a Pap smear, at the Brevard County Health Department. A cytopathologist allegedly interpreted the Pap smear as having cellular changes consistent with the herpes simplex virus. However, a health department nurse reported that the test was normal. Her obstetrician did not look at the actual Pap smear and Brothers was not notified of the cytopathologist’s findings.

About seven months later, Brothers delivered her baby vaginally. Two weeks later the child was diagnosed with herpetic meningoencephalitis, which led to profound brain damage. This child is now 6 years old. She has developmental delays, speech and vision problems and difficulty walking.

Brothers filed a lawsuit against the health department alleging that its employees chose not to diagnose the herpes simplex virus and prevent Brothers from transmitting the virus to her unborn child by performing a Cesarean section. There were other allegations of preventative medical attention that could have prevented and avoided the predictable outcome. Before trial, the parties settled the case for $3.2 million.
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In this medical malpractice case, an appeal was taken by the plaintiff after a jury verdict was entered in favor of the defendant, Mercy Hospitals East, claiming that the trial court abused its discretion. The claim was made that the court chose not to strike for cause a venireperson after she expressed during voir dire a disqualifying bias in favor of Mercy. She stated that she would “start off slightly in favor” of Mercy in this case because her sister was a registered nurse at another Mercy facility.

Since this venireperson served on the jury in this case, the appellate court reversed and remanded for a new trial because the appeals panel found that the venireperson’s stated bias disqualified her from jury service on this case and she was not subsequently rehabilitated.

The original lawsuit stemmed from allegations that the hospital providers were negligent in connection with the Cesarean-section delivery of Thaddeus Thomas, resulting in brain damage to the newborn. The case proceeded to trial on March 16, 2015 and a jury returned a verdict for Mercy Hospital on March 26, 2015. The only issue on appeal was asserted that the trial court committed reversible error when it denied the plaintiffs’ motion to strike the venireperson for cause, who was later seated as a juror and took part in the verdict in this case.
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In August 2015, the plaintiffs, Kristopher Crim and Teri Crim, acting on behalf of their biological son, Collin Crim, filed a medical malpractice lawsuit against the defendant physician, Dr. Gina Dietrich, claiming that she chose not to comply with the standard of care applicable to an obstetrician. The Crims claimed that Dr. Dietrich’s negligent failure to obtain Teri’s informed consent prior to Collin’s natural birth resulted in a fracture to Collin’s right clavicle and nerve damage that extended down his right side to his shoulder, wrist, hand and fingers.

Following the presentation of the Crims’ case to the jury, Dr. Dietrich moved for a partially directed verdict on the issue of informed consent, which was granted by the trial judge. After additional evidence and argument, the jury returned a verdict in Dr. Dietrich’s favor and against the Crims on their remaining claim.

The Crims had sought expenses under Section 15 of the Rights of Married Persons Act (750 ILCS 65/15 (2014)). The court later imposed costs on the Crims as permitted by Section 5-109 of the Code of Civil Procedure, 735 ILCS 5/5-109. The Crims appealed, arguing that the trial judge erred by (1) granting Dr. Dietrich a directed verdict on the issue of informed consent; and (2) barring certain medical testimony. As the appeals panel pointed out, because they agreed with the Crims’ first argument on the directed verdict on informed consent, the trial court’s decisions were reversed.
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A Wisconsin appellate court has ruled that a trial judge improperly excluded a defendant physician’s expert testimony. The expert wanted to testify about the maternal forces of labor being a cause of the plaintiff child’s brachial plexus injury.

In this case, Leah Bayer and her husband filed a lawsuit against her obstetrician, Dr. Brian Dobbins, claiming that he mishandled their infant’s shoulder dystocia, causing the baby girl to suffer a permanent brachial plexus injury.

The defendant doctor contended that the child’s injury came from maternal forces of labor. This is probably the most common and over-used defense in a birth trauma injury cases. The Bayer family then filed a motion in limine and requested that the judge exclude the defendant’s expert testimony related to the maternal forces of labor theory. The trial judge granted the motion.

However, the appellate court reversed. Whether expert testimony is admissible under the Daubert standard depends on whether an expert is qualified and uses a methodology that is scientifically reliable and whether the testimony will assist the trier of fact to determine a fact in issue.
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Irena Dujmovic-Terman was seven weeks pregnant when she began prenatal care with the defendant obstetrician and gynecologist, Dr. Elliot Levine on Feb. 1, 2008. She was 37 years old at the time. Because of her advanced maternal age, Dr. Levine recommended genetic testing for fetal anomalies. The patient agreed at her 11-week visit.

The blood draw for the quad screen test was planned for the 15-week visit on March 27, 2008, but Dr. Levine’s staff chose not to perform the blood draw at that time, giving no explanation.
Dr. Levine later took the first quad screen blood draw on April 24, 2008. The test results came back from the lab on April 29 showing a high risk of fetal anomaly (trisomy 21 Down syndrome) and thus Dr. Levine signed off on them on May 2. Dujmovic-Terman was not informed of the results during the next three weeks.

Dr. Levine finally told her about the results at her next visit on May 22 when she was 23 weeks pregnant. Dr. Levine ordered an amniocentesis at Weiss Memorial Hospital, which was scheduled for June 3, the next available appointment. However, Dr. Levine chose not to tell the patient that a legal abortion would not be available in Illinois once she passed gestation of 23 weeks and 6 days. He also failed to order the amniocentesis on an expedited basis.
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On June 6, 2006, the newborn baby, America Camacho, was delivered by the defendant obstetrician, Dr. Sonya Thomas, at Norwegian American Hospital in Chicago. Baby America weighed 10.5 pounds at birth. A medical negligence lawsuit was filed against Dr. Thomas and Norwegian American Hospital. The family of America maintained that Dr. Thomas chose not to review a June 1, 2006 prenatal ultrasound report, negligently chose not to suspect fetal macrosomia based on the ratio of the fetal head circumference to abdominal circumference, and relied solely upon the estimated fetal weight measurement of just under 8 pounds before the vaginal delivery.

Fetal macrosomia is a medical term used to describe a newborn whose size at birth is significantly larger than average. A baby diagnosed with fetal macrosomia will have a birth weight of more than 8 pounds, 13 ounces (4000 grams).

Fetal macrosomia poses health risks for the baby and the mother. One of the most common dangers to the unborn fetus is injury to the baby’s shoulder or injury to the important nerves in the baby’s shoulder area that control movement and arm function.
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Andrew and Marni Hotchkiss, a couple in their 30s, were struggling with infertility. They consulted an obstetrician and infertility physician, Dr. Siu Ng-Wagner. The couple and the doctor agreed to use a gestational carrier. As the Hotchkiss family selected potential surrogates online, the couple sent these candidates to Dr. Ng-Wagner for medical screening. Dr. Ng-Wagner subsequently interviewed Christina Jensen and told the Hotchkiss family that everything was “all clear.”

Jensen delivered the Hotchkiss’s baby at 25 weeks gestation after developing pre-eclampsia during the pregnancy. The newborn child developed sepsis and died just 3 weeks after birth.
The Hotchkisses filed a lawsuit against Dr. Ng-Wagner and her medical practice claiming that she chose not to review Jensen’s medical records before recommending her as a suitable surrogate.

This would have revealed Jensen’s history of pre-eclampsia in her pregnancy the year before the Hotchkiss’s baby’s birth. The plaintiffs also argued that Dr. Ng-Wagner had a duty to inform the Hotchkisses that she had not reviewed Jensen’s records before clearing her to be named a surrogate.
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