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Failure to Perform C-Section (Stillborn) - The McBane Case

Filed under Birth Injury, Stillbirth

The McBane Case

On February 9, Lisa McBane was admitted to ABC Hospital by her treating obstetrician due to a concern over her pregnancy induced hypertension and proteinuria. The purpose of Mrs. McBride’s admission was to monitor her for signs and symptoms of preeeclampsia or HELLP syndrome, which likely would require an emergency Caesarean section.

The first few days were relatively uneventful, until, at approximately, 10:40 p.m. on February 12, Mrs. McBane complained to an obstetrical nurse, of nausea, vomiting, diarrhea, and right upper quadrant pain. Mrs. McBane’s blood pressure also increased to 200/110 and respirations to 28/minute. Significantly, nausea, vomiting, right upper quadrant pain, and high blood pressure are classic signs of severe preeclampsia.

As a result, the obstetrical nurse phoned the obstetrician, who was at home sleeping, and informed him of Mrs. McBane’s condition. However, completely ignoring that Mrs. McBane’s complaints were classic signs for preeclampsia, and further ignoring that preeclampsia was the exact condition that Mrs. McBane was admitted to the hospital to monitor, the obstetrical nurse suggested to the obstetrician that Mrs. McBane was experiencing a gallbladder attack. Further failing to appreciate the situation, the obstetrician accepted the assumption that Mrs. McBane was experiencing a gallbladder attack and prescribed Compazine (to control nausea and vomiting) and a low fat diet. The standard of care however, is clear – the obstetrician should have come to the hospital and performed a Caesarean section.

Later that night, at approximately 2:45 a.m., the nurse again phoned the obstetrician and informed him that Mrs. McBane’s pain had returned and that her blood pressure was, as the obstetrician classified it, “dangerously high” at 221/116. In response, the obstetrician ordered pain medication. Remarkably, both the nurse and the obstetrician again failed to realize that Mrs. McBane’s continuing symptoms, high blood pressure and right upper quadrant pain, were classic signs of preeclampsia.

Still later that night at approximately 3:00 a.m., the obstetrician called the hospital and asked the nurse if there were any other obstetricians available in the hospital to examine Mrs. McBane. The nurse advised that another attending obstetrician was in the hospital. Thereafter, per the treating obstetrician’s advice, the nurse summoned the attending obstetrician (however, as he testified to in his deposition, he was only informed about a possible gallbladder attack and never informed that Mrs. McBane was being monitored for pregnancy induced hypertension and/or preeclampsia).

Shortly before 4:00 a.m., after his examination of Mrs. McBane, the attending obstetrician called the treating obstetrician and advised that Mrs. McBane appeared to have uncontrolled hypertension, superimposed HELLP syndrome, a fetus with non reassuring fetal heart tones, and that this required an emergency Caesarean section.

A decision to perform an emergency Caesarean section was made at 3:51 a.m.; however, the emergency Caesarean section was not performed until almost an hour later. The standard of care requires that an emergency Caesarean section in any American hospital offering obstetrical care be performed within thirty minutes (i.e. “the thirty-minute rule”). The baby, a non-viable female infant, Megan Alexis McBane, was born stillborn.

On behalf of the stillborn’s Estate, suit was brought against the treating obstetrician, ABC Hospital (based on the negligence of the nurse and for failing to be able to perform a C-section within thirty-minutes), and the attending obstetrician.

Shortly before trial, this case settled at a formal Mediation for a substantial amount. It should also be noted that the treating obstetrician was unable to find any obstetrician to defend his actions.