Attempted VBAC Causing Brain Damage

Filed under Birth Injury, Cerebral Palsy

The Heffron Case

Case Summary

The minor-Plaintiff was born virtually lifeless and required immediate intubation and resuscitation.​ He suffered neonatal asphyxia, acute neonatal depression secondary to uterine rupture and brain damage. As a result of all of these conditions, he also suffered a severe gastroesophogial reflux disease and was unable to eat, walk or talk independently.​

​​Case Details

​​In the mid – 1990’s, insurers and hospital groups began saving money by strongly encouraging obstetricians to perform fewer C-sections. Vaginal deliveries were thought to be less expensive than C-sections because vaginal deliveries resulted in fewer hospital days. It became routine for hospitals and insurers to track each OB’s “C-section rate.” OB’s became fearful of economic sanction if their C-section rate was too high. This pressure to perform fewer C-sections resulted in obstetricians’ failure to order needed C-sections to avoid a potential brain injury. This phenomenon became worse in the area of what is called a VBAC.

Traditionally, there was an obstetrical rule that said: “once a C-section, always a C-section.” This rule came from the understanding that once a woman had a C-section, she would thereafter be at risk for a uterine rupture if she attempted a vaginal delivery, due to the scarring left by the original C-section. However, in the era of “cost containment” and “managed healthcare,” providers thought they could save money by lowering C-section rates via the VBAC (Vaginal Birth After C-section). OBs were required to counsel their patients to “attempt” a VBAC. Theoretically, a VBAC could be safely converted to a C-section if the vaginal delivery became difficult or in the event of a uterine rupture. Tragically, it was often the case that the emergency C-section which became required during a failed VBAC could not be performed in time to save the baby or avoid a brain injury.

In this case, the mother of the child, Ms. Heffron, was pregnant with her second child. Her first pregnancy had resulted in an emergency cesarean section, which left her with a uterine scar and at risk for uterine rupture in any subsequent vaginal birth.

One week before Ms. Heffron’s due date, her doctor telephoned Ms. Heffron and told her that for personal reasons – he was leaving town, he wanted to deliver the baby via induction (VBAC) that evening. He told her to go to the emergency room at the hospital and tell the Emergency Department that she was in labor and have them admit her. Ms. Heffron did as she was told, and reported having labor pains and she was admitted to the hospital.

The next morning, the doctor came to see Ms. Heffron and administered Pitocin. Pitocin is a drug that is used to induce contractions and progress a mother into labor. The Pitocin did not work and so shortly before noon, Ms. Heffron requested a cesarean section. Around noon, she felt an excruciating pain in her abdomen, and for a second time, she requested a cesarean section. The doctor did not examine her, and a nurse only reported that her water had not broken.

Thirty-five minutes later, the baby experienced a severe low heart rate. Ms. Heffron’s OB came into the room, realized that Ms. Heffron may have just experienced a ruptured uterus and ordered an emergency C-section; but then he inexplicably left the floor. The Defendant doctor was repeatedly paged to report to the OR for the emergency C-section, however, he could not be located. All this time, while Ms. Heffron was waiting to give birth, the baby was exhibiting clear signs of distress.

After a lengthy delay, another doctor, who was uninvolved in the case and who just happened to be eating lunch, was summoned from the lunch room to perform the emergency C-section. The doctor rushed in, and began to perform the C-section and immediately noticed the uterine rupture. The minor-Plaintiff was born virtually lifeless and required immediate intubation and resuscitation. He suffered neonatal asphyxia, acute neonatal depression secondary to uterine rupture and brain damage. As a result of all of these conditions, he also suffered a severe gastroesophogial reflux disease and was unable to eat, walk or talk independently.

Harry S. Cohen & Associates was able to provide some degree of comfort and counseling for the parents in addition to a prompt case review and other legal advice during a very difficult time following the baby’s birth. Eventually, suit was filed in Allegheny County and a long and arduous litigation ensued. Shortly before trial, the case concluded with a multimillion dollar settlement.

After the settlement, Harry S. Cohen & Associates set up a special needs trust for the child. The trust then funded the construction of a totally accessible home for the family so the child will be able to reside there for the entirety of his life. The trust also funds for a lifetime of necessary purchases to make the victim’s life as well as money can, such as the periodic purchase of a van, constant therapies and a lifetime income.

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