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Baltimore Medical Malpractice Lawyers > Newborn Brain Injury Due To Delayed Delivery September 2022

Lawsuit Against Frederick Health Hospital

On September 30, 2022, WVFK&N attorneys Keith Forman and Dave Grzechowiak filed a medical malpractice claim on behalf of a newborn who suffered an avoidable brain injury.

The complaint alleges that prenatal measurements of the baby, which were above the 90th percentile, demonstrated that the fetus was large for his gestational age—with several weeks remaining in the pregnancy. Nonetheless, the fetus was noted to be healthy in utero by all parameters that could be measured (positive fetal movement, normal heart rate, normal fetal positioning). There were no concerns about fetal health during the prenatal period. The health care providers knew or should have known that (1) macrosomia is defined as birthweight of more than 4,000 grams (8 pounds 13 ounces); (2) macrosomia is associated with an increased risk of labor and delivery complications, particularly maternal and/or fetal trauma during birth (including shoulder dystocia and hypoxia)—and death; (3) that risk factors for macrosomia include obesity, excessive gestational weight gain, male fetus, and post-term pregnancy; and (4) that cesarean section delivery is to be offered and recommended for a fetus with an estimated fetal weight consistent with macrosomia. On April 20, 2020, a nurse midwife admitted the mother at Frederick Health Hospital for a scheduled induction of labor. At no time during or leading up to the labor and delivery admission did the midwife order an assessment of estimated fetal weight to ascertain whether a safe vaginal delivery was likely. Likewise, there is no documentation in the medical record that the midwife offered or recommended a cesarean section to the mother, or that she discussed any particular indication for a cesarean section with the mother. The mother was 41 weeks and 2 days gestation at the time of the induction. Labor induction commenced shortly after 7 p.m. on April 20, 2020. Throughout the induction, the fetal monitoring strips showed minimal to moderate variability with multiple early, late, and variable decelerations of the fetal heart rate. Meconium was noted when the membranes ruptured spontaneously at 10:12 p.m. At 2:19 a.m. on April 21, a nurse contacted the midwife about the concerning fetal heart tracings. The midwife told the nurse to continue with labor. The decelerations of the fetal heart rate continued. At 10:25 a.m. it was noted: “NICU team at bedside ready for delivery.” Soon thereafter, the fetal heart rate monitor and the maternal pulse began to overlap resulting in signal ambiguity. From that point on, the fetal heart rate was neither detected nor displayed on the fetal monitor. The nursing staff failed to recognize this abnormality and failed to take corrective action to restore the fetal heart rate on the fetal heart rate monitor. As such, the nursing staff and the medical staff were unaware of the fetal status leading up to delivery. At 10:48 a.m., there was delivery of the fetal head, with immediate notice of a shoulder dystocia. Several maneuvers were attempted to free the baby, with delivery occurring four minutes later at 10:52 a.m. The baby was floppy and apneic at birth with an “undetectable heart rate.” He required CPR and did not immediately respond to resuscitation. The delivery note confirmed that the baby was macrosomic with a birth weight of 5,330 grams (11 pounds 12 ounces). His Apgar scores were 0, 2, 3, and 4 at 1 minute, 5 minutes, 10 minutes, and 20 minutes. He had a pH of 7.15 and a Base Excess of -17, signifying metabolic acidosis. The baby was transferred to Johns Hopkins Hospital for hypothermia treatment (cooling of the brain), where he was later diagnosed with numerous conditions, including hypoxic ischemic encephalopathy, brachial plexus injury, feeding difficulties, persistent pulmonary hypertension, among other injuries. An MRI at six days of life revealed injuries consistent with the sequelae of a perinatal acute ischemic insult. Today, the baby suffers from physical and mental injuries, including intellectual disability and neurological injury which will permanently and severely impact his daily life, education, and vocational prospects.

The lawsuit alleges that the injuries were a result of the negligence of Frederick Health Hospital and its employees in failing to timely respond to concerning clinical signs and failing to timely deliver the baby.

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

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