Legal: Failure to timely inform physician of changes on FHR strip

May 1, 2008

Failure to timely inform physician of changes on FHR strip

In 2001, a 19-year-old Minnesota woman was admitted for induction of labor at 36 and 6/7 weeks in her first pregnancy. There were no problems so the obstetrician went home, and was 20 minutes away. Around 8:00 PM, the doctor called and was updated on the status of the patient, which included the information that there were no problems with the FHR. Around 10:20 PM, the fetal monitor showed severe, prolonged variable decelerations. The doctor was called, but did not arrive for 50 minutes. An emergency C/S was performed, but despite aggressive resuscitation efforts, the infant developed severe disabilities.

The patient sued and claimed that the doctor was not appropriately available for emergency problems that might arise during labor, in failing to arrange for other physicians to promptly see the patient if he was unavailable, and in failing to promptly come to the hospital after being notified of the FHR. She claimed the hospital was negligent in failing to note changes in the FHR, failing to notify the physician in a timely manner, and failing to take steps to mitigate or reverse the fetal distress pending the physician's arrival.

The obstetrician claimed he was not called at the first sign of difficulty and he came to the hospital as soon as he was called. The doctor also claimed that the change in the FHR was sudden and could not have been anticipated. The hospital asserted that the FHR was reassuring until there was a sudden and unanticipated change and maintained that its employees acted with appropriate speed and actions after the FHR deteriorated. A $2.5 million settlement was reached, with contributions from both the doctor and the hospital.