Failure To Timely And Properly Treat Hypoxic-Ischemic Brain Injury
Lawsuit Against Emory Healthcare, Inc. | March 26, 2019 – State Court of DeKalb County, Georgia
According to the complaint, on March 28, 2017 the child’s mother presented to Grady Memorial Hospital complaining of contractions and 10 out of 10 pain. She was 35 weeks and 1day gestation. She was known to have insulin dependent diabetes. A biophysical profile performed about five weeks earlier had reported an estimated fetal weight greater than the 97th percentile, and polyhydramnios, which is excess amount of amniotic fluid. Measuring large for gestational age and polyhydramnios are often seen in fetuses of diabetic mothers and require close observation, fetal monitoring and timely interventions including early delivery to avoid serious injury. She was admitted to the hospital with a plan to continue fetal monitoring and obtain a biophysical profile the following day. The fetal heart rate tracings eventually became concerning with an elevated heart rate baseline, minimal variability, and occasional decelerations. No nursing interventions to improve fetal oxygenation or attempt to alleviate the decelerations or improve variability are documented for several hours. An ultrasound showed an increased amount of amniotic fluid from the previous examination, with an estimated fetal weight greater than 97th percentile, but was scored as an 8 out of 8, which is considered reassuring. Throughout the afternoon, maternal contractions continued and the tracing remained concerning with persistent decelerations, and periods of minimal variability, indicative of poor fetal oxygenation. Despite several hours of concerning repetitive and prolonged decelerations the day before, and having no fetal monitoring overnight or non-stress test tracings to evaluate fetal status in a 35 weeks’ fetus already showing signs of the in-utero effects caused by uncontrolled maternal diabetes, the healthcare providers ordered that the mother be discharged from the hospital with the plan being to continue biophysical profiles twice weekly, and to be delivered at 39 weeks. On April 3, 2017, the mother returned to Grady Memorial Hospital as instructed, to have a repeat biophysical profile performed. She was 36 weeks’ gestation. The biophysical profile was dramatically changed from the exam just three days earlier. There was no fetal tone and no fetal breathing was evident. When the mother was finally placed on the fetal monitor, there was no fetal heart rate variability. Well oxygenated fetuses typically have moderate variability. Absent variability is associated with fetal asphyxia. A cesarean section delivery was eventually ordered due to the persistent Category II tracing with absent fetal heart rate variability and the biophysical profile. The mother was not taken to have her cesarean section for nearly another hour, and once in the operating room it took the surgeons an additional forty minutes to deliver the baby. At birth, the baby was limp, had no respiratory effort and his heart rate was significantly below normal at 60 beats per minute. His initial blood gas results showed metabolic acidosis. He was diagnosed with hypoxic respiratory failure, hypoxic-ischemic encephalopathy and shock. Today, the child is permanently disabled as a result of the severe brain injury he suffered shortly before birth due to poor perfusion, and lack of oxygen and blood flow to his brain, which was caused by the defendants.
The lawsuit alleges that the defendants failed to properly and timely respond to the child’s condition and failed to timely and properly treat the child’s deteriorating clinical status. The child is developmentally delayed as a direct and proximate result of the defendants’ negligence. The child suffers from permanent physical and mental impairments that he will never recover from, and which will require a lifetime of care and treatment.
The action is pending in the State Court of DeKalb County, Georgia.