Legal: Did oxytocin cause this brain injury?

A New York woman was admitted to the hospital in 2000 in active labor after her membranes ruptured. She was 5-cm dilated on arrival and at 8 cm an hour later. No further progress occurred over the next hour and the obstetrician ordered oxytocin. The oxytocin was increased twice and after almost an hour, an FHR deceleration to 80 bpm for 11 minutes occurred and the oxytocin was stopped. The FHR returned to normal and the oxytocin was restarted and increased. An hour later the patient began pushing and the FHR showed late decelerations and a hypertonic contraction pattern. After 3 hours of pushing, a sudden drop of the FHR occurred to 60 without recovery and an emergency C/S was done. The infant was profoundly depressed and acidotic and diagnosed with hypoxic encephalopathy. An MRI revealed bilateral brain damage, and the child was subsequently diagnosed with cerebral palsy, spastic quadriparesis, and a seizure disorder.

The woman sued those involved with her delivery and claimed the oxytocin should not have been continued in the face of repeated late decelerations and that its misuse caused hypertonic contractions. She maintained the contractions were adequate and oxytocin was not necessary.

The defense claimed there was adequate recovery and a return to baseline, which justified the continuation of oxytocin and also contended that there was good FHR variability, indicating no compromise to the baby. A pre-trial settlement was ultimately reached for $3 million with the obstetrician and his group.