Improper tube placement blamed for hypoxic insult
<court>North Carolina Superior Court</court>
Upon presenting to a hospital with contractions 3 to 5 minutes apart, a gravida was placed on electronic fetal monitoring. The Ob/Gyn determined she was 1 cm dilated and 50% effaced, with the fetus at minus-2 station.
Following this examination, the woman’s contractions became less frequent. The fetal-heart-rate tracing was not formally reactive. Despite the patient’s protests, the Ob/Gyn recommended she go home.
About 6 hours later the woman returned to the hospital, again with contractions 3 to 5 minutes apart. She delivered 20 minutes after her arrival. Although thick meconium was present, endotracheal suctioning was not performed. The infant demonstrated no spontaneous respirations or movements and was transferred to the neonatal intensive care unit (NICU). Episodes of bradycardia occurred, followed by blank, unresponsive stares. The newborn was diagnosed with diffuse hypoxic insult.
Medical records failed to indicate who rendered care to the infant for 20 minutes after the neonate was removed from the delivery room. A respiratory therapy note stated that the baby was intubated prior to admission to the NICU, but indicated the tube had dislodged during transport.
The infant was reintubated 10 minutes after NICU admission. However, a chest x-ray performed 12 minutes later showed that the endotracheal tube was placed down the right mainstream bronchus; it also revealed that the left lung had collapsed. Records indicated that the endotracheal tube was not repositioned immediately and that needle aspiration to correct the pneuomthorax was not performed until after the endotracheal tube was replaced.
- The case settled for $1,225,000.
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.