Hospitals May be Held Liable for Negligence In Birth Injury Labor Induction Cases

Often an obstetrician will order levels of medicine to induce labor and the medication may lead to obstetrical malpractice. A treating obstetrician may be found to be negligent by prescribing doses of labor induction medication, such as oxytocin, that may induce or augment labor, but may lead to serious birth injuries to the unborn fetus.  Oxytocin is a natural hormone found in humans, but the synthetic version is prescribed to help with contractions in the second and third stages of labor.

The use of what are known as high-alert or off-label medications to ripen the cervix or induce and augment labor can result in the mother’s contractions being too strong or too frequent or even too long, which may cause serious and permanent damage to the fetus. 

Accordingly, medical professionals in labor and delivery should be clear on understanding uterine activity and its effect on the fetus’s ability to be oxygenated. In addition, as is usually the case, the fetus’s heart rate must be monitored.

The potential for harm to the unborn fetus is great. If the blood flow caused by excessive uterine activity reaches a critical level, the fetus may become hypoxic, acidotic and ultimately can suffer asphyxia if the condition lasts for an extended period of time. Hypoxia is the lack of sufficient oxygen in the body.  Acidosis is the condition diagnosed by what is found in the blood when the body is lacking sufficient oxygen for an extended time.  There are different types of acidosis, such as metabolic acidosis, which is the condition in which the body produces too much acid.

Uterine contractions are something that a clinicians count by their number, their duration of each contraction and the relaxation time in between.

If a mother were hyperstimulated by labor-inducing drugs, the frequency of contractions to define that condition has varied from 5 or more contractions in 10 minutes to more than 5 contractions in 10 minutes or 6 or more contractions in 10 minutes or more than 5 contractions in 10 minutes averaged over a 30-minute time period. Uterine tachysystole is a condition in which the mother experiences excessively frequent uterine contractions during the pregnancy.  Generally, uterine tachysystole occurs when contractions take place more frequently than once every two minutes.

The important issue here is that the medical professionals taking care of the expectant mother must be aware of excessive uterine activity. Problems associated with excessive uterine activity include periods of absent and minimal variability, fewer accelerations and more and late recurrent decelerations. 

When there is evidence of excessive uterine activity, there may be an immediate need to intervene. Obstetric professionals are aware that delay in taking readings to monitor fetal heart rate patterns could lead to serious injury to the fetus. 

Hospitals may be held liable for birth injuries to the mother and child because of hyperstimulation drugs used to induce labor. 

In a state supreme court case, the corporate hospital was found to be specifically liable for negligence because it was unable to uphold the proper standard of care to the patient to ensure the patient’s safety and well-being.  In that state supreme court case, it was held that the hospital had a nondelegable duty owed to the patient, which included a duty to use reasonable care in the maintenance of the facilities and equipment; a duty to select and retain only competent physicians; a duty to oversee all people who practice medicine within its confines as to patient care; and a duty to formulate, adopt and enforce adequate rules and policies to ensure quality care to patients. Thompson v. Mason Hospital, 591 A. 2d 703 (Pa. 1991).

In Illinois, it has been held that a hospital has an affirmative duty to act and protect patients when the likelihood of some type of harm is sufficiently foreseeable that a reasonable hospital can anticipate a risk of injury.  Kus v. Sherman Hospital, 268 Ill. App. 3d 771 (Appellate Court of Illinois, Second Dist., Jan. 5, 1995).

There are several drugs that are administered in hospitals to induce labor. The most commonly known drug is oxytocin, which is also marketed as Pitocin. Pitocin or oxytocin has been listed by the Institute for Safe Medication Practices as a “high-alert” drug. That means that it can be misused in such a subtle way that it can cause intrapartum asphyxia to the unborn fetus.  Oxytocin increases the risk of excessive uterine activity and can also impair the blood flow to the fetus. All of this is a risk that the standard of care requires must be carefully monitored. Accordingly, many hospitals and departments of obstetrics have developed standards, policies and guidelines for the use of oxytocin in labor and delivery. Those guidelines usually detail the need for informed personnel to understand the adverse effects of the use of these high-alert drugs.

Most times the dispensing of labor-inducing drugs is done by nurses, residents, midwives and doctors. The hospital may be liable in the case where procedures are not in place that would safeguard the fetus and mother in labor and delivery. 

Kreisman Law Offices has been handling birth injury cases for individuals and families who have been harmed, injured or died as a result of the carelessness or negligence of a medical provider for more than 38 years in and around Chicago, Cook County and its surrounding areas, including Chicago (Bridgeport, Canaryville, Lincoln Park, Gold Coast, Chinatown, Little Italy), Bridgeview, Bartlett, Bensenville, Crestwood, Crete, Downers Grove, Elk Grove Village, Frankfurt, Gurnee and Lincolnshire, Ill.

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