Two Lawrence, Kansas family practice physicians, a labor and delivery nurse, and hospital recently settled the claims of Kaitlyn (last name withheld), age three, for a total of $2,900,000. $1,000,000 each, representing policy limits, was paid on behalf of the family practice physician and the nurse in attendance during the labor, $500,000 was paid by the community hospital (the maximum allowed under the Kansas Tort Claims Act), and $400,000 on behalf of the family practice physician who mismanaged the resuscitation of the severely depressed infant at birth. Vic Bergman and Steve Six handled the case on behalf of Kaitlyn and her family.

This was the second pregnancy for Kaitly's mother, whose first pregnancy resulted in a successful cesarean delivery for failure to progress. Labor began early in the morning of November 13, 1996. The family practice physician (physician #1) saw the mother at 0800, ruptured her membranes revealing a dark, thick amniotic fluid containing meconium, a concerning finding associated with fetal distress. The fetal monitor strip also showed non-reassuring signs which had existed since the mother's admission at 0100. Physician #1 ordered amniofusion, a procedure to dilute the thick fluid, and left.

Several times that morning physician #1 was in the patient's room, but she did not look at the fetal monitor strip, relying instead on the nurse's statements that the fetal monitor strip was reassuring. At their depositions all the healthcare providers agreed the strip contained numerous ominous findings and no reassuring features.

At 1315 and again at 1340, the fetal heart rate dropped into the 60's (see photo on page 3). Physician #1 was occupied with a cesarean section of another patient and unavailable. Physician #2 was at the hospital and was asked by a nurse to stop in to evaluate the labor and immediately called for a cesarean delivery.

At birth, Kaitlyn was lifeless with no spontaneous respirations or detectable heart rate. After suctioning the nose and mouth of thick meconium, the infant was handed to physician #2 who began immediate positive pressure ventilation by bag and mask, with chest compressions done by a nurse. Although the infant exhibited no response to the resuscitation effort, physician #2 continued to bag for four minutes until the pediatirician finally arrived and immediately intubated Kaitlyn who responded with a heart rate in the 100's.

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