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Case #4051 Failure to Perform a Timely Cesarean Section


On April 9, it is alleged that the Plaintiff presented to the Defendant Hospital at approximately 2:30 a.m., in labor.  By 3:30 a.m., a fetal monitoring device was affixed which produced a strip indicative of fetal stress.  It is further alleged that at the time the Plaintiff presented, she was 41-3/7 weeks pregnant, and was, therefore, postdates.  She also had a history of a postdates pregnancy with a previous Cesarean Section for failure to progress.  It is asserted that these Defendants knew, or by the exercise of due care should have known that the Plaintiff was postdates and therefore her child was vulnerable to the effects of a vaginal birth.  It is asserted that in a postdates pregnancy, the placenta can be aged and incapable of supporting the Infant Plaintiff throughout the stresses of a vaginal birth.  Further, the Defendants knew or by exercise of due care should have known of the previous Cesarean Section and its complications.

Notwithstanding the fact that the Plaintiff was postdates and had a strip which was non-reassuring, these Defendants utilized Pitocin — a drug which artificially augments and strengthens the contractions of labor and the forces brought to bear on the Infant Plaintiff.  Predictably, the Pitocin caused a strengthening of the contractions such that the Plaintiff was over-stimulated with excess force brought to bear on the Infant Plaintiff through the course of a contra-indicated vaginal birth.  By 6:50 a.m., it is alleged that the strip was worsening — showing loss of beat-to-beat variability and significant decelerations which were deepening over time.  Contrary to the standards of care, these Defendants failed to intervene with a judiciously timed Cesarean Section which was required under the circumstances.  In fact, it is alleged that these Defendants negligently increased Pitocin over the course of time rather than performing the Cesarean Section — thereby creating an even more hostile environment for the Plaintiff’s yet unborn baby.

It is asserted that by 1:40 p.m., the fetal monitoring strip revealed serious and ominous decelerations to a level of 90 beats per minute.  However, these Defendants persisted in their negligence by failing to perform a Cesarean Section which was required by the standards of care.  Additionally, these Defendants failed to perform a scalp PH which was required under these circumstances.

It is alleged that these Defendants continued with their negligence by increasing the Pitocin at approximately 4:20 p.m.  By 4:40 p.m., decelerations had deepened even more with the heart rate falling to 60 beats per minute for 120 seconds at a time.  By 5:25 p.m., it is alleged that the Plaintiff was only 6 centimeters dilated.  However, these Defendants persisted in their ongoing and continuing negligence by failing to perform a timely Cesarean Section.

By 6:30 p.m., it is alleged that the Plaintiff had spiked a fever to 101 degrees.  However, these Defendants continued by negligently failing to deliver the child by Cesarean Section.  At 7:35 p.m., the temperature had increased to 102 degrees.

Tragically, these Defendants continued in their negligence by increasing the Pitocin again at 8:00 p.m. with no birth through Cesarean Section.  It is alleged that through the course of these many hours, the strip continued to deteriorate, showing that the Plaintiff’s unborn baby was suffering stress and frank distress due to the ongoing negligent failure to birth the child through a properly timed Cesarean Section.

It is alleged that at 9:30 p.m., these Defendants finally attempted to birth the child vaginally through the use of a vacuum extractor.  When the birth was finally accomplished, the Infant Plaintiff was born with Apgars of 2 and 4.  Further, it is alleged that fetal tachycardia in the range of 190 through 200 was manifested on the fetal monitoring strip.

As the direct and proximate result of the ongoing negligence of these Defendants and each of them, the Infant Plaintiff was made to suffer through a tortuous vaginal birth process during which he lost adequate oxygen to his brain.  Accordingly, he was born severely depressed due to oxygen deprivation and suffered severe and irreversible brain injury as a direct and proximate result.

Upon birth, it is alleged that this baby’s PH was only 7.05, with a base deficit of ‑23.  Further, he had already spiked a white blood count of 17,000 which subsequently increased to 26,000.  He required intubation, and was ultimately transferred to the University of Maryland where a feeding tube was necessary as the Infant Plaintiff had sustained such severe brain injury that he was unable to ingest food in a natural fashion.

It is alleged that due to his brain injury, the Infant Plaintiff has ongoing home health care provided by the staff of an area Pediatric Hospital.  The Infant Plaintiff continues to be tube fed, is being medicated with Phenobarbital for seizures and has microcephaly due to these Defendant’s negligence.

It is alleged that had these Defendants and each of them conformed with the applicable standards of care, a properly timed Cesarean Section would have been performed with a normal and healthy child being born as the result.  However, due to the ongoing negligence of these Defendants in failing to intervene, the Infant Plaintiff has suffered permanent and irreversible brain injury.

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