Laboring mother sent home; child suffers hypoxic insult
<court>Undisclosed County (NC) Circuit Court</court>
A woman at term in her second pregnancy presented to a hospital with contractions 3 to 5 minutes apart. Upon examination, her Ob/Gyn established she was 1 cm dilated and 50% effaced, with the fetus at –2 station.
As the night progressed, however, the woman’s contractions became further apart. The physician opted to send her home (a drive of more than 30 minutes)—despite the fact that electronic fetal monitoring revealed nonreactive tracings, and over the patient’s protests that her last delivery occurred very quickly once active labor began.
The next morning, the patient once again presented with contractions 3 to 5 minutes apart. Twenty minutes later she delivered the infant, who at birth was floppy and cyanotic and exhibited no spontaneous respirations or movements.
The medical record made no note of the care administered until 20 minutes after the child’s birth, when he was admitted to the neonatal intensive care unit. The infant was intubated; however, a chest x-ray showed that the tube had been placed down the right mainstem bronchus, and the left lung had collapsed. Still, tube repositioning did not occur until 30 minutes after the initial placement and needle aspiration for the pneumothorax was not done for another 10 minutes.
Subsequent radiologic studies indicated diffuse hypoxic insult. The child at age 5 was cortically blind; had significant hypotonia; and was unable to walk, talk, or engage in any purposeful activities.
- The case settled for $1.2 million.
The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, of Nashville, Tenn. (www.verdictslaska.com) While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.