3889 Case Study: Shoulder Dystocia During Childbirth | Harry S. Cohen & Associates

Shoulder Dystocia During Childbirth

Filed under Birth Injury, Shoulder Dystocia

The Haller Case

Ms. Haller was expecting the birth of her first baby. Her prenatal visits went fine, and a few days after her due date, Ms. Haller’s doctor scheduled her for an induction of labor.

Ms. Haller went to the hospital, where she was admitted for labor, and given a dose of Pitocin, a drug given to help start the labor process. Labor continued for several hours, until around 7:00 p.m. whenever Ms. Haller became fully dilated and began pushing. A little after 8:30 p.m., the baby’s head started crowning, and the doctor entered the labor room to complete the delivery. At 8:50 p.m, the nurses and the doctor set everything up for the delivery, and the pediatrician was called to attend the delivery.

Ms. Haller continued to push, and at a little bit after 8:55 p.m., the baby’s head was delivered. However, the baby’s body did not follow, and the doctor diagnosed a shoulder dystocia.

A shoulder dystocia is when the baby’s head delivers but the body does not follow because the baby’s shoulder gets stuck behind the mother’s pubic bone. This is a medical emergency. When a shoulder dystocia is encountered, the doctor is to make sure that certain things do not happen. For example, he is not supposed to pull on the baby’s head to try to pull the baby out, the nurses are not supposed to push on the top of the mother’s stomach to try to push the baby out, and the mother is to stop pushing. Unfortunately in this case, those rules weren’t followed.

Once the shoulder dystocia was encountered, the nurses pressed on the mother’s belly in the wrong place, and then told her to continue to try to push the baby out. At the same time, the doctor began pulling on the baby’s head to try to pull the baby out. In the meantime, the baby’s grandmother, a nurse at the hospital, was watching all of this happen.

Eventually, after a few minutes, the baby was delivered. However, the baby boy suffered a tear to several of the nerves in his brachial plexus. The brachial plexus is a series of nerves that run from the neck down through the shoulder to the arm. These are the nerves that get stretched during the shoulder dystocia, and which can be ripped, torn, or pulled from the neck if the doctor doesn’t perform the right maneuvers. In this case, the baby boy suffered tears in the cervical nerves C6 and C7. After delivery, he was taken home and followed-up with a local doctor who told them that the baby boy had to undergo surgery to try to repair the torn nerves, with a series of seven (7) nerves grafts done. However, he is left with a permanent injury.

A lawsuit was brought against the obstetrician who delivered the baby, as well as the hospital because of the nurses’ actions. On behalf of the mother and baby, we consulted with an obstetrical expert, as well as a pediatric neurologist, a life care planner and an economist. The experts were all able to show that the doctor used excessive traction (pulled too hard) on the baby’s head during delivery, and that the nurses pushed on the mother’s belly and instructed her to push the baby out, when they weren’t supposed to. The experts were all able to show how this led to the permanent lifelong injury.

The doctors and hospital said that they didn’t do anything wrong, and went to the extent to try to hire a biomechanical engineer to say that the baby was hurt by the “endogenous” forces of labor; in other words, that the baby was hurt in the womb. We objected to this as being junk science and that it wasn’t based on good evidence or engineering. We also asked the trial judge to hold what is called a Frye hearing; that is a hearing to determine if the biomechanical engineer’s science was good or not.

The case proceeded to trial and a jury was selected. However, after jury selection, the doctor and hospital agreed to settle the case for a significant settlement.

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