Articles Posted in Birth Injury

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When an infant is tragically injured during childbirth by the negligence of an obstetrician, nurse wife or nurse, the defense, with few exceptions, relies on medical publications. Most of these publications come from the American College of Obstetricians and Gynecologists (ACOG). On the other hand, a plaintiff’s neuroradiology expert would be called to testify about the baby’s time of injury. ACOG has taken most birth trauma injury cases as having occurred in the prenatal stages of childbirth. In other words, during labor and delivery the HIE injury (hypoxic ischemic encephalopathy), which is the basis for the lawsuit, didn’t occur during labor and delivery, but instead occurred as a matter of course during the time prenatally. That’s the standard defense.

ACOG published in January 2003 a document that created strict criteria for establishing the existence of intrapartum HIE. Applying this stringent criteria, ACOG defenders argued that the injury to the baby occurred not during labor and delivery but prenatally. The claim that the baby was asphyxiated intrapartum, that is during labor and delivery, could not have happened because the strict criteria were not met.

The published paper by ACOG took the position that 4-10% of moderate to severe neonatal encephalopathy occurred as a result of hypoxia in the intrapartum period.

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Carol and Keith Klaine filed a medical malpractice lawsuit against Frederick Dressen D.O. and Southern Illinois Medical Services d/b/a The Center for Medical Arts. In an amended complaint, the plaintiffs added a party defendant, Southern Illinois Hospital Services d/b/a St. Joseph Memorial Hospital and Memorial Hospital of Carbondale (SIHS), for negligent credentialing of Dr. Dressen.

In the discovery process, SIHS provided over 1,700 pages of documents. However, SIHS refused to provide certain documents, which it listed in a privilege log, as required by Illinois Supreme Court Rule 201(n), asserting that the withheld documents were privileged pursuant to, inter alia, the Medical Studies Act (735 ILCS 5/8-2101) and the Healthcare Professional Credentials Data Collection Act (Credentials Act) (410 ILCS 517/1 et seq.).

The plaintiff moved the court to review the SIHS excluded documents that it claimed were privileged for an in-camera review. After reviewing the documents, the circuit court judge agreed with SIHS that all of the documents were privileged, with the exception of those documents contained in “Group Exhibit B,” “Group Exhibit F” and “Group Exhibit J.”

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On Sept. 17, 2009 Crystal McFadden was admitted to Northwestern Memorial Hospital in full-term labor. Her care was managed by a team of resident obstetricians under the direction of the defendant, Dr. Jeffrey Dungan, the supervising attending obstetrician.

During the course of her labor, the residents and nursing staff documented late and variable decelerations on the fetal heart monitor with periods of minimal or undetectable variability, but they described the fetal heart tracings as being reassuring overall.

Around 3 a.m. on Sept. 18, 2009, after McFadden had been trying to push for 1.5 hours, the fetal heart tracings became non-reassuring and the senior obstetrician resident called Dr. Dungan to perform delivery. By then the baby’s head was crowning, so the delivery was accomplished with a vacuum extractor. However, the infant was born with no signs of life. The neonatologist in the delivery room stated that the baby appeared to be hydropic with generalized swelling, ascites (accumulation of fluid in the peritoneal cavity), and pleural effusion.

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Iala Suarez was 24 weeks pregnant when she went to her obstetrician, Dr. Michael Coffey, for a regularly scheduled appointment. During that visit, testing showed that she had protein in her urine and high blood pressure. The next day, she went to the Peace River Medical Center, where she underwent a 24-hour urine test and a blood pressure evaluation. Suarez was discharged. The urine test results came back about 30 minutes later showing that she had preeclampsia.

Preeclampsia is a pregnancy condition considered a complication that comes with high blood pressure and signs of damage to another organ system, often the kidneys.

Over the next several days, Suarez saw Dr. Coffey during this time and went to Peace River Medical Center for an evaluation. She continued to experience high blood pressure, increased protein in her urine and restricted fetal growth. She eventually returned to the hospital where she underwent an emergency Cesarean section.

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Stacy Maxberry attempted a vaginal birth after a Cesarean section birth. This is often referred to as “V-back.” During the delivery, the fetal monitor showed repetitive decelerations, a dangerous sign for the unborn child. The obstetrician in charge of the birth was Dr. Matthew Whitted, who was contacted about the repetitive decelerations showing on the fetal monitor. However, Dr. Whitted did not come to the hospital to look at the fetal monitoring strips. Maxberry was told to continue pushing.

When the fetal heart rate patterns worsened, Dr. Whitted was called again. This time he ordered a Cesarean section, which was done 30 minutes later. Stacy Maxberry’s son was stillborn.

She sued Dr. Whitted claiming that he chose not to call for a timely Cesarean section after the first phone call and chose not to evaluate the fetal monitoring strips more closely. In the hour between the first and second telephone call to Dr. Whitted, Maxberry argued that her unborn baby suffered a fatal hypoxic event. The jury agreed and entered its verdict in favor of Stacy Maxberry for the wrongful death of her unborn child at $1.5 million.

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During Tristan Hamilton’s delivery, his mother was given Pitocin to induce labor. The treating obstetrician instructed attending nurses to give no more than 20 milli-units of Pitocin to allow only four contractions every ten minutes. The nurses did not follow those instructions.

Because of the excessive amount of Pitocin given (hyperstimulation) and numbing effect of the epidural, Tristan’s mother was unable to push, prompting the obstetrician to attempt a forceps delivery. The baby then became stuck in the birth canal and the physician completed the delivery using a vacuum extractor.

At birth, Tristan had Apgar scores that were one at one minute and three at five minutes. He suffered brain damage in the delayed delivery. He is now 8 years old and has severe motor dysfunction and is unable to walk or talk.

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On Sept. 5, 2015, Jaclyn Pena-Prather arrived at Sherman Hospital in Elgin, Ill., for an elective induction of labor. She was more than 41 weeks’ pregnant. She was a patient of Dr. Carol Korzen, who practiced obstetrics and gynecology in Elgin.

After admission, an external monitor was applied, and the fetus was continuously monitored throughout labor. At 2:15 a.m. on Sept. 6, 2015, she received an epidural for pain. At 4:45 a.m., a nurse contacted Dr. Korzen to update her on the patient’s progress. Dr. Korzen was present at 7:20 a.m. Pena-Prather was coached to begin pushing. At 8:21 a.m., the baby, Gianna, was delivered vaginally, weighing 6 lbs., 4 oz.

However, Gianna’s Apgar scores were very low. One minute after birth, Gianna’s score was zero. At 5 minutes, her score was 1. At ten minutes, her score was 3. The umbilical cord was described as “thin and shoe-string-like,” and was coiled seven times. Gianna was diagnosed with hypoxic-ischemic encephalopathy (HIE) and metabolic acidosis.

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During the birth of Jasmyn Finch, the obstetrician, Dr. Claire Bernardin encountered Jasmyne’s shoulder stuck behind her mother’s pelvic bone or sacral promontory. When a shoulder dystocia does occur during the delivery phase, it is considered an emergency. It is a dangerous occurrence that can be overcome with the use of maneuvers, such as the McRoberts maneuver. Jasmyne suffered shoulder dystocia, but with the help of an assistant, Dr. Bernardin delivered Jasmyne. Unfortunately, Jasmyne was born with left brachial plexus injury.

As a result of the brachial plexus injury, Jasmyne, who is now 19, cannot lift her left arm above her shoulder. In addition, her left shoulder is 8 centimeters shorter than her right arm.

The brachial plexus is a network of nerves that runs from the spine, neck and through the shoulders. In childbirth, when the shoulder gets stuck as in Jasmyne’s situation, the nerves can be stretched or torn and permanently disrupted. Some brachial plexus injuries heal without the need of surgery. But in this case, the injury to the right shoulder was permanent and devastating.

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H.D. was admitted to a hospital in labor. The nurses and midwife observed H.D. throughout the night without any notable changes. However, early the next morning, the fetal monitor showed non-reassuring signs of the unborn child. No one consulted an obstetrician or warned a doctor about the non-reassuring signs.

About six hours later, H.D. delivered her son; he was born with the umbilical cord wrapped around his neck three times. The hospital’s resuscitation team was attending to another patient, which resulted in an 8-minute delay in having the child intubated.

As a consequence, the baby suffered severe brain damage. He is now 6 years old and has cerebral palsy, developmental delays and a seizure disorder.

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In a confidential settlement, the parties agreed to $1,250,000 for the unfortunate death of a newborn infant. In this case, before the mother’s scheduled Caesarean section, the mother underwent three transplacental amniocenteses to assess her baby’s lung maturity. The purpose of a transplacental amniocentesis is to compare transplacental with non-placental amniocentesis because of possible complications.

Amniocentesis is a frequently used invasive procedure during a woman’s pregnancy guided by ultrasound to remove a sample of amniotic fluid for testing. The procedure requires specialized medical or assistant training. Amniocentesis is a technique for withdrawing amniotic fluid from the uterine cavity using a needle.

The fluid is then tested in a laboratory to determine the health of the unborn fetus. The fluid is composed mostly of fetal substances including urine and secretions. Many times amniocentesis is done to determine whether there are genetic difficulties or to study the maturity of the unborn fetus’s lung maturity. There are risks involved with the transplacental amniocentesis, which occurred here. There was fetal bleeding from an alleged placental abruption that may have been caused by the amniocentesis procedure.

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