Illinois Birth Injury Lawsuit Criticizes Nurses For Chain of Command Breakdown – 9.5 Million Settlement in The Northern Trust Company, et al. v. Ghia, et al.

An Illinois birth injury case involving allegations that a delayed cesarean section resulted in the baby’s cerebral palsy and spastic quadriplegia recently settled for $9.5 million while the trial was underway. The Northern Trust Company, et al. v. Ghia, et al., 04 L 7500.
Like many birth injury lawsuits, the case involved claims that the hospital and obstetrician failed to recognize the baby was in distress and order a c-section in a timely manner. The mother, Alecia Owen, presented to the hospital at 41 weeks pregnant for an induced pregnancy. After being administered Pitocin and an epidural her labor progressed slowly and eventually raised concerns with the hospital’s nursing staff.
Monitoring of the baby’s heart rate was showing intermittent decelerations, which could be a sign of fetal distress. When the obstetrician, Dr. Nirali Ghia, was notified of the decelerations, he ordered an amnioinfusion, a procedure that can help reduce variable decelerations if there is a suspicion of cord compression. However, Dr. Ghia told not one, but several, nurses that the patient did not need a c-section even though the decelerations became more prolonged.

Another hour passed before Owen was taken into delivery, at which point Dr. Ghia still did not order a c-section. Instead, Dr. Ghia first attempted a vacuum delivery and only performed a c-section after the vacuum delivery was unsuccessful. The baby was born with APGARs of zero at one minutes and one at five minutes; an APGAR of seven is considered normal. The baby was eventually diagnosed with cerebral palsy and spastic quadriplegia.
What is interesting about the case is that in addition to being critical of the obstetrician, the complaint also alleged that the nursing staff failed to implement chain of command procedures in order to ensure a prompt delivery. The nursing chain of command refers to the tiers of authority through which orders are passed and decisions made amongst the different departments and units. Every nursing unit should have an established chain of command that sets out who to contact if there are any nursing problems that need immediate attention.
So while traditionally a doctor would have the final say regarding a patient’s care and treatment plan, if a nurse recognizes that something more needs to be done for a patient then he or she can institute the chain of command in order to ensure the patient is receiving the proper care. This typically involves contacting the head or charge nurse, who then contacts a nurse higher up in the chain, such as the Director of Nursing. The nursing chain of command is an additional safeguard that ensure patients are getting appropriate care.
In the present case the plaintiffs were critical that the nurses did not institute the chain of command. Based on the case facts the nurses did recognize that the baby was in distress, as evidenced by their numerous reports to Dr. Ghia of the fetal decelerations. However, the nurses took no further action when Dr. Ghia failed to order the c-section. Therefore, the nurses also shared the responsibility of the delayed c-section; if the nurses had instituted the chain of command there is a chance that Owen would have been delivered earlier.
Both Dr. Ghia and the hospital settled during the trial, with the hospital contributing $7.5 million and the obstetrician $2 million. The $9.5 million settlement has been placed in a structured settlement and is expected to reach an eventual payout of $15.2 million in order to fund the baby’s future medical care.
Kreisman Law Offices has been handling Illinois birth injury lawsuits for over 30 years, serving those areas in and around Cook County, including Barrington, Glenview, Wheaton, and Cicero.
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