subject: Physician Fails To Diagnose Umbilical Cord Compression And Child Experiences Brain Injury [print this page] Physician Fails To Diagnose Umbilical Cord Compression And Child Experiences Brain Injury
Pregnancy carries with it the possibility of complications a number of of which may, if not diagnosed and treated immediately, result in substantial harm to the unborn child and the mother. One such complication, normally referred to as umbilical cord compression, occurs when the umbilical cord comes under pressure. Circumstances under which this happens include when the cord slips into the birth canal and gets compressed as the baby descends, or when the umbilical cords becomes wrapped around the baby's neck . As the pressure on the cord increases, the oxygen essential for the health and even the survival of the baby becomes more and more restricted.
If doctors or nurses find a substantial slowing down of the baby's heart rate they should look at a cord compression as a possible reason. This is specially true if the heart rate slows downs in waves or episodes - a pattern that is known as decelerations. If the baby's heart rate drops too low and does not quickly return to normal immediate action needs to be takes to protect the baby from suffering brain damage or death due to the lack of oxygen. If the compression is not severe then repositioning the mother to lessen pressure on the cord, or giving her oxygen and fluids, may ease the problem. In those situations where these steps do not reduce the pressure on the cord, it may become necessary to perform an emergency C-section.
The inability on the part of a physician or nurse to identify the signs of a cord compression and to immediately take suitable action to resolve the situation or deliver the baby might lead to a medical malpractice claim. In one reported claim, an expectant mother, at full term, showed up at the hospital for the planned delivery of her baby. The staff gave her Pitocin to induce labor. After the drug was given, the fetal heart rate monitor showed multiple umbilical cord compressions as decelerations of the unborn baby's heart rate. The staff repositioned the woman after which the baby's heart rate went back to normal.
Regrettably, when the woman requested to use the bathroom, the obstetrics resident disconnected the fetal heart rate monitor. It was discontinued for 11 minutes. These eleven minutes were vital. The cord became compressed limiting the baby's oxygen supply. The baby was born suffering from asphyxiation with resulting significant mental retardation and cerebral palsy.
The law firm representing the family admitted evidence at trial that, with the history of decelerations, disconnecting the fetal heart rate monitor for those critical eleven minutes was below the acceptable standard of care. Basically, it came with too high a risk that there might be further umbilical cord compressions that would not be discovered and therefore would not, and indeed did not, lead to such curative actions as more position changes and, if required, an emergency C-section that could have kept the child from suffering brain damage. The law firm reported that the jury awarded $15.8 million for the family.
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