3807 Case Study: Failure to Perform C-Section (Stillborn) | Harry S. Cohen & Associates

Failure to Perform C-Section (Stillborn)

Filed under Stillbirth

The Thomas Case

Rose Thomas, then aged 30-years, was pregnant with her fourth child. Her estimated date of confinement was January 12.

On December 23, at thirty-seven and one-seventh (37-1/7) weeks gestation, Mrs. Thomas notified her obstetrician that she experienced decreased fetal movement. The obstetrician, over the telephone, ordered Mrs. Thomas to go to ABC Hospital for testing.

Following his orders, Mrs. Thomas went directly to the hospital where a non-stress test was performed and determined by a nurse to be reactive. A biophysical profile was also performed that demonstrated a score of four out of eight (4/8), which should have required immediate follow-up. Nonetheless, after the obstetrician was notified of the biophysical profile result, he inexplicably gave instructions to discharge Mrs. Thomas to home. The discharge instructions were that Mrs. Thomas was to call him if decreased fetal movement occurred (which is precisely the reason she was sent to the hospital in the first place).

Four days later, on December 27, Mrs. Thomas took her oldest daughter to the emergency department at XYZ Hospital because of her daughter’s nausea and vomiting. During the visit, Mrs. Thomas advised the hospital staff that she was experiencing abdominal cramping and that she could possibly be in labor. Mrs. Thomas was then examined by the emergency room physician who also telephoned the obstetrician to advise him of the situation. Nevertheless, after emergency room physician’s exam and phone conversation with the obstetrician, Mrs. Thomas was discharged home, advised to follow up with her obstetrician as needed, and advised to go to XYZ Hospital if she believes that she is in active labor.

Three days later, on December 30, Mrs. Thomas followed-up for a regularly scheduled appointment with her obstetrician at his office. At that time, Mrs. Thomas was noted to be having what appeared to be labor pains, and on exam, was fully dilated. Thereafter, in the obstetrician’s office, the infant, Jody Ann Thomas, was delivered without any sign of life. The autopsy report concluded that Jody Ann Thomas died sometime within the preceding forty-eight (48) hours and that the baby had no congenital deformity or intrauterine infection.

On behalf of the stillborn’s estate, suit was brought against the obstetrician, ABC Hospital and the emergency room physician.

The obstetrician was grossly negligent by failing to examine Mrs. Thomas after her December 23 non-stress test and biophysical profile; failing to respond appropriately to a biophysical profile which should have compelled immediate follow-up; failing to appreciate the emergency nature presented by Mrs. Thomas; and by failing to timely deliver infant.

When questioned in his deposition how he could make such an obvious error, the obstetrician testified that it would be typical for him to have 85 patients per day, deliver over 400 babies per year, and perform between 450 and 500 surgeries per year. He also testified that this unacceptable number of patients he was treating was essentially forced upon him by his employer, ABC Hospital, and that the hospital failed to provide any backup and/or any reliable backup. Furthermore, he testified that he raised these issues to the attention of his superiors at the hospital without ever receiving a response.

The emergency room physician was negligent for failing to appreciate the emergency nature presented by Mrs. Thomas on December 27. The proper care would have been to admit Mrs. Thomas to XYZ Hospital or direct her to ABC Hospital for further testing and evaluation. Instead, he discharged Mrs. Thomas to home assuming that she was faking labor in an attempt to have her daughter treated expeditiously.

The case was settled prior to trial for a substantial amount.

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