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Medical Verdicts

PROM or protein C: Which caused injury?

May 2005 · Vol. 17, No. 5

<court>Hillsborough County (Fla) Circuit Court</court>

A woman at 40 weeks’ gestation presented to an Ob/Gyn due to a suspected amniotic leak. After examining the patient, the physician determined no amniotic fluid was present and sent the woman home.

The following day the woman once again presented with a suspected amniotic leak. Upon examination, a second Ob/Gyn observed green mucus, prompting the doctor to admit her to the hospital, where fetal heart monitoring and oxytocin administration were initiated.

Twelve hours after oxytocin was started, the woman was just 4 cm dilated and febrile. When, 3 hours later, fetal monitoring indicated signs of distress, the first Ob/Gyn was called. He soon left, however, to attend to another scheduled delivery.

Six hours later, when the woman’s temperature climbed to 101.1° and fetal monitoring indicated a heart rate of 160 to 170 beats per minute, a cesarean delivery was ordered. However, another 90 minutes passed before the procedure was initiated. At that time, fetal monitoring showed an almost flat heart rate with no variability.

The child was born with brain damage and cerebral palsy due to chorioamnionitis.

The plaintiffs sued, claiming the 2 obstetricians were negligent for failing to diagnose a ruptured membrane, administer prophylactic antibiotics to prevent chorioamnionitis, properly follow the patient, and order a timely cesarean section.

The defendants denied negligence, arguing that the child’s injury stemmed from a protein C deficiency.

  • The jury awarded the plaintiffs $4.6 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 ( While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.