Articles Posted in Birth Injury

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The Illinois Appellate Court for the Fourth District reversed a jury’s verdict for defendants, which included OSF Healthcare System, in the Circuit Court of McLean County.  The case centered around an injury and subsequent death of a 3-year-old boy, Christian Rivera, in 2003. The jury trial was held in July 2011. 

During the trial, the family of Christian offered its expert witness, Dr. Finley Brown, to testify as a medical expert in family practice.

The defendants were allowed by the trial judge to cross-examine Dr. Brown for the issue related to his annual earnings as an expert witness for an 8-year period. Plaintiff’s counsel had argued against the broad timeframe, but the trial judge denied plaintiff’s motion to limit the timeframe. Defense used this testimony to say the jury that Dr. Brown was a “go-to guy for expert opinions.”

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In June 1991, Amanda Eckstein was born at Good Samaritan Hospital and delivered by defendant and obstetrician, Martin Gallo, M.D. In the plaintiff’s complaint, it was alleged that Dr. Gallo should have ordered a Cesarean section rather than a vaginal delivery with forceps. Ms. Eckstein alleged that there was evidence of her fetal distress on the fetal monitor strips, which should have prompted Dr. Gallo to order the C-section.

However, with the vaginal delivery, Amanda’s shoulder was hung up and caused shoulder dystocia, which lasted for approximately 5 minutes. Shoulder dystocia occurs in the delivery room when a child’s head is delivered, but the shoulder gets caught on the mother’s pelvis. Amanda was born without a heart rate and no respiratory rate for more than 5 minutes.

It was contended by Amanda that she had been without oxygen and suffered a permanent brachial plexus injury/Erb’s palsy to her left shoulder because of the doctor’s negligence. Erb’s palsy is nerve damage or resulting weakness to the baby’s upper group of the arm’s nerves.

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The Missouri Supreme Court has found that the statute that limits noneconomic damages in medical malpractice cases to $350,000 unlawfully infringes on a jury’s constitutional right to determine the amount of damage that a person has sustained from medical negligence.

In this Missouri case, Deborah Watts filed suit for medical negligence against the hospital and others alleging that her son suffered catastrophic brain injuries because of hospital and medical providers’ negligence. Ms. Watts went to Cox Medical Center at 39 weeks of pregnancy after she felt cramping and decreased fetal movement. No diagnostic tests were completed, and she was sent home. When she returned two days later, she was this time placed on a fetal heart tracing monitor. More than an hour later, her son Naython was delivered by Caeserean section. Unfortunately, Naython suffered catastrophic brain injuries.

The jury awarded $1.45 million in noneconomic damages and $3.371 million in future medical damages. However, because of the Missouri statute capping noneconomic damages, the trial judge reduced the noneconomic award to $350,000. Ms. Watts appealed, arguing that the statute violates the right to trial by jury and other violations of the state constitution.

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A hospital’s neonatal intensive care unit is the triumph of modern medicine’s investment in technology, pharmacy and know-how, says Dr. Rahul K. Parikh, a pediatrician in Walnut Creek, Calif. Dr. Parikh wrote an essay published in a recent edition of the New York Times.

Dr. Parikh points out that babies born somewhere between 23 and 26 weeks of gestation, or what’s called the limit of viability, are placed in the NICU. In the 1960s, when the first NICUs opened, premature infants had a 95 percent chance of dying. Today, they have a 95 percent chance of survival.

Now we face a difficult choice, Dr. Parikh says, one not unlike that facing physicians who take care of adults near the end of their life: whom to fight for and whom to let go. The decision says volumes about how we have come to regard the tiniest, frailest of patients.

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Pre-eclampsia is a medical condition that affects one in twenty pregnancies and can lead to various complications for the mother and child, including stroke, seizures, or even death. Pre-eclampsia can be diagnosed during the second trimester and occurs when the mother develops hypertension, i.e. high blood pressure, or unusually high concentrations of protein in her urine. While there is currently no treatment for pre-eclampsia, a recent study published in Reproductive Sciences could help identify those women at risk for developing pre-eclampsia.

The article, titled “Placental Protein 13 and Decidual Zones of Necrosis: An Immunologic Diversion That May be Linked to Preeclampsia,” was published by Harvey J. Kliman, MD, PhD, a research scientist operating out of Yale University, and several other scientists. The article focused on recent findings Kilman and his colleagues had unearthed about the role of Placental Protein 13 (PP13) and what this could mean for pre-eclampsia patients.

PP13 is a protein made by the placenta during pregnancy. Prior research had found PP13 levels to be very low among women who develop pre-eclampsia; however, the role of PP13 in pregnancy had previously been unknown. In the present study, the doctors studied placentas from normal pregnancies that had been terminated prior to the 14th week of gestation. They not only found the PP13 to be concentrated in maternal tissue surrounding the veins running under the placenta, but also found a high degree of necrotic maternal tissue in the same area.

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Just as there is a difference between state laws and federal laws, so is there a difference between medical clinics who receive federal funding and those who don’t. If a medical facility receives federal funding, its staff are considered federal employees and as such are subject to federal laws. This means that if a doctor at a federally-funded clinic commits medical malpractice then the corresponding medical malpractice claim will be handled by a federal court, not a state court.

The Seventh District of the Illinois Appellate Court recently reviewed whether a medical malpractice claim brought against federal employees was filed during the statute of limitations. If a claim is not brought during the appropriate statute of limitations, it is then barred from litigation, i.e., it cannot be filed or proceed to trial. However, the appellate court found that Arroyo v. United States, 10-2311 (7th Cir. 2011), had been brought during the appropriate time frame and therefore the $29.1 million verdict was upheld.

Arroyo was a birth injury lawsuit involving claims that the neonatal staff failed to recognize and treat baby Christian Arroyo’s infection in a timely manner. Christian had contracted a bacterial infection from exposure to his mother’s blood during his May 2003 birth. Generally, pregnant women undergo a variety of blood work tests during the month before their due date. However, because Arroyo was premature, his mother had not yet undergone these tests and therefore doctors were not aware that would have tested positive for Group B Streptococcus (GBS).

Because exposure to GBS can lead to permanent injuries in babies, doctors take several precautions when a mother has not undergone these prenatal tests. Most importantly, the medical staff must be on the lookout for any signs or symptoms of neonatal sepsis, i.e., an infection in the baby’s bloodstream. If there is even a suspicion of neonatal sepsis, the standard of care for treating such infections is to administer antibiotics to begin fighting the suspected infection. If the sepsis is not treated immediately, it can lead to severe brain damage.

This is what happened in Arroyo’s case. Despite signs and symptoms that Arroyo had contracted an infection, his doctors failed to administer antibiotics. As a result, Arroyo suffered from severe and permanent brain injuries, which include spastic quadriplegia, cerebral palsy, seizure disorder, communication deficits, the inability to swallow, incontinence, and permanent pain. It is likely that if Arroyo had received antibiotics in a timely manner that his injuries would have been drastically reduced.

However, the Arroyo family was not immediately aware that Christian Arroyo’s brain damage could have been avoided. It was not until the mother gave birth to her second son in July 2004 that she became aware of the importance of neonatal antibiotics and began to understand that Christian’s permanent brain injuries could have been avoided if not for the doctors’ negligence. The family filed a medical malpractice lawsuit against those doctors a year and a half after becoming aware of the true cause of Christian’s injuries.

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To many women, pregnancy and childbirth is a magical time that ends with the arrival of a new family member. However, for many women pregnancy and labor are anything but easy. Some women suffer difficult pregnancies and are placed on high risk status, or put on bed rest. Other women undergo difficult and complicated labor and deliveries, sometimes resulting in birth injuries to the baby. However, a recent article in The New York Times highlighted another potential complication of the birthing process – stillbirths.

Despite America’s status as a wealthy nation that offers high quality prenatal care, stillbirths continue to be a problem for many pregnant women. A group of papers put together by The Lancet, a British medical journal, stated that about 1 in 300 babies continue to be stillborn in high-income countries. And while about 98 percent of the global stillbirths occur in low- or middle-income countries, the report calls into question what doctors and families can be doing to decrease the incidences of stillbirths in the U.S.
Some of the risk factors for stilbirths include maternal obesity, maternal age over 35, smoking during pregnancy, and multiple pregnancies, e.g., twins or triplets. Reports suggest that obesity is the cause of 18 percent of stillbirths in higher-income nations, a statistic that is not surprising considering other medical reports citing the increase in adult obesity in the U.S. However, while the negative effect of obesity on one’s heart and general health are well-known, perhaps the effect of obesity on one’s fetus is not as well-known. Educating American women about the link between maternal obesity and stillbirth could at least make more women aware about this problem and perhaps work towards lowering the cases of maternal obesity, just as educating women about the risks of smoking during pregnancy has lowered the rate of smoking-related stillbirths.

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The use of medications to induce labor has become increasingly common over the last 50 years. Pitocin is one of the most well-known medications given to mothers to try and speed labor along. However, this drug does not come without its risks, which can include uterine rupture, more intense contractions, and fetal stress.

The Cook County birth injury lawsuit of Louis Montes, a minor, et al. v. West Suburban Hospital Medical Center, Inc., 05 L 14157, involves the use of Pitocin during a 2005 delivery. The baby’s mother was given Pitocin in order to promote labor. However, she was given too much of the drug, which led to a hyperstimulated uterus and to fetal distress.

A review of the fetal heart tracings taken during this period clearly demonstrate that the baby was in distress. However, the West Suburban Medical Center nurses failed to alert the obstetrician of the baby’s fetal distress. Because he was not aware of the problem, the doctor did not order a timely c-section to avoid injury to the baby.

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A Cook County medical malpractice lawsuit was critical of a Naperville hospital for its failure to appropriately monitor the vital signs of an expectant mother. As a result of the poor monitoring by the Cook County hospital, the mother not only lost her baby, but had to undergo future surgery herself. Sabine C. Miller v. Edward Hospital, et al., 05 L 1192.

In November 2004, 30 year-old Sabine Miller was brought by ambulance to Edward Hospital. She was 14 weeks pregnant and had developed severe abdominal pain and vomiting. Upon her arrival, the Naperville hospital immediately began evaluating Miller to determine whether her baby was the cause of her severe pain.

The Emergency Department was able to rule out any problems with the fetus and Miller’s pregnancy. However, in order to determine what was the cause of Miller’s abdominal pain, the staff elected to admit her for further testing and observation. Up to this point, there were no violations in the standard of care administered by the Edward Hospital staff. It was not until Miller was admitted to the hospital’s postpartum unit that the medical negligence occurred.

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Topamax is an anticonvulsant medication that is prescribed to treat epilepsy and the associated seizures, or can also be prescribed to prevent migraine headaches. Recently, the Food and Drug Administration (FDA) released a new warning about some birth defects associated with Topamax. Specifically, the drug warning states that mothers taking Topamax showed higher incidences of cleft lips and cleft palates than mothers not taking Topamax.

This discovery was made by the North American Antiepileptic Drug (NAAED) Pregnancy Registry, whose data showed that 1.4% of infants exposed to Topamax during the first trimester were likely to develop a cleft lip or cleft palate. The prevalence of cleft lips or palate in infants with no exposure to anticonvulsant medications was 0.07%.

In light of this new information, the FDA elevated the Topamax’s pregnancy category from C to D. Under Category D, “There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in
pregnant women despite potential risks.” Physicians are advised not to prescribe Topamax to pregnant women unless the potential benefits of the drug outweigh the potential risks to the fetus.

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