Articles Posted in Shoulder Dystocia

This Supreme Court case comes from an appeal twice to the appellate court and originally from the Circuit Court of Adams County, Ill. The issue was “whether the ruling of the appellate court, 2016 IL App (4th) 150843, reversing the judgment and remanding this case for a new trial requires a trial de novo on all claims.” The first appellate court decision answered this question in the affirmative. The Illinois Supreme Court granted motions by the Illinois Association of Defense Trial Counsel to file an amicus curiae brief in support of defendant and the Illinois Trial Lawyers’ Association (ITLA) to file an amicus curiae brief in support of plaintiff’s position.

Because the resolution of the appeal concerned a narrow-certified question, the Illinois Supreme Court summarized the facts pertinent to making its decision.

In August 2015, plaintiffs Kristopher Crim and Teri Crim, acting on behalf of their biological son, Collin Crim, who was born on June 17, 2005, filed a fourth amended medical malpractice claim against the defendant, Gina Dietrich, D.O., alleging two claims: (1) Defendant failed to obtain Teri’s informed consent to perform a natural birth despite possible risks associated with Collin’s large size, and (2) defendant negligently delivered Collin, causing him injuries. The allegations supporting the informed consent claim are found in paragraph (a) through (j) of plaintiffs’ fourth amended complaint, while sub-paragraphs (k) and (l) concern the allegations related to professional negligence during the delivery of the child.
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During the delivery of Baby Doe, a shoulder dystocia was encountered. That is the medical condition in which a fetus in labor and delivery has a shoulder caught on the pelvis of the mother. An obstetrician in this case performed maneuvers to try to resolve the dystocia.

However, Doe suffered a severe brachial plexus injury that necessitated surgery to repair the nerve avulsion. Brachial plexus injury to the child is the result of the push and tug that often takes place in a should dystocia situation during delivery. The baby’s shoulder and arm nerves are stretched such that permanent damage often occurs to the child’s arm.

Unfortunately, the surgery in this case was unsuccessful. Doe now has partially lost the use of his right arm and hand.
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The Supreme Court of Iowa affirmed the judgment of the district court dismissing the plaintiff’s medical malpractice claims against the medical provider defendants, holding that there was no reversible error.

The child involved in this case is identified as T.D., who was born Aug. 31, 2007 at the Henry County Health Center. Dr. James Widner, employed by Family Medicine of Mt. Pleasant P.C., was the physician in charge of T.D.’s prenatal care and delivery.

During labor and delivery, the child’s shoulder became stuck on his mother’s pelvis. The defendant physicians and nurses performed maneuvers to resolve the stuck shoulder. However, the plaintiff child T.D. was born with a permanent nerve injury, brachial plexus, preventing the normal use and function of the child’s left arm. Shoulder dystocia is a birth injury that occurs in cases just like this, when the baby’s shoulder gets stuck inside the mother’s pelvis. This condition is a medical emergency because the infant’s delay in birth may cause severe brain damage or death if not resolved in six minutes or less. Dr. Widner and the nurses performed maneuvers that resolved the shoulder dystocia in one minute and ten seconds. However, T.D. was born with a permanent injury to his left shoulder and arm, a nerve injury referred to as a brachial plexus that prevents normal use and function of his arm. T.D.’s delivery was captured on a 21-minute birth video recorded by T.D.’s aunt.
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Zoila Fuentes Medina was admitted to the Brooklyn Hospital Center to deliver her baby. During her prenatal treatment at the hospital’s high-risk clinic, concerns were raised about possible macrosomia. Macrosomia is a condition in which a fetus has a predicted birth weight of more than 8 lbs. 13 oz. Suspected fetal macrosomia is not an indication for induction of labor. Induction in a macrosomia condition does not improve maternal or fetal outcomes.

A sonogram taken before her admission revealed that her baby was above the 90th percentile in size. First-year resident Dr. Patrick Ellis attended to the delivery under the supervision of on-call physician Dr. Yves Richard Jean-Gills.

Medina’s baby became caught on her pubic bone when delivery was attempted. Dr. Ellis applied extreme force to the baby’s head and neck. As a result, the baby suffered a brachial plexus injury that resulted in permanent Erb’s palsy.
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On July 8, 2003, Madison Drake was delivered by obstetrician Dr. Timothy Durkee at Swedish American Hospital in Rockford, Ill. During the vaginal delivery of this newborn, a shoulder dystocia was encountered. Essentially that means that the baby’s shoulder was caught or stuck on the mother’s pubic bone. Dr. Durkee used the McRoberts maneuver with suprapubic pressure to finish the delivery of the baby.

Madison’s mother, Nicole Drake, consented to vaginal delivery, but claimed that she requested a C-section several times during her labor.

Madison suffered a left humerus fracture, brachial plexus injury, and a mild hypoxic brain injury that left baby Madison with cognitive deficits and executive function impairment. The brachial plexus injury would most likely have been caused by the effort to dislodge the baby’s shoulder that was stuck on the mother’s pubic bone.
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In this confidential settlement, during the delivery of Baby Doe, a shoulder dystocia occurred. The attending physician, Dr. Roe, released the impacted shoulder and delivered Baby Doe, who suffered a right brachial plexus injury. The brachial plexus injury required nerve graft surgery.

In spite of the surgery to correct the brachial plexus injury, Baby Doe now has a paralyzed right arm, shoulder and hand. Baby Doe’s mother suffered vaginal injuries as well during the delivery.

Baby Doe and her parents filed a lawsuit against the obstetrician, Dr. Roe, and the hospital that delivered Baby Doe, alleging that they chose not to properly handle the shoulder dystocia and safely delivery the baby. The Doe family claimed that Dr. Roe had encountered shoulder dystocia during the delivery of Baby Doe’s older sibling, but chose not to alert the Doe parents about this or the need for a Cesarean section delivery for future pregnancies.
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On June 6, 2006, the newborn baby, America Camacho, was delivered by the defendant obstetrician, Dr. Sonya Thomas, at Norwegian American Hospital in Chicago. Baby America weighed 10.5 pounds at birth. A medical negligence lawsuit was filed against Dr. Thomas and Norwegian American Hospital. The family of America maintained that Dr. Thomas chose not to review a June 1, 2006 prenatal ultrasound report, negligently chose not to suspect fetal macrosomia based on the ratio of the fetal head circumference to abdominal circumference, and relied solely upon the estimated fetal weight measurement of just under 8 pounds before the vaginal delivery.

Fetal macrosomia is a medical term used to describe a newborn whose size at birth is significantly larger than average. A baby diagnosed with fetal macrosomia will have a birth weight of more than 8 pounds, 13 ounces (4000 grams).

Fetal macrosomia poses health risks for the baby and the mother. One of the most common dangers to the unborn fetus is injury to the baby’s shoulder or injury to the important nerves in the baby’s shoulder area that control movement and arm function.
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Beatriz Escobar received prenatal care from the defendant obstetrician, Dr. Daniel Rostein. She was admitted to MacNeal Hospital for induction of labor at 38 weeks gestation on the afternoon of Oct. 3, 2005.

On admission, she was given Pitocin at progressively increased dosages throughout the evening. After fetal monitor strips indicated possible fetal complications around midnight, Dr. Rostein, who was not at the hospital, ordered preparations for a Cesarean section delivery.

Once Dr. Rostein arrived at the hospital and evaluated Escobar, he found no fetal concerns and decided to proceed with the original plan for a vaginal delivery.

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During the delivery of Gwendolyn E., her shoulder became stuck or she encountered shoulder dystocia. Shoulder dystocia is a term used when the baby’s shoulder gets stuck behind the pelvic bone of the mother during delivery. Because of the shoulder dystocia involving Gwendolyn’s delivery, the attending obstetrician, Dr. Miguel Carbonell, applied traction.

As a result of the traction, Gwendolyn suffered a brachial plexus injury, which required many surgeries. She is now 6 years old but has limited use of her left hand because of the nerve injuries to the brachial plexus. The brachial plexus is a network of nerves that runs from the spine to the neck to the shoulders. During a shoulder dystocia delivery, the baby can have those nerves stretched or torn, which results in very serious mobility injuries to the shoulder, arms and hands.

Gwendolyn’s mother filed a lawsuit against Dr. Carbonell and the employer, Associates for Women’s Health of Southern Oregon, alleging use of excessive traction.

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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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