A Michigan woman presented to the hospital at 37 weeks’ gestation with complaints of contractions and abdominal pain. She had a history of cesarean section and was scheduled for a repeat cesarean at 39 weeks.
The woman was seen by the nurses and her obstetrician was consulted by phone. Her cervix was found to be 0.5 cm dilated and the monitor showed irregular contractions and a normal fetal heart rate (FHR). She was given medication to stop the contractions and when she reported her pain level to be 0/10, she was discharged home.
The next night after midnight, the woman returned with further complaints of abdominal pain (9/10) and contractions. The monitor showed that she was contracting and she was admitted to the hospital. Six times over the course of 8 hours, the nurses spoke via phone with the obstetrician, who prescribed 3 doses of pain medication in response to the patient’s complaints of pain. The patient paged the nurses for help throughout the night and also called the obstetrician on his personal cell phone to tell him she was in pain and to ask him to help her. The obstetrician told her an ultrasound would be done and the baby delivered in the morning.
The woman’s pain was mostly nonresponsive to medication and the FHR became non-reassuring at 8 am. Five minutes later, a cesarean was ordered via phone by the obstetrician, who stated he was on his way to the hospital. The surgery was started at 8:52 am by another obstetrician who was at the hospital. The attending obstetrician arrived just after the incision. The fetus was found floating outside the ruptured uterus and was delivered at 8:54 am. He suffered hypoxic ischemic encephalopathy with resulting severe brain damage and was transferred to the neonatal intensive care unit where he received hypothermia and was hospitalized for 84 days. After cooling therapy was completed, the parents were informed that the infant had a 70% chance of cerebral palsy (CP). Feeding tube placement was required and the infant was moved to a long-term care facility and diagnosed with spastic quadriplegic CP. During the child’s first year of life, he required hospitalization for many episodes of aspiration pneumonia, and a tracheostomy was eventually placed. The child can hear but can only see light. He requires assistance with all activities of daily living and will need 24-hour care for the rest of his life.
A lawsuit was filed on behalf of the child and alleged negligence by the obstetrician in delaying the delivery when the patient was in the hospital contracting and had severe abdominal pain. Thus, the uterus was allowed to rupture, which caused the child’s severe brain injury.
The verdict: The case settled for $9 million.