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Improper Elective Birth Induction Leads to Cerebral Palsy

An unfortunate newborn suffered cerebral palsy as the result of negligent labor and delivery at a rural southwest Kansas hospital, resulting in a $4 million settlement. It was yet another birth injury that resulted from an ill-advised elective induction and a poorly trained and inexperienced nurse who did not understand the basic principles of Pitocin use, fetal heart monitoring, or patient evaluation.

Our client’s mother was admitted to the hospital for a questionable induction of labor using Pitocin (oxytocin) at 39 weeks. The Pitocin was ordered before the physician saw or examined the patient. The nurse doubled the dose every 15 minutes, which is highly aggressive and not within the standard of care. The labor did not progress normally. After two and a half hours of Pitocin, the doctor ruptured the membrane and installed an internal uterine pressure catheter.

But he did not evaluate the clinical picture and left too quickly, just before a dramatic decrease in the fetal heart rate. The nurse did not appreciate the abnormalities. Hours later, providers recognized the need for rapid delivery by cesarean section and did so in 13 minutes. The baby – our client – was in critical condition at birth. For some unexplained reason, cord blood gases were not initially obtained. But three hours later, they showed persistent, severe metabolic acidosis, caused by an inadequate flow of oxygenated blood through the placenta to the baby’s brain in the hours before delivery. As a result, our young client sustained a brain injury and severe cerebral palsy.

Vic Bergman and David DeGreeff, along with referring co-counsel Steve Brave, represented the plaintiff. Experts were obtained in obstetrics and gynecology, labor and delivery nursing, neuroradiology, neurology, neonatology, life care planning, and economics.

Negligence was shared by the physician, the nurses, and the hospital. The nurses completely mismanaged the Pitocin, which significantly contributed to the unfortunate outcome. They failed to appreciate the significance of any abnormal findings and report them to the physician. They failed to evaluate the patient correctly. Hospital protocols with regard to the use of Pitocin were confusing and misleading. The hospital failed to provide competent nurses or to validate critically important nursing competencies. The physician abdicated his direct responsibility to the patient, particularly in light of the obviously limited competency of the nurses and his office location just one minute from the mother’s hospital room. He failed to adequately evaluate his patient during the course of the day. His decision to induce labor was questionable, particularly because he did not assess his patient before making the order and did not obtain informed consent.

We alleged that had the nurses timely recognized the fetal abnormalities and called the physician to the bedside, an emergent cesarean section would have been performed at least hours earlier, resulting in a perfectly healthy baby. This was a completely preventable tragedy.

Some of the settlement funds, which came from the physician and the hospital, went to two structured settlements for the child. Recovery was limited because a county employed the hospital and physician, so they were covered by the Kansas Tort Claims Act, which limited damages against each to $500,000 or the amount of liability insurance, whichever is greater. A $5 million policy covered both the hospital and physician. Given the overall ceiling on the recovery of $5 million, we think the settlement was advantageous.

Our Firm will stay committed to representing children and their families who are injured at birth through mismanagement of pregnancy, labor, delivery, and early childhood care.

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