Did delayed delivery of second twin cause cerebral palsy?
<court>Kings County (NY) Supreme Court</court>
A woman presented to a hospital for the delivery of twins. For most of the 20 hours prior to the first child’s delivery, she was cared for by nurses and first-year residents, and had continuous fetal monitoring. The first-year resident delivered the first twin vaginally in the presence of an attending physician. After the first baby was born with slight meconium staining, the mother stopped having contractions. Oxytocin was then administered. The second twin was monitored every 3 to 4 minutes, and was noted to have a good fetal heartbeat. Approximately 42 minutes later, the defendant physician delivered the second infant. The child was blue at birth and hypotonic, with shallow breathing. While the first child had Apgar scores of 9 and 10, the second child’s were 6 and 7. The second twin now suffers from cerebral palsy, has motor skill deficits in his hands and right arm, and uses a walker or wheelchair.
In suing, the mother claimed that the fetal strips showed decelerations for 2 hours before delivery of the first child. Therefore, the doctor should have performed a cesarean to deliver both twins. She further argued that had continuous rather than intermittent monitoring been used on the second twin, fetal distress would have been noted and the doctor could have performed a timely cesarean.
The obstetrician claimed that adequate supervision was provided and further alleged that intermittent monitoring was as reliable as continuous monitoring. He also noted that there were no signs of fetal distress and, therefore, no reason to perform a cesarean. In addition, the woman’s pediatric neurologist testified on behalf of the physician, saying he believed the infant’s brain damage took place in utero before the 35th week of gestation.
- The jury awarded the plaintiff $61,662,500.
The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts. While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.