Legal: Failed vacuum and forceps results in CP

May 1, 2009

Pregnant teenager goes into labor and family practitioner attempts delivery using vacuum extractor.

A 15-YEAR-OLD PREGNANT TEENAGER went into labor at term and was admitted to an Illinois hospital in 2002. She was cared for by a family practitioner who was covering for her physician. He called for an obstetric consult the next morning when she was not progressing, and oxytocin was started. Variable decelerations were noted about 15 minutes later when she began pushing, and when they worsened, the FP attempted delivery using a vacuum extractor. After two attempts, however, he could not move the head down. He then applied forceps, but was unsuccessful. Following profound bradycardia, the nurses called the obstetrician to the delivery room, and an emergency cesarean section was performed 16 minutes after her arrival. The infant had hypoxic ischemic encephalopathy, which resulted in cerebral palsy, spastic quadriplegia, mental retardation, and the need to be fed via a gastrostomy tube.

A lawsuit was filed against the FP, the obstetrician, and the hospital. The hospital argued that the nurses acted properly during the delivery and that it was the FP's responsibility to contact the obstetrician if needed. The FP maintained that the obstetrician wanted a vaginal delivery and left him to accomplish it. The obstetrician claimed she had completed her consultation and the baby was stable when she left. A $25,040,859 verdict was returned against the FP. A defense verdict was returned for the other defendants.

LEGAL PERSPECTIVE The total amount of damages awarded in this case was huge and was entirely assessed against the family practitioner. The defendants, however, had entered into settlement agreements with the plaintiff. Most often, juries are unaware of these agreements and award damages without that knowledge. In this case, the family practitioner had agreed to settle for his $1 million policy limit. The other defendants had entered into high/low agreements with the plaintiff. In this case, the obstetrician entered into a $1 million/$500,000 high/low agreement and since she was found not liable, the $500,000 was contributed on her behalf. The hospital had an $11 million/$4 million high/low agreement and thus contributed the $4 million. As a result, the child was to receive a total of $5.5 million. These agreements can serve to guard against excessive amounts awarded by juries, although there is the chance that a payment will be made even though the defendant is found not liable.