Lawsuit filed when second twin presents with cerebral palsy

September 1, 2011

A Pennsylvania woman pregnant with twins went to a hospital for induction of labor at term. Her infant was born, having a seizure 2 hours after birth. He was diagnosed with cerebral palsy and is now fed via tube.

The woman sued those involved with the delivery, claiming that for most of the day the nurses were monitoring only 1 fetal heart rate (FHR), that her contraction pattern was indicative of uterine hyperstimulation, and that the twin who was monitored showed decelerations in the FHR. She claimed that the obstetrician was negligent in arriving too late to deliver the first twin, and she alleged that the second twin's FHR had dropped to about 90 beats per minute and there was negligence in the lack of proper monitoring and failure to timely perform a cesarean delivery.

The obstetrician testified that he had not been informed of the decelerations shown on the fetal monitor and of the mother's rapidly progressing labor. The hospital maintained that the nurses had communicated proper information to the physician, that the injuries to the infant occurred after the physician's arrival, and that the patient's weight of 322 pounds made monitoring twins difficult during the labor and delivery. A $21,573,993 verdict was returned against the hospital only.

In this case more than $19 million was awarded for future medical expenses and will be paid in annuities. The parties had reached a high/low settlement before the jury reached a verdict. Here, the high amount was set at $33 million and the low at $5.75 million. Because the verdict was for the plaintiff, the award will be for the $33 million. Had the verdict been for the defense, the plaintiff would have received $5.75 million. This sometimes serves to curb what might be a huge runaway jury verdict, but it also guarantees the plaintiff some award because she might be giving up a larger amount.

This case also is an example of the scenario of "dueling defendants" in a malpractice case. This situation is very difficult to defend and usually is not one that you would want to put before a jury. Once the jurors see the defendants pointing fingers at one another, they assume that some negligence must have happened or the defendants would not blame each other. In this case, the physician claims the nurses did not inform him of the FHR tracing and the patient's progress, and the nurses claim they did communicate the information. This problematic situation–disagreement about communication between caregivers–can be eliminated by documenting exactly what was communicated to the physician in the medical record, leaving no opportunity for different recollections later during a lawsuit.

Failure to place a cerclage in a timely manner alleged

A MARYLAND WOMAN WENT to a hospital in 2007 after a positive home pregnancy test. She advised the physicians that she had required a cerclage for a diagnosis of incompetent cervix in a prior pregnancy that had resulted in a term delivery. She was told that she was about 7- 2/7 weeks' gestation based on ultrasound, and was instructed to follow up with the hospital's clinic for prenatal care. The patient went to the clinic for several visits and had normal laboratory tests. She had another ultrasound at 16 weeks to confirm dates and evaluate the cervix. The ultrasonographer reported cervical funneling and changes consistent with incompetent cervix. No cerclage was placed at that time. After the ultrasound visit the patient was called and told to come to the hospital the following week for placement of the cerclage. When she presented she already was 1 cm dilated with bulging membranes. The cerclage was placed, but she developed an infection which resulted in delivery about 1 week later. The infant died from prematurity and infection. The patient sued the hospital and a $500,000 settlement was reached.