Birth Injury Due to Failure to Deliver
Lawsuit Against Johns Hopkins Hospital | September 18, 2020
On September 18, 2020, WVFK&N attorneys Christopher Norman and Brian Cathell filed a medical malpractice claim on behalf of a minor child who suffered a brain injury due to a failure to deliver in the face of non-reassuring fetal heart rate tracings.
The complaint alleges that on October 26, 2015, the child’s mother presented to Johns Hopkins Hospital for a labor and delivery visit related to elevating blood pressures during her pregnancy. She was 33 weeks and 2 days’ gestation at the time. She was ordered to undergo fetal non-stress tests on Mondays, Wednesdays, and Fridays and she was to monitor her blood pressures at home. All fetal non-stress tests were reassuring thereafter. On November 3, 2015, the mother reported a leakage of fluids at 3:30 a.m. and was admitted to Johns Hopkins Hospital at 10:14 a.m. for preterm rupture of membranes. She was at 34 weeks and 1-day gestation. At 12:20 p.m. on November 3, 2015, the mother consented to undergoing a caesarean section and the induction of labor. A vaginal delivery was planned. On November 3, 2015 at 1:00 p.m., labor began. Pitocin was started at 1:14 p.m. The tocodynamometer and electronic fetal monitoring (“EFM”) showed no contractions, a reassuring fetal heart rate (“FHR”). Over the next several hours, Pitocin was increased, and the monitor showed irregular contractions. At 7:20 p.m. on November 3, 2015, the mother complained of pain with contractions and was requesting an epidural. She was informed that an anesthesiologist was not available at that time. At 7:26 p.m., Pitocin was decreased to 6 mU/min. At 8:56 p.m. Pitocin was paused for epidural placement and at 9:02 p.m. the mother was given an epidural. Ten minutes later, at 9:12 p.m., Pitocin was reinstituted. Fetal monitoring at 11:00 p.m. and 11:30 p.m. showed variable decelerations. The mother was placed on oxygen at 11:50 p.m. At 12:02 a.m. on November 4, 2015, fetal monitoring showed variable and late intermittent decelerations. At 12:13 a.m., Pitocin was increased. At approximately 1:20 a.m., the fetal heart rate decelerated to the 90s. At 1:30 a.m., there were strong contractions every 2-4 minutes for 60-90 second durations, and late intermittent decelerations. The late and variable intermittent decelerations persisted for several hours. At 4:00 a.m., fetal monitoring showed a late intermittent deceleration to 70 bpm for eleven (11) minutes. It was noted that the fetus responded to a scalp stimulation but would bradycardia when stopped. At 5:19 a.m. the fetus had another prolonged deceleration in the setting of tachysystole (to 70 bpm for 10 minutes) and that caput was noted. The plan was to allow the fetus to recover and then augmentation with Pitocin should be given as needed. Category I tracings continued until approximately 8:30 a.m. when the mother was noted to be fully dilated, 100% effaced, and the fetus was in the +2 birthing station. At 8:34 and 8:42 a.m. FHRs were noted to be 120 and 115, respectively. At 9:13 a.m., the fetus decelerated to the 90s with a slow recovery back to the 100s and then recovered to prior baseline of 130. There were several prolonged variable intermittent decelerations over the next several hours. The providers increased the Pitocin to induce more powerful contractions. At 1:00 p.m., it was noted that the amniotic fluid was blood tinged. The fetal heart tracing records show that around 1:49 p.m. it appears that the health care providers had difficulty obtaining a reliable fetal heart tracing and that this failure persisted until the time of birth at 2:47 p.m. The child was delivered vaginally at 2:47 p.m. At birth, a tight nuchal cord was found and cut. The records indicate that the child was without spontaneous cry, was gray, limp, and apneic with poor tone. He was transferred to the NICU shortly after birth. He was noted to be suffering from respiratory distress syndrome, metabolic acidosis, and germinal matrix hemorrhage, among other findings. Imaging studies performed following his admission showed progressively worsening bilateral germinal matrix hemorrhages.
The child’s injuries were a result of the negligence of Johns Hopkins Hospital and its employees. The lawsuit alleges that the defendants failed to order an earlier cesarean section delivery in the face of non-reassuring fetal heart rate tracings. The child will require significant medical care and treatment for the rest of his life.
The action is pending in the Circuit Court for Baltimore City, Maryland.