Articles Posted in Birth Injury

Emanuel A. Friedman M.D. introduced the Friedman Curve in 1955. In a recently submitted article written by Michigan lawyers Jesse M. Reiter and Emily G. Thomas, the authors and stalwarts of the Birth Trauma Litigation Group write that the gold standard for assessing the normal and abnormal progress of labor was changed in 2014. The change by the American College of Obstetrics and Gynecology (ACOG) replaced Friedman’s curve with new labor standards.

The purpose of the Friedman Curve was to assess labor progression and to identify whether the mother had a “reduced likelihood of a safe vaginal delivery.”  When there was an abnormal progress of labor, such as when neonatal morbidity and mortality were greatly increased, the analysis called on obstetricians to decide very quickly to rescue the unborn baby.

According to the Friedman papers, an “arrest of dilation” was diagnosed by documenting the lack of dilation progress in the active phase of labor. “Protracted active-phase” dilation was defined to be 1.2 cm per hour or 1.5 cm per hour where there was more than one fetus to be delivered.  According to the paper submitted by attorneys Reiter and Thomas, two vaginal examinations done by the same individuals spaced two hours apart was good enough to make this diagnosis. If the cervix did not dilate according to the maximal slope on Friedman’s curve over two hours, the patient was diagnosed with failure to progress/arrest of labor and delivered by Cesarean delivery. Cesarean delivery was then recommended to avoid neonatal death or catastrophic injury. Many studies over the 60 years showed that the research supported the Friedman Curve.

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This was a birth injury case in which the jurors were asked to award up to $7.5 million for a life care plan for the baby girl, Jill Todd, as well as $1.4 million in lost wages and an unspecified amount of damages for pain and suffering. The issue in this case was whether the University of Iowa’s Health Center physicians and staff provided proper care to Jill Todd in November 2010.  After two days of deliberation, the jury returned a 9-1 verdict finding that the University of Iowa Health Center was negligent but that negligence wasn’t “a cause of damage” to the child. This was an odd verdict or at least one that most would consider inconsistent.

Investigators confirmed that they were looking into an unusual claim of jury tampering in this medical malpractice, birth injury case involving the University of Iowa Hospitals and Clinics. As a result of the jury’s unusual verdict, the University of Iowa Hospitals and Clinics paid nothing for the injured child.

After a 3-week trial, the jury found that the hospital was negligent in caring for a mother who suffered complications before giving birth in 2010. But the jurors found that negligence was not a cause of damage to the child. The baby suffered brain damage and is severely disabled. The jury awarded no compensation to the family.

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A Cook County jury entered its verdict in favor of the defendant obstetrician, Dr. Cynthia Page, following a trial claiming that the birth of Anthony Ruiz was delayed causing him a lifetime of cognitive deficits.

The family of Anthony Ruiz, a minor, claimed in their Cook County, Ill., lawsuit that a delay in performing a Cesarean section surgery at Elmhurst Memorial Hospital on Sept. 16, 2010 was the cause of the baby’s cognitive impairments, including a lower IQ, diminished executive function and impaired fine motor skills.

The case centered on a nurse who telephoned the defendant obstetrician Dr. Page at 12:31 a.m. to tell her about the baby’s distress. Dr. Page arrived at the hospital at 12:48 a.m. and a C-section was ordered at 12:56 a.m. The newborn was delivered at 1:20 a.m.

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This was a medical malpractice and wrongful death case of a newborn baby. The issue on appeal to the Vermont Supreme Court was whether the defendants’ (two physicians and hospitals) motion to dismiss predicated on the plaintiff’s (the family of the newborn) failure to timely serve summonses on these defendants was justified.

The parents of the newborn baby alleged that on June 12, 2012 their son died as a result of medical malpractice at the defendant hospital and at the hands of two physicians, who were claimed to have been negligent in their care and treatment or lack of it.

The plaintiffs filed their complaints against both sets of defendants on June 20, 2014. Under the applicable code of civil procedure, the plaintiffs had 60 days to serve the defendants with summonses.  On Aug. 18, 2014, the day before the 60-day period was set to expire, plaintiffs moved for an enlargement of time for service, requesting that the court extend the deadline for service of process “for an additional sixty (60) days.”

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On April 6, 2007,  Dramara Sviels was born at Memorial Medical Center in Springfield, Ill. During the delivery, Dramara contracted Group B Streptococcus infection, which was claimed not diagnosed before Dramara was discharged from the hospital the next day. As a result of the infection, it progressed to very serious meningitis, which was diagnosed on April 8, 2007. The meningitis left Dramara with cerebral palsy and seizure disorder. According to the report of this case, the lifetime medical and caretaking expenses would amount to more than $20 million.

In the lawsuit filed by Dramara’s family, it was maintained that the child was exhibiting symptoms of sepsis during his stay at Memorial Hospital at the time of his discharge and during an April 7 phone call from Dramara’s  parents to the hospital nursery after discharge. The lawsuit maintained that these symptoms should have been immediately treated.

The experts who testified on behalf of Dramara’s family stated that a chain of command protocol at the hospital should have been initiated to delay the infant’s discharge and that the nurses who handled the April 7 phone call should have referred the baby to a pediatrician or to the emergency room for immediate care.

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Zofran is an anti-nausea drug.  It has been linked to serious birth defects when used during pregnancy.  In 2015, a federal panel created the special multidistrict litigation docket for victims who had been using the Zofran drug made by GlaxoSmithKline (GSK).

The defendant, GSK, filed a motion in this federal district court claiming that the lawsuit was pre-empted by federal law under the U.S. Supreme Court decision in Wyeth v. Levine.  In that case, it was held that federal regulatory clearance of a medication does not shield the manufacturer from liability under state law.  The U.S. District Court in the Massachusetts district, however, denied the motion stating that the judge was “loath to dismiss” the claims without giving families a chance to develop the facts of their respective cases through discovery.

Zofran was first approved by the federal Food and Drug Administration in 1991.  It is intended to control extreme cases of nausea such as with cancer medications or following an invasive surgery.  It has not been approved for use during a pregnancy.  However, the drug Zofran has been prescribed by physicians to expectant mothers to lessen the symptoms of morning sickness.

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When an infant is tragically injured during childbirth by the negligence of an obstetrician, nurse wife or nurse, the defense, with few exceptions, relies on medical publications. Most of these publications come from the American College of Obstetricians and Gynecologists (ACOG). On the other hand, a plaintiff’s neuroradiology expert would be called to testify about the baby’s time of injury. ACOG has taken most birth trauma injury cases as having occurred in the prenatal stages of childbirth. In other words, during labor and delivery the HIE injury (hypoxic ischemic encephalopathy), which is the basis for the lawsuit, didn’t occur during labor and delivery, but instead occurred as a matter of course during the time prenatally. That’s the standard defense.

ACOG published in January 2003 a document that created strict criteria for establishing the existence of intrapartum HIE. Applying this stringent criteria, ACOG defenders argued that the injury to the baby occurred not during labor and delivery but prenatally. The claim that the baby was asphyxiated intrapartum, that is during labor and delivery, could not have happened because the strict criteria were not met.

The published paper by ACOG took the position that 4-10% of moderate to severe neonatal encephalopathy occurred as a result of hypoxia in the intrapartum period.

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Carol and Keith Klaine filed a medical malpractice lawsuit against Frederick Dressen D.O. and Southern Illinois Medical Services d/b/a The Center for Medical Arts. In an amended complaint, the plaintiffs added a party defendant, Southern Illinois Hospital Services d/b/a St. Joseph Memorial Hospital and Memorial Hospital of Carbondale (SIHS), for negligent credentialing of Dr. Dressen.

In the discovery process, SIHS provided over 1,700 pages of documents. However, SIHS refused to provide certain documents, which it listed in a privilege log, as required by Illinois Supreme Court Rule 201(n), asserting that the withheld documents were privileged pursuant to, inter alia, the Medical Studies Act (735 ILCS 5/8-2101) and the Healthcare Professional Credentials Data Collection Act (Credentials Act) (410 ILCS 517/1 et seq.).

The plaintiff moved the court to review the SIHS excluded documents that it claimed were privileged for an in-camera review. After reviewing the documents, the circuit court judge agreed with SIHS that all of the documents were privileged, with the exception of those documents contained in “Group Exhibit B,” “Group Exhibit F” and “Group Exhibit J.”

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On Sept. 17, 2009 Crystal McFadden was admitted to Northwestern Memorial Hospital in full-term labor. Her care was managed by a team of resident obstetricians under the direction of the defendant, Dr. Jeffrey Dungan, the supervising attending obstetrician.

During the course of her labor, the residents and nursing staff documented late and variable decelerations on the fetal heart monitor with periods of minimal or undetectable variability, but they described the fetal heart tracings as being reassuring overall.

Around 3 a.m. on Sept. 18, 2009, after McFadden had been trying to push for 1.5 hours, the fetal heart tracings became non-reassuring and the senior obstetrician resident called Dr. Dungan to perform delivery. By then the baby’s head was crowning, so the delivery was accomplished with a vacuum extractor. However, the infant was born with no signs of life. The neonatologist in the delivery room stated that the baby appeared to be hydropic with generalized swelling, ascites (accumulation of fluid in the peritoneal cavity), and pleural effusion.

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Iala Suarez was 24 weeks pregnant when she went to her obstetrician, Dr. Michael Coffey, for a regularly scheduled appointment. During that visit, testing showed that she had protein in her urine and high blood pressure. The next day, she went to the Peace River Medical Center, where she underwent a 24-hour urine test and a blood pressure evaluation. Suarez was discharged. The urine test results came back about 30 minutes later showing that she had preeclampsia.

Preeclampsia is a pregnancy condition considered a complication that comes with high blood pressure and signs of damage to another organ system, often the kidneys.

Over the next several days, Suarez saw Dr. Coffey during this time and went to Peace River Medical Center for an evaluation. She continued to experience high blood pressure, increased protein in her urine and restricted fetal growth. She eventually returned to the hospital where she underwent an emergency Cesarean section.

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