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Hypoxic-Ischemic Brain Injury Due To Failure To Timely Deliver

Lawsuit Against Washington Hospital Center | July 8, 2020

On July 8, 2020, WVFO attorney Keith Forman filed a medical malpractice claim on behalf of a minor child who suffered a brain injury due to a delayed delivery.

The complaint alleges that in late February 2018 and early March 2018, the child’s mother was scheduled for induction by Washington Hospital Center secondary to her chronic hypertension complicating pregnancy. The decision to induce the child’s mother secondary to chronic hypertension was a deviation from both the national standard of care and guidelines published by the American College of Obstetrics and Gynecology. On March 16, 2018, the child’s mother presented to Washington Hospital Center for her negligently scheduled induction. As of this date, the child had an estimated gestational age of 37 weeks and 4 days. At approximately 10:03 a.m. on March 16, 2018, a doctor documented that the “Medical Indication for Labor Induction” was “Chronic Hypertension.” However, chronic hypertension is not a medical indication for induction at 37 weeks and 4 days. A Bishop Score was also performed which was scored a 0 – meaning that the child’s mother’s cervix was completely unfavorable for labor. At approximately 10:30 a.m., the electronic fetal heart rate monitoring was described as normal. Shortly thereafter, the induction began and continued throughout March 16, 2018 and into March 17, 2018. Throughout the initial stages of the induction, the electronic fetal heart rate monitoring remained normal. At approximately 4:36 a.m. on March 17, 2018, the cervix was still closed. Nevertheless, the induction continued. At approximately 1:17 p.m., Pitocin was started and increased over the proceeding hours. At approximately 2:25 p.m., the fetal heart rate tracing became undetectable, which resolved with maternal position changes. At approximately 6:17 p.m., a pelvic exam revealed that the child’s mother was now 5.0 cm dilated and 50 percent effaced. A “Round Note” authored at 6:50 p.m. indicated that the Pitocin was running at 16 mu. The fetal heart rate monitoring was described as “category II (indeterminate)” at approximately 7:30 p.m. on March 17, 2018. At approximately 9:02 p.m., the Pitocin was increased to 18 mu. Despite the high doses of Pitocin, following a lengthy induction, the child’s mother was still not demonstrating an adequate contraction pattern as of 9:30 p.m. on March 17, 2018 – almost 34 hours after the induction had begun. At or around 12:05 a.m., the uterine contraction pattern was demonstrating irregular contractions. At or around 12:15 a.m., the fetal monitoring began exhibiting a decrease in variability from moderate to minimal variability in addition to variable decelerations. Despite clear episodes of excessive uterine resting tone, and changes in the fetal heart rate, no intervention was undertaken by the obstetrical or nursing staff. The uterine contraction pattern and fetal heart rate tracings continued to deteriorate over the next several hours. At approximately, 6:55 a.m., the child’s mother was described as being fully dilated. The fetal heart rate tracings continued to deteriorate for over an hour. The child was delivered vaginally at 8:06 a.m. on March 18, 2018. The child was depressed at birth, requiring resuscitation. Because of his worsening clinical status in the newborn period, the child was transferred to Children’s National Medical Center where he was diagnosed with anoxic brain damage and hypoxic-ischemic encephalopathy.

The child has cerebral palsy, global developmental delay, and other injuries as a result of the negligence of Washington Hospital Center and its employees. The lawsuit alleges that the defendants negligently delayed delivery via cesarean section despite the obvious signs of fetal distress. The child suffered permanent neurological injuries and damages and will require significant medical care and treatment for the remainder of his life.

The action is pending in the Superior Court for the District of Columbia (Civil Division).

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