Missed Signs Of Fetal Distress Lead To Medical Malpractice Settlements
Serious complications can occur after a pregnant woman goes into labor and before her baby is delivered
. Physicians are responsible for monitoring the labor process. They also have the responsibility of being able to recognize signs that a complication has arisen that can pose a risk to the health of the unborn baby. And they have the responsibility of taking appropriate, timely action. When they fail to do so, as when a physician stubbornly takes the position that the labor process is proceeding normally and that the unborn baby is doing well even in the face of data clearly showing otherwise, the result can be a child with a permanent disability - a disability that could have been prevented.
Consider the following cases:
Case 1:
In this case a pregnant woman was admitted to the hospital already in active labor. Over the course of the next nine hours the nurse noted that the tracing from the fetal heart rate monitor was reactive and reassuring. Then the unborn baby's heart rate began to climb. It actually reached the 170-180 bpm (beats per minute) range and yet the obstetrician steadfastly held that this was normal and that there was no need for any emergency action. The obstetrician eventually performed a vaginal delivery.
After the delivery the baby is transferred to NICU. While there he is in prolonged initial depression and experiences respiratory distress. Testing reveals that he has bleeding in the brain with an accumulation of blood under the scalp. Within days an MRI shows that the baby has brain damage. The type of brain damage is consistent with the loss of oxygen prior to birth, a situation that would account for the extreme fetal distress noted in the fetal heart rate monitor. A few days later he began having seizures. As the baby grew it became clear that he has serious difficulty with speech, and he has problems with motor control. The law firm that handled this case reported that they were able to obtain a settlement on behalf of the child and his family in the amount of $1 million.
Case 2:
A hospital admitted a woman who had undergone a C-section in a previous pregnancy and was now in the 41st week of her current pregnancy. After she was admitted the nurse recorded that the woman had a normal ultrasound BPP and a non-reactive non-stress test. The nurse also noted that the fetal heart rate monitor indicated that the baseline for the unborn baby's heart rate was in the 160's. The notes from the nurse indicated that, in discussion with the midwife and with the obstetrician, a vaginal delivery was planned. This is known as a VBAC and carries with it certain risks. The obstetrician's notes indicate that at one point the baby's heart rate went down to the 70's with a contraction. On examination of the woman's cervix the obstetrician decided that delivery was not imminent and applied a gel to induced labor. According to the nurse's notes after the application of the gel the woman began having mild irregular contractions.
The obstetrician then also noted intermittent late decelerations. Three and a half hours after her admission, the obstetrician transferred care to another physician who, having reviewed the fetal heart rate tracings, recommended that the mother be closely watched. Two and a half hours later there was a deceleration to 70-90s that lasted for 10 minutes. Yet it took fifty-seven minutes before the physician delivered the baby via a C-section. The child suffers from physical and neurological deficits. She requires occupations, physical and speech therapy. The law firm that handled this matter reported a settlement of $900,000.
These two cases show how doctors can completely blind themselves to the presence of signs indicating the presence of a serious complication during labor. In the first case, the obstetrician held on to the position that the unborn baby's heart rate tracings were normal even when they clearly exhibited tachycardia, a condition that indicates the baby is in severe distress. So the obstetrician never deviated from the planned vaginal delivery.
The first doctor in the second case decided on a course of action early on and from that point forward new developments could not change his view. The doctor that took over, however, knew about the high heart rate early after admission, the drop into the 70's range, and the intermittent late decelerations, and so recommended that the woman be closely watched. It then took a drop of the fetal heart rate into the 70's-90's range for a full ten minutes before the nurse notified the doctor and it then took the doctor almost another hour to perform the C-section.
Two of the three doctors acted as though they were treating a woman with a perfectly normal labor. The suspicion of second doctor in the second case that something might be wrong appears to have been raised when he took over the woman's care. Yet he allowed a delay in performing the emergency C-section. All the signs necessary to recognize that the baby was in fetal distress and needed immediate attention were there, right in front of them. It is difficult to say whether these doctors learned anything from their mistakes so that they do not make them again with another child in the future. Once a doctor has made a mistake that permanently harms a child, an experienced birth injury attorney, however, can help the family achieve a recovery that protects the child's future.
by: Joseph Hernandez
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