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Birth Injury Due to Failure to Identify Cord Prolapse

Lawsuit Against Greater Baltimore Medical Center | September 30, 2020

On September 30, 2020, WVFO attorneys Keith Forman and Myles Poster filed a medical malpractice claim on behalf of a child who suffered brain injury due to a failure to identify cord prolapse.

The complaint alleges that on April 24, 2017 the child’s mother, who was pregnant with twins, underwent an ultrasound to assess the twins and to measure the mother’s cervical length. The ultrasound found that there was advanced cervical dilation. In violation of the standard of care, the doctor failed to appreciate, diagnose, and report a funic presentation with the umbilical cord for the child in the prolapsed membranes through the cervix. This was a critical finding that was required under the standard of care to be reported to the mother’s obstetrician. Because of the advanced cervical dilation observed on the April 24, 2017 ultrasound, the mother was transferred by stretcher to labor and delivery at GBMC for evaluation and monitoring. Prior to being transferred, the ultrasound doctor communicated her findings to the obstetrician, but did not convey the umbilical cord within the prolapsed membranes. The obstetrician was ignorant of the fact that there was a funic presentation with the child’s umbilical cord below the presenting part, which had prolapsed into the cervix, which led to an improper plan of care. Had the doctor been aware of the child’s funic presentation, the standard of care required either immediate delivery by cesarean section, or expectant management for a period of no longer than 48 hours to allow for the administration of betamethasone and magnesium sulfate for neuroprotection, and then cesarean section. This management was necessitated by the high risk of true cord prolapse, which could happen at any time in the setting of significant membrane prolapse. Cord prolapse is a true obstetrical emergency as the umbilical cord is the child’s lifeline for oxygen and nutrition and, if cord prolapse occurs, the child will be damaged within a short period of time. On the morning of April 27, 2017, at approximately 8:11 a.m., the same ultrasound doctor began performing a follow-up ultrasound. Remarkably, she again failed to see, and document, that the umbilical cord for the child was below the presenting part, and had prolapsed into the cervix. As such, the obstetrician was unaware of the prolapse. At 9:40 a.m., the mother’s membranes ruptured and, unsurprisingly, the child’s umbilical cord prolapsed through the vagina. A STAT cesarean section was called and the twins were emergently delivered. As a direct result of the Defendants’ negligence, the child went on to suffer intraventricular hemorrhage, post-hemorrhagic hydrocephalus, and periventricular leukomalacia. These brain injuries, which were avoidable had the Defendants complied with the standard of care, have caused the child to suffer from cerebral palsy and severe developmental delay.

The child’s injuries were a result of the negligence of Greater Baltimore Medical Center and its employees. The lawsuit alleges that the Defendants failed to diagnose a cord prolapse despite evidence of prolapse on the ultrasounds. The child will require significant medical care and treatment for the rest of her life.

The action is pending in the Circuit Court for Baltimore County, Maryland.

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