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seven minutes after birth. During that seven minutes, plaintiffs'
evidence was that Trevor was not given chest compressions to circulate
whatever oxygenated blood he might have. The net effect was that
Trevor did not receive adequate oxygen and continued to sustain
neurologic injury as the result of asphyxia.
The theories of liability were quite varied, depending upon the
defendant. Obstetrician #1 failed to obtain an informed consent
for the VBAC. The mother alleged she was not informed of the one
percent risk of uterine rupture, or the fact that up to forty
percent of VBACs fail (resulting in repeat cesarean sections),
or that she had the absolute right to have a VBAC. Moreover, the
mother believes she was mislead and coerced into attempting the
VBAC. Obstetrician #1 also failed to provide an adequate continuity
of care, with her partner not installing the internal monitor
as planned, and her other partner (obstetrician #2) coming into
the situation relatively cold, resulting in significant delay
in recognizing the problem and ordering the cesarean section.
Obstetrician #2 failed to recognize the possibility of a uterine
rupture in a timely way, and delayed calling the cesarean section
for at least eight and possibly up to
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twelve minutes, based upon the expert testimony.
Obste- trician #2 also failed to request the presence of the
appropriate resuscitation team, which was a responsibility that
was shared with the nurse.
The significant allegations of fault against the hospital focused
on the mismanagement of the pitocin by the nurse, and the failure
of the hospital staff to follow their own policy on the presence
of a team of three experienced resuscitators in the delivery room.
As a consequence of the ruptured uterus, fetal extrusion, and
delay in delivery, Trevor was born severely asphyxiated, with
a one minute apgar score of one. As a consequence of the failure
to properly resuscitate Trevor, he remained in an asphyxial state
and sustained ongoing injury after birth, with a five minute apgar
score of one, andten minute apgar score of three.
Trevor has one of the worst combinations of injury we have ever
encountered, with the dominate lesion being in the region of the
basal ganglia of the brain. He has choreoathetoid cerebral palsy
and spastic quadriplegia, meaning that his right and left side
are as though they are on a string, ten minute apgar score of
three.
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Trevor has one of the worst combinations of injury we have ever
encountered, with the dominate lesion being in the region of the
basal ganglia of the brain. He has choreoathetoid cerebral palsy
and spastic quadriplegia, meaning that his right and left side
are as though they are on a string, so that when he moves his
right arm forward his left arm tends to come back in a twisting
motion, and his legs tend to scissor. Trevor is unable to utilize
speech. He will have to learn to communicate using assistive devices.
Trevor appears to have normal intellectual function and cognition.
He is handsome and has a wonderful personality. He is working
extremely hard in therapy to develop control over his head and
some of his muscles, so that he will be able to access communication
and be independently mobile with various technological devices.
Trevor is blessed with intelligent and energetic parents who have
devoted themselves to maximizing all of his potential. But no
matter what anybody does Trevor is going to have to live with
the severe consequences of this tragic case of medical malpractice
for the remainder of his relatively normal life expectancy.
We wish Trevor and his wonderful family the best of everything
as they continue to deal with the aftermath of this terrible tragedy.
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