Birth Injury / Medical Malpractice

Result – $2,500,000

In this birth injury / medical malpractice case, a baby boy suffered catastrophic brain damage and cerebral palsy due to the delayed delivery and inadequate resuscitation which caused birth asphyxia, hypoxic-ischemic encephalopathy (brain injury due to lack of oxygenated blood) and spastic quadriparesis with athetoid features, cerebral palsy (weakness and incoordination of the limbs). The defendant doctor was the mother’s physician throughout the pregnancy. There were three failed induction attempts but ultimately the mother went into labor and presented to defendant Hospital at 1:15 a.m. Fetal heart rate monitoring initially showed a very reassuring fetal heart rate pattern. When the amniotic membrane’s ruptured at 9:00 a.m., moderate meconium (baby’s first bowel movement) with particulate was noted, and there were very frequent uterine contractions and periods of diminished fetal heart rate variability. The defendant doctor inserted an intra-uterine pressure catheter and began amnio-infusions (pushing saline into the uterus in attempts to dilute the particulate meconium which places the baby at risk for aspiration). The hospital nurses did not monitor the amnio-infusions nor make attempts to improve the fetal heart rate by changing maternal position, providing oxygen, or giving IV fluids. As the labor progressed, the fetal heart rate monitor showed worsening deep decelerations that persisted through the second (pushing) stage of labor and variability was lost, but the parents were never informed of the non-reassuring fetal information. The defendant doctor did not make any efforts to expedite delivery or convert to a C-section.

At delivery, the baby was limp and blue with no respiratory effort. He was a large baby, weighing almost 10 pounds. No cord blood was obtained, so the level of his acidosis can only be calculated in retrospect. He had a heart rate over 100, and his one-minute Apgar scores were 2, 5, and 6. Since non of the hospital nurses were trained to intubate babies and they had failed to have a neonatologist present at delivery, the anesthesiologist was called, who arrived and intubated the baby at 10 minutes of life to provide endotracheal suctioning. When suctioned, 1-2 cc of greenish meconium was aspirated and the baby was reintubated. The neonatologist was called by the anesthesiologist at 19 minutes of life, and did not arrive for another 35 minutes.

After his birth, the baby was critically injured with severe diffuse hypoxic-ischemic encephalopathy (HIE). He continued on the ventilator and remained unstable with seizures with a markedly abnormal EEG. Early CT scans showed diffuse edema. A brain MRI/MRA revealed diffuse areas of ischemia, small subdural and subarachnoid hemorrhages, and bilateral cerebral swelling. He also had evidence of liver and renal dysfunction from the HIE. The parents were told that the prognosis from his massive brain injury was dismal and he would soon die. However, the baby did not die. He stopped having seizures and became more responsive to his surroundings, turning toward his parents’ voices and reaching to them. He demonstrated a will to survive, so the parents began to feed him through the nasogastric tube, then with a bottle. He gained weight and in three weeks they began arrangements to get him involved with therapists and developmental specialists.

This baby boy defied the early predictions, but is now severely developmentally delayed with spastic quadriplegia with athetoid features. He has cerebral palsy. He has low trunk tone such that he cannot even sit up unassisted, but he also has excessive extremity tone, right worse than left, making his arms and legs rigid and unable to coordinate movements. At two-and-three-quarter years old, he could scoot himself forward on his belly, but he could not crawl on his hands and knees, nor walk. He is microcephalic (small head size) because his injured brain has not grown normally. Though visually impaired, he recognizes his parents. He can follow some simple commands, but can say no words. He can eat soft foods orally and drink from a bottle, but cannot eat regular textured foods, nor feed himself. He requires no ventilatory support and breathes unassisted. The resources obtained in settlement will assist this baby and his family in obtaining specialized health care to meet his challenging needs.