Late Recognition of Fetal Distress Resulting in Baby’s Death

Filed under Birth Injury, Stillbirth

The Doth Case

This was a very sad case of our client coming to the hospital carrying a healthy baby and leaving the hospital following a tragically disastrous delivery which all ended with our client’s baby’s death.

Helen Doth was near term (having carried her baby for almost 40 weeks) when her young obstetrician, a defendant in this case, chose to have Helen deliver her baby via an induction (where medication is given by way of an intravenous feed). Up to that point, Helen’s prenatal course was unremarkable. On the morning of the delivery, Helen came to the hospital as directed and was administered the induction medication, Pitocin. Following that, the first several hours went normally. At some point, the fetal monitor (which is a belt wrapped around Mom’s belly and which records how the fetus is responding to the mother’s contractions) started to demonstrate signs of irregularity, but neither the defendant obstetrician nor the obstetrical nurses recorded this abnormality. The abnormal fetal heart rate would be depicted on the fetal monitor strip (the piece of paper printed out by the fetal monitor) or on a monitor screen typically positioned at the central nurses’ station. It is both the nurses’ and the doctor’s responsibility to record such abnormalities in the patient’s chart or medical record. These abnormalities were, in this instance variable decelerations, which is a form of irregular fetal heart tracing.

There was an attempt at artificial rupture of membranes (ARM) which was not successful but subsequently a spontaneous rupture of membranes (SRM). The labor progressed with more Pitocin infusion and then the defendant obstetrician diagnosed a fetal malpresentation. The baby’s right arm was over the baby’s head. This is called a compound presentation. Unless there is some other problem caused by a compound presentation, it is the standard of care to simply allow the Mom to deliver vaginally; however, the young obstetrician chose to reduce the compound presentation by turning the fetus in the womb. The obstetrician apparently believed that she had done the reduction without complication; however, she should have observed Mom and the fetal heart rate even more closely than usual following this reduction to assure that the reduction did not cause any problems. Instead, the obstetrician and the nurses were seemingly oblivious to what followed. The fetal heart rate pattern, as revealed on the fetal monitor strip, became extremely ominous. The fetal heart pattern demonstrated severe fetal distress – the condition where the fetus is not receiving sufficient oxygen. Apparently, the reduction caused a prolapsed cord, where the fetus cannot receive sufficient oxygen. A fetus experiencing severe fetal distress must be delivered emergently via a C-section to avoid the chance of injury or death to the fetus from hypoxia (insufficient oxygen).

The baby’s fetal distress persisted for hours with apparently no recognition by the obstetrician or the obstetrical nurses. Finally, the defendant obstetrician appreciated the fetal distress once it became so severe there was little to no chance of saving the baby from a hypoxic (Insufficient oxygen) insult. The OB ordered a STAT C-section. Upon delivery, the infant was immediately handed to an awaiting pediatrician who began resuscitation along with anesthesia. The female infant was taken to the radiant warmer and noted to have no heart rate and no respiratory effort and no tone. The infant was then transferred via helicopter to a larger hospital’s neonatal intensive care unit (NICU) where she remained on life support until it was discontinued and the baby tragically died four days following the birth. The family came to Harry S. Cohen & Associates shortly after this sad event. Like so many of our clients, this family was far less concerned with recovering money than they were with achieving some small measure of justice. They also wanted to bring this event to the attention of anyone who might be in a position to reduce the chance of a similar event occurring to anyone else.

Every case that we review at Harry S. Cohen & Associates is internally reviewed by our experienced team of lawyers and healthcare providers. No matter how clear we believe any malpractice case is after our internal review, we then have that case reviewed by an eminently qualified physician in the same field as the potential defendant. In this case, our expert OB consultant informed us that this was one of the worse cases of malpractice that he had ever seen. That opinion was apparently confirmed because shortly after we requested records from the offending hospital, we were contacted by the hospital with an offer to negotiate an out-of-court settlement, even before any lawsuit would be filed. This is extremely rare. We believe our track history firm’s history for aggressively and successfully pursuing cases like this led to a settlement at the same dollar level as would have been achieved had we filed suit, taken discovery and done everything else on the case, which typically takes 2 to 3 years.

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Publisher: Harry S. Cohen and Associates, P.C.