Articles Posted in Labor and Delivery Negligence

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Keyanna Vaughn, the mother of Marcus Crawford Jr., was first admitted to the University of Illinois Hospital in Chicago for induction of labor on Aug. 11, 2009. This was done after test results were revealed during a prenatal visit.

On Aug. 12, 2009, a hospital intern and senior resident attempted vaginal delivery without success. Dr. Meredith Cruz was a maternal/fetal medicine fellow who took over at that time. Dr. Cruz had completed her OB/Gyn residency in June 2009 and had recently begun her maternal/fetal medicine program.

Dr. Cruz diagnosed that the fetus was experiencing shoulder dystocia. Shoulder dystocia is a specific situation arising in labor and delivery when the delivery of the baby’s head occurs, but the anterior shoulder of the baby cannot pass through the birth canal and requires the doctor’s or nurse midwife’s manipulation or maneuver to rotate the baby. In other words, a shoulder dystocia is diagnosed when the baby’s shoulders do not deliver right after the baby’s head is delivered. The baby gets stuck in the birth canal as a result, which can clearly be a very serious dilemma.
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During the delivery of the newborn in this case, the fetal monitor of the fetus indicated non-reassuring signs over the course of several hours, including heart rate abnormalities. In this summary of the case, the baby is Baby Doe. This was a confidential settlement in which the parties were identified as Doe, being the mother of the newborn, Baby Doe and Roe, being the physician, the obstetrician and hospital that were sued.

The mother of Baby Doe experienced uterine tachysystole. Uterine tachysystole is defined as six contractions in a ten-minute period.There have been many studies as to whether more than six contractions over a ten-minute period within the first four hours of labor induction is associated with adverse infant outcomes. However, six more contractions in ten minutes were significantly associated with fetal heart rate decelerations.

A nurse at the Roe hospital notified the treating obstetrician who allegedly reviewed the monitor strips but did not re-examine Baby Doe’s mother.Baby Doe was born in a depressed condition with Apgar scores of 3 at one minute and 6 at five minutes.
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Kimberly Williams went into labor at 20 weeks’ gestation. Full-term gestation is generally 39 weeks. She was admitted to Sinai Grace Hospital where she delivered a stillborn boy at the facility’s labor and delivery unit.

Later, Williams requested a repeat ultrasound. The treating obstetrician, Dr. Charlene Williams, declined to order the test and instead gave Cytotec to deliver the placenta.

The use of Cytotec is used to reduce the risk of stomach ulcers caused by nonsteroidal anti-inflammatory drugs for pregnant women. Significantly, Cytotec may cause abortion, premature birth or birth defects if taken during a pregnancy.
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A federal district court judge in Harrisburg, Penn., has entered a judgment for $42 million to the parents of a Pennsylvania boy left disabled because of brain injuries. In the federal lawsuit, it was alleged that the brain injury was caused by a doctor who used forceps during the delivery process of the child.

The judgment came after a six-day trial in September on claims by a Chambersburg, Penn., couple, Christiana Late and Nathan Armolt. Their 5-year-old son, identified only as D.A. in court documents, understands language but cannot speak, read or write.  He will eventually have to use a motorized wheelchair in order to move about.

The family sued the federal government for errors allegedly made by an obstetrician for Keystone Women’s Health Center, a federally supported facility. Dr. Thomas Orndorf, who was not sued, delivered the child Feb. 21, 2012, at Chambersburg Hospital. Under the law, when a federally financed clinic has been alleged to be negligent causing injury to a patient, the remedy is a claim against the United States under the Federal Torts Claim Act.
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The birth injury to a newborn is perhaps the most heartbreaking injuries that human beings face. The birth of a newborn child is a remarkable event by itself. It comes with the promise of a long and healthy life. However, when an obstetrician, nurse midwife or labor and delivery nurse are negligent, this can cause a birth injury, brain damage or birth trauma. The results are devastating to the baby as well as to the parents and siblings.

In particular, the birth injury to a newborn child who has been injured permanently by the negligence of a labor and delivery team has long-term effects on the mother. In fact, too often mothers are injured during child birth; this may well play a role in their ability to bear more children.

The physical effects on a mother who gives birth to a newborn child coupled with a traumatic labor and delivery injury are easily recognized. The mother may suffer from uterine bleeding, bone fractures and bruising, a uterine rupture that may have been caused by an error in the Cesarean delivery, fissures, infection, pre-eclampsia or eclampsia, uterine hyper-stimulation, vaginal tears or even the wrongful death of the mother. Maternal deaths are much more common than one would expect.
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According to the World Health Organization (WHO), the United States maternal mortality ratio has increased between 1990 and 2013 by 136%. Between 2003 and 2013, there were 7,210 maternal deaths in the U.S., according to the Center for Disease Control’s (CDC) database. The rise in maternal deaths is stunning compared to the rest of the world where the maternal mortality rates have decreased by 45% between 1990 and 2013. Compared to other developed regions of the world, the U.S. is lagging far behind in this area. In developed regions of the world, the maternal mortality ratio was down 38%.

Furthermore, neonatal deaths between 2003 and 2013 numbered 277,886 in the U.S. That number of neonatal deaths compared to Sweden, Iceland and the United Kingdom was significantly higher. The birth trauma injuries for neonates for the year 2004, for example, were 1.1-7.5/1,000 births.

Also alarming is the fact that in the U.S., the likelihood of maternal death in high-poverty areas of the country are twice as high as other areas. The maternal mortality rates per 100,000 live births by race or ethnicity was highest among non-Hispanic black women. The next highest, which was less than half, were of American Indians/Alaska native Americans. In short, African-American women are three times more likely to die from pregnancy-related causes than white women.

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Karla Fountaine received prenatal care from a general practitioner, the defendant Dr. Cheryl Gill. At the time, she was 34 years old. During her pregnancy, she developed gestational diabetes.

When she began bleeding and suffering from increased blood pressure and headache, she was admitted to a hospital but shortly thereafter she was sent home. At 34 weeks gestation, she was readmitted to the hospital with continuing headaches and spiking blood pressure. She passed out in the hospital. An obstetrician delivered her baby.

Fountains suffered brain damage and subsequently died after the birth of her child. She was a former auto worker who had been retraining for another position. She was survived by her husband, an infant son and two other minor children.
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Christina Yarbrough and David Goodpaster brought a medical negligence lawsuit against Northwestern Memorial Hospital (NMH) and Northwestern Medical Faculty Foundation (NMFF) after the premature birth of their daughter, Hayley Joe Goodpaster. This case came to the Illinois Appellate Court by the request of NMH regarding the doctrine of apparent authority in the medical negligence context. The trial court certified a question of law pursuant to Illinois Supreme Court Rule 308.

The question was this: “Can a hospital be held vicariously liable under the doctrine of apparent agency set forth in Gilbert v. Sycamore Mun. Hosp., 156 Ill.2d 511 (Ill. 1993), and its progeny for the acts of the employees of an unrelated, independent clinic that is not a party to the present litigation?”

The case involved Christina Yarbrough, who believed she was pregnant. She went to Erie Family Health Center Inc. (Erie) a federally funded, not-for-profit clinic on Nov. 14, 2005 after searching the Internet for a nearby clinic offering free pregnancy testing. After receiving a positive pregnancy test, healthcare workers at Erie inquired where Yarbrough would receive prenatal care. Yarbrough was advised that if she obtained prenatal care from Erie, she would deliver at NMH and would receive testing and additional care at NMH, including ultrasounds. She was given a pamphlet and a flyer with information regarding scheduling tours and classes at NMH. The plaintiffs in this case alleged that based on her knowledge of NMH’s reputation and the information provided by Erie, Yarbrough believed that if she received prenatal care from Erie, she would be receiving treatment from NMH health care workers.
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Llulin Cruz, 31, was admitted to St. Barnabas Hospital to deliver her first child. The attending obstetrician was Dr. Michael Ihemaguba, who performed a midline episiotomy after he delivered the baby’s head. Dr. Ihemaguba then told Cruz to continue pushing. This resulted in a fourth-degree laceration, which Dr. Ihemaguba then repaired. The next day, Cruz complained of vaginal gas and Dr. Ihemaguba told her this would improve over time.

About 5 months later, Cruz became pregnant with her second child. She consulted midwife Gloria Murray for prenatal care and told her that she had fecal-smelling vaginal discharge. Murray called Dr. Ihemaguba and told him about Cruz’s symptoms. Dr. Ihemaguba instructed Murray to do nothing, but he told her to send Cruz to him after the baby was born.

After the vaginal delivery, which the midwife performed, Cruz was diagnosed as having a rectal-vaginal fistula. Cruz required 13 surgeries during the next 3 years, including an ileostomy and a “pulled down” procedure involving removal of her rectum. Cruz has lost control of her bowel function and is no longer able to engage in sexual relations. As she ages, her medical condition is expected to worsen, necessitating a permanent colostomy.

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Emanuel A. Friedman M.D. introduced the Friedman Curve in 1955. In a recently submitted article written by Michigan lawyers Jesse M. Reiter and Emily G. Thomas, the authors and stalwarts of the Birth Trauma Litigation Group write that the gold standard for assessing the normal and abnormal progress of labor was changed in 2014. The change by the American College of Obstetrics and Gynecology (ACOG) replaced Friedman’s curve with new labor standards.

The purpose of the Friedman Curve was to assess labor progression and to identify whether the mother had a “reduced likelihood of a safe vaginal delivery.”  When there was an abnormal progress of labor, such as when neonatal morbidity and mortality were greatly increased, the analysis called on obstetricians to decide very quickly to rescue the unborn baby.

According to the Friedman papers, an “arrest of dilation” was diagnosed by documenting the lack of dilation progress in the active phase of labor. “Protracted active-phase” dilation was defined to be 1.2 cm per hour or 1.5 cm per hour where there was more than one fetus to be delivered.  According to the paper submitted by attorneys Reiter and Thomas, two vaginal examinations done by the same individuals spaced two hours apart was good enough to make this diagnosis. If the cervix did not dilate according to the maximal slope on Friedman’s curve over two hours, the patient was diagnosed with failure to progress/arrest of labor and delivered by Cesarean delivery. Cesarean delivery was then recommended to avoid neonatal death or catastrophic injury. Many studies over the 60 years showed that the research supported the Friedman Curve.

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