Was cesarean indicated for baby with shoulder dystocia?
<court>Monroe County (NY) Supreme Court</court>
A woman presented to a hospital at 42 weeks’ gestation for delivery by midwives. Oxytocin was administered to induce labor. Approximately 2 hours into the second stage of labor, an obstetrician was called in to evaluate the delivery due to concerns that the child might be too large for the small mother to deliver vaginally. The physician told the midwives to continue with the second stage. Soon after, the fetal head delivered, but the midwife in charge suspected shoulder dystocia and asked for help from both an obstetrician and a pediatrician. It took 3 minutes to complete the delivery. The baby required resuscitation and was born with neurologic depression.
Over the next 11 hours, the infant suffered a series of seizures and was found to have bleeding in the brain. The baby was then treated at another hospital, where he was diagnosed with hypoxic ischemic encephalopathy. He now suffers from cerebral palsy and mental retardation.
In suing, the mother alleged that the head midwife allowed a midwife trainee to deliver the baby, but took over once shoulder dystocia was encountered. The woman further alleged that once shoulder dystocia was encountered, the midwives should have called in an obstetrician to perform a cesarean.
The head midwife maintained that excellent care was provided and that any brain damage the infant suffered occurred in utero, not during delivery.
- The jury awarded the infant plaintiff $8,651,000 and the mother $150,000 for loss of service.
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.