Brain damage in premature twin
A 35-year-old Michigan woman pregnant with twins presented to the hospital at 33 weeks’ gestation. She was found to have high blood pressure and proteinuria, and was admitted for delivery. The twins were delivered via cesarean and because of their prematurity and low birth weight, were admitted to the neonatal intensive care unit (NICU). Twin A started breathing rapidly and was placed on oxygen with continuous positive airway pressure (CPAP) therapy. He continued to have breathing problems over the next 2 days and then suffered a collapsed lung and was intubated. He required a chest tube and was hospitalized for 36 days. His brain imaging was initially normal, but on discharge some brain injury was seen on imaging. The child now suffers from brain damage, hypotonic non-spastic cerebral palsy, developmental delays, cognitive deficits, and hearing loss.
The patient sued those involved with the delivery, and alleged the brain damage was due to lack of oxygen. They contended that the nasal cannula CPAP was set too high, and air in the chest was not recognized in a timely manner, resulting in the collapsed lung, decreased oxygen, slow heart rate, and low blood pressure. They further argued that the intubation was misplaced and not done timely, causing more injury.
The defense asserted that the infant’s injuries were due to the maternal preeclampsia that necessitated early delivery and wererelated to prematurity as well as twin-twin transfer syndrome and probably genetics.
The parties reached a settlement agreement in the amount of $4.35 million.
Unrecognized shoulder dystocia results in Erb’s palsy
In 2004, a New Jersey obstetrician performed a delivery in which a terminal bradycardia was encountered. He chose to use a vacuum to deliver the infant in an effort to avoid asphyxia and brain damage. The infant was acidotic and was resuscitated, but subsequently diagnosed with Erb’s palsy, and has permanent brachial plexus injury with limited function of the shoulder, arm, and hand.
In the lawsuit that followed it was alleged the physician failed to recognize or record that the delivery was complicated by a shoulder dystocia, and that he applied too much traction to the fetal head as he attempted to expedite the delivery.
The jury returned a verdict in favor of the child and awarded $1 million.
Alleged failure to treat near-fatal sepsis
A 33-year-old Texas woman developed an increased temperature following delivery. She was given acetaminophen and the temperature returned to normal. She complained of postpartum pain and required narcotic pain medications. The obstetrician discharged the patient the next day. She then developed severe pain that worsened, returned to the hospital the next day and was admitted with a diagnosis of sepsis of uncertain origin. The woman was subsequently found to have a group A streptococcal infection. She underwent a course of intravenous antibiotics and was later transferred to a major hospital. A tracheotomy was performed and she was placed on a ventilator. Multiple chest tubes were also placed and she spent several days in the intensive care unit and remained on a ventilator during a 2-week hospital stay.
The patient sued those involved with her postpartum care and alleged that they failed to treat her infection in a timely manner. She contended that the physician should have ordered an infection work-up on her in the hours after delivery when she complained of severe pain and had spikes in temperature. She alleged she was in severe pain even when discharged, and that she continues to experience fatigue and decreased stamina. She also claimed the chest tubes left scars. She stated that she missed bonding with her son as a newborn.
The defense argued the patient’s clinical picture did not warrant an infection work-up, that Group A strep infection is exceedingly rare and that, in this case, the infection did not have a pelvic or obstetrical source and probably originated in the lungs.
The jury returned a defense verdict.