Was decreased fetal movement mishandled?
<court>Suffolk County (NY) Supreme Court</court>
Five weeks before her due date, a 28-year-old gravida reported decreased fetal movement and no activity during a kick test. A physician performed a biophysical profile and noted a score of 8 out of 10 with a nonreactive stress test. The woman was sent home and advised to inform the group of any additional changes in fetal movement.
She contacted the group 5 days later, again noting an absence of fetal movement. At the hospital, another physician in the group was unable to detect a fetal heart rate. Another 3 and a half hours passed before the doctor delivered the child by cesarean section.
Though born with an Apgar score of 9, the child was hypoglycemic and acidotic, and later diagnosed with periventricular leukomalacia. Age 6 at the time of the trial, she suffers from seizures, spastic quadriparesis, and cortical blindness.
The plaintiff alleged that the first physician misread the biophysical profile and the second physician was negligent in delaying cesarean delivery after failing to detect a heartbeat. All 3 group members were cited for not responding appropriately to the mother’s initial complaint of decreased fetal movement.
The defendants maintained the biophysical profile was correct. They argued that, in light of the high Apgar score at birth, the child’s condition likely stemmed from a chronic condition precipitated by placental insufficiency several weeks before delivery.
- The jury awarded the plaintiff $111.7 million. A high/low agreement reached prior to the verdict reduced the award to $6 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.