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Medical Verdicts

Cesarean ordered late, no OR available

February 2005 · Vol. 17, No. 2
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<court>Lake County (Ill) Circuit Court</court>

Approximately 1 half-hour after admission, fetal monitoring of a woman presenting with ruptured membranes revealed 2 periods of brief deceleration. In the half-hour that followed, however, no decelerations were reported.

The obstetrician left to see other patients, and instructed the nurse to continue fetal monitoring and report any changes. Several periods of decelerations followed, but the nurse never informed the physician. Instead, approximately 1 hour after the first of these decelerations, she reported to the doctor that both mother and fetus were fine.

Following this conversation, the child’s heart rate again dropped, at one point reaching 39 beats per minute. A new nurse contacted the doctor, noting the woman was 8 cm dilated but never conveying the extent of the decelerations.

An emergency cesarean was ordered, but 34 minutes passed before an operating room was available. The child was born with an Apgar score of 0, but was resuscitated. He suffers brain damage and cerebral palsy, and is unable to walk or talk.

In suing, the plaintiff argued that nurses were negligent for not notifying the obstetrician of the heart-rate decelerations promptly. Had this information been conveyed, it was argued, cesarean delivery would have occurred sooner. The plaintiff further cited the hospital for negligence for failing to have an operating room available.

The defendants argued the child’s condition stemmed from a ruptured umbilical cord.

  • The obstetrician settled for $450,000 during trial. The jury awarded the plaintiff $23.3 million against the hospital.

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 ( While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.

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