Justia Lawyer Rating for Robert D. Kreisman

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The use of fetoscopy was first developed in the 1990s. The process involves ultrasound-guided placement of a stethoscope – a small, fiber optic instrument – in the uterus to see the fetus and the placenta.

Fetoscopy as a surgical procedure can treat various fetal conditions including congenital diaphragmatic hernia and bladder outlet obstruction. Its most common use is the treatment of a rare condition, Twin-Twin Transfusion Syndrome (TTTS).

The condition of TTTS occurs when identical twins share a placenta with blood vessel connections that cause blood to flow unevenly between the two fetuses. According to the article, “Caught on Camera” by attorney Jeffrey B. Killino, one of the fetuses develops a small amniotic sac while the other sac becomes too large. Laser fetoscopy allows the laser to break up and collapse these blood vessel connections. Reportedly, if the condition is not treated, both of the fetuses can die. TTTS occurs in approximately 1 in 2,500 pregnancies. It is expected that there will be a rise in TTTS occurrences because of the increase in fertility-assisted pregnancies.
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Shunteria McIntyre, 20, received prenatal care from Dr. Orlando Muniz. Over a three-month period, she lost 26 pounds and complained of nausea and vomiting while visiting Dr. Muniz. She suffered additional weight loss later as well.

After eventually delivering a still-born baby, McIntyre died at her home. The cause was determined to be septicemia, acute diarrhea, and intrauterine fetal demise.

McIntyre’s personal representative brought a medical malpractice and wrongful death lawsuit against Dr. Muniz among others. The trial court dismissed the case reasoning that McIntyre’s pre-suit medical expert was not qualified to provide expert opinion testimony under Florida law and that McIntyre also chose not to comply with the pre-suit discovery process for medical malpractice claims under Florida law.
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Zoila Fuentes Medina was admitted to the Brooklyn Hospital Center to deliver her baby. During her prenatal treatment at the hospital’s high-risk clinic, concerns were raised about possible macrosomia. Macrosomia is a condition in which a fetus has a predicted birth weight of more than 8 lbs. 13 oz. Suspected fetal macrosomia is not an indication for induction of labor. Induction in a macrosomia condition does not improve maternal or fetal outcomes.

A sonogram taken before her admission revealed that her baby was above the 90th percentile in size. First-year resident Dr. Patrick Ellis attended to the delivery under the supervision of on-call physician Dr. Yves Richard Jean-Gills.

Medina’s baby became caught on her pubic bone when delivery was attempted. Dr. Ellis applied extreme force to the baby’s head and neck. As a result, the baby suffered a brachial plexus injury that resulted in permanent Erb’s palsy.
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A premature Baby Doe, at 30 weeks’ gestation, was delivered at Conemaugh Memorial Medical Center. Shortly after her birth, Baby Doe was diagnosed as having a right-sided cephalohematoma, which was confirmed by a CT scan.

A cephalohematoma is a collection of blood that occurs underneath the skin in the periosteum of an infant’s skull bone. Cephalohematoma does not pose any risk to the brain, but it causes unnecessary pooling of the blood from damaged blood vessels between the skull and the interlayers of the baby’s skin. In almost all cases, a cephalohematoma will go away within weeks or months. It usually appears as a bump on a baby’s skull.

The defendant neonatologist, Dr. John Chan, diagnosed Baby Doe as having a subgaleal hemorrhage and ordered that the baby’s head be wrapped with an ACE bandage as a pressure dressing.
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Katie and Michael Smith were expecting their sixth child when an examination showed that there was an absence of a fetal heartbeat. Katie Smith later delivered the fetus at Maine General Medical Center.

Tissue samples from the chromosomal testing were taken in the presence of the parents and the couple stated unequivocally to an attending physician that they did not want other samples taken from the baby’s body or additional procedures performed.

Nevertheless, pathologist Carol Saunders later removed a tissue from the baby in the pathology lab, leaving a large, gaping hole in the left side of the body. The Smith family discovered this deformity caused by the pathologist when they went to a funeral home to view the baby’s remains.
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Baby Doe, a twin, was born at 32 weeks gestation. Baby Doe was admitted to a hospital’s NICU where she remained in stable condition for several days.

Baby Doe developed a low-grade fever, tachycardia and irregular breathing. The next day, Baby Doe’s condition worsened. Her oxygen saturation dipped down to 78 percent, her glucose dramatically increased and her physical movement decreased.

A blood culture led to a diagnosis of bacterial infection, for which Baby Doe was given antibiotics. Within two weeks, Baby Doe was diagnosed as having a brain abscess and underwent surgery.
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More than a few studies have been conclusive showing that infants with hypoxic-ischemic encephalopathy have benefited when cooled to a temperature of 30 degrees Centigrade in a median time of 58 minutes. The cooling of newborns inspired oxygen requirements in a test involving six infants diagnosed with HIE.

Five of those infants required inotropic support during the cooling procedure. The cooling would be progressively reduced after 1-2 days. Inotropic support is the intensive care of newborns to stabilize circulation and to optimize oxygen supply.

Over the years, HIE has been recognized much more frequently. The onset of cases of HIE are caused by stroke, compressive forces or changes in oxygen circulating through the fetus before and immediately after delivery.
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Two weeks after Baby Doe’s premature birth, she developed signs of jaundice. Seven hours later, a check of her bilirubin revealed a severely elevated level of 29. The attending doctor ordered retesting of the bilirubin level but did not order any treatment.

Hours later, when a second bilirubin test showed a level of 27.1, the same doctor was notified by nurses of the out-of-balance level. By the next morning, the child’s bilirubin level increased to 32.1. Another physician began treating Baby Doe the next morning and ordered phototherapy, which began more than 17 hours after Baby Doe’s first bilirubin test was reported to the first doctor. Phototherapy is the usual treatment for jaundiced newborns.

Baby Doe suffered kernicterus resulting from severe jaundice. Kernicterus is a kind of brain damage caused by excessive jaundice, just as Baby Doe had endured. Baby Doe is now 10 years old. She suffers from cerebral palsy and cannot speak or walk. The Doe family sued the health system that employed the doctors involved alleging that they chose not to timely test Baby Doe’s bilirubin level at the first signs of jaundice and chose not to timely treat the jaundice. That failure caused the child’s permanent and severe injuries.
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Grayson Charlton, a twin, was in the breech position at the time of her delivery at Delaware County Memorial Hospital. The treating obstetrician, Dr. Steven Troy, allegedly applied traction to deliver Grayson, resulting in a popping sound. After the delivery, Grayson was diagnosed as having suffered a spinal cord injury and avulsed nerve roots to her right arm.

Grayson is now 5 years old and is paralyzed from the chest down requiring her to be confined to a wheelchair. Grayson has undergone extensive physical and occupational therapy.
Grayson’s parents, individually and on Grayson’s behalf, sued Dr. Troy, the hospital and two health networks under an agency theory, claiming liability for Dr. Troy choosing not to prevent the baby’s head from becoming hyperextended during the delivery.

The Charlton family experts testified that Grayson’s injuries could have occurred only after application of excessive longitudinal traction.
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In this lawsuit, the mother identified as Ms. Doe was admitted to a hospital to deliver her first child. Although the labor and delivery were prolonged, the treating obstetrician, Dr. Laura Fortner, advised Doe to keep pushing for another 30 minutes.

The obstetrician returned an hour later and used forceps and a vacuum extractor to deliver the baby who had become stuck in Doe’s birth canal. The baby’s Apgar scores were one at one minute and five at five minutes, requiring resuscitation.

The child, now age 16, has been diagnosed as having suffered hypoxic ischemic encephalopathy (HIE), which affects his cognitive, social and fine motor skills.
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