Lax protocols blamed for delayed birth
<court>Honolulu County (Hawaii) Circuit Court</court>
A woman admitted for delivery was under the care of her family physician, who ruptured her membranes. Within 1 to 2 minutes the fetal heart tracing showed a prolonged deceleration from 150 to 60 bpm lasting 4.5 minutes. A vaginal exam revealed a loop of cord along the left side of the infant’s head. During the next 28 minutes, the fetal heart rate ranged from 60 to 120 bpm with evidence of significant fetal distress, including several instances in which the heart rate was lost altogether.
The physician lifted the infant’s head, reducing the cord, and instructed the mother to push. The infant was born with a fractured right humerus, a small subdural bleed, and an intracerebral contusion.
The child now has limited cognition, residing in a nursing home for 24-hour care. He has a gastric tube and a tracheostomy.
In suing, the family claimed the infant sustained severe brain damage from anoxia. They claimed the physician was negligent in failing to order a cesarean section. They claimed the hospital lacked a written on-call protocol and call list, resulting in the primary OB being busy in another hospital and the back-up OB being more than 45 minutes away.
The physician asserted he was unaware of a prolapsed cord at the time and that the records were written in retrospect. The hospital maintained its on-call policy was correct. The defendants claimed the infant’s injuries were related to something other than anoxia from the prolapsed cord.
- The case settled for $11 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, Nashville, Tenn (www.verdictslaska.com). The available information about the cases is sometimes incomplete; pertinent details may be unavailable. Moreover, the cases may or may not have merit. Still, these cases represent types of clinical situations that may result in litigation and are meant to illustrate variation in verdicts and awards.