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Uterine Rupture Leaves Baby Catastrophically Injured Tragic Example of the Danger of Vaginal Birth after Previous Cesarean Section and Use of Oxytocin. Two Kansas City area obstetricians, their professional corporation, and a Kansas City Metropolitan hospital, recently settled the claims of Trevor (last name withheld), age three and a half, and his parents, for a total of $6,400,000. $3,400,000 was paid on behalf of the obstetricians and their professional corporation, and $3,000,000 on behalf of the hospital. Victor Bergman and Steve Six handled the case on behalf of Trevor and his family. This was the second pregnancy for Trevor's mother, whose first pregnancy resulted in a cesarean section for failure to progress. The mother testified that when she became pregnant again with Trevor, she strongly desired to have a repeat cesarean section, but defendant obstetrician #1 pushed hard in favor of a vaginal delivery after cesarean birth (VBAC), advising that a cesarean section could not be done unless there was a specific medical justification, which there was not. The pregnancy proceeded uneventfully until the mother's water broke and irregular contractions began in the early morning hours of April 5, 1995, when she was advised to go to the hospital. Obstetrician #1 ordered pitocin (oxytocin), which was started at 10:15 a.m., in an attempt to augment the progress of labor. The order to the nurse was to increase the pitocin slowly "until an adequate labor pattern is established." Obstetrician #1 made arrangements for a partner to see the mother between 11:00 a.m. and noon to install an internal uterine pressure catheter but he failed to appear. The internal monitor is the only way to determine the true duration, frequency, strength, and tone of the uterus and its contractions. In a woman with a scarred uterus from a previous cesarean section, such internal monitoring is important to avoid hyperstimulation and hypertonicity of the uterus, both of which increase the risk for rupture of the uterus and injury to the mother and/or fetus. As the labor progressed, and the nurse increased the amount of pitocin, the external uterine contraction monitoring was suggestive of hyperstimulation, but this went unappreciated by the nurse. |
Welcome The passage from the womb to the world is a perilous journey, fraught with risks and hazards. We entrust ourselves and our loved ones to the care of physicians and hospitals who, with their special expertise, assume the responsibility to make the passage as comfortable and safe as possible. When medical mismanagement occurs the consequences can be catastrophic injury that kills or permanently disables mother or child. For more than twenty years our firm has had the opportunity to investigate, evaluate, and pursue scores of these tragic cases. This issue of the Newsletter is devoted to the many wonderful parents and beautiful children who we have represented on the complex battlefield of birth injury litigation. In This Issue
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