Newborn Brain Injury Due To Delayed Delivery | May 3, 2022
Lawsuit Against Grady Memorial Hospital
On May 3, 2022, WVFK&N attorneys Mary Koch and Sarah Smith filed a medical malpractice claim on behalf of a baby who suffered an avoidable brain injury.
The complaint alleges that the child’s mother became pregnant for the first time in the fall of 2019. She was assigned an estimated date of delivery of June 5, 2020, based on ultrasound. She received her prenatal care at the Grady Memorial Hospital High-Risk OB Clinic, beginning on December 10, 2019, due to her chronic hypertension. The prenatal care was largely uneventful. On April 28, 2020, at approximately 10:22 a.m., the mother was seen and evaluated at Grady Memorial Hospital. As of this date, the mother was 33 weeks and 6 days gestation. During her April 28, 2020, admission to Grady Memorial Hospital, the mother had one severe range blood pressure of 163/115 and her protein-to-creatine ratio was .53. There were no other signs of pre-eclampsia (i.e., no headache, upper quadrant pain, edema, thrombocytopenia, etc.). Given her blood pressures and protein-to-creatinine ratio, she was diagnosed with superimposed preeclampsia. At the conclusion of her April 28, 2020, visit, she was given a first dose of betamethasone, instructed to return to the high-risk clinic the following day for her second dose of betamethasone, and discharged home. As instructed, she returned to the clinic on April 29, 2020, for the second dose. On May 1, 2020, the mother returned to the high-risk clinic for a scheduled appointment, and for her weekly antenatal testing. At her prenatal visit, she expressed no concerns, and the documentation confirmed that a diagnosis of superimposed preeclampsia had been made on April 28, 2020. AT this appointment, the mother was 34 weeks 3 days gestation. She was found to have a non-reassuring BPP 4/8 (absent breathing and tone). She was then sent to labor and delivery at approximately 11:56 on May 1, 2020. At approximately 12:26 she was connected to electronic fetal monitoring and uterine contraction monitoring. The initial fetal monitoring was reassuring with a baseline of approximately 120 beats per minute with moderate variability and no deceleration. Her first four blood pressure readings were 158/101, 160/109, 187/150 and 173/111, at 12:27, 12:30, 12:45 and 13:00, respectively. Accordingly, she met the criteria for a diagnosis of severe preeclampsia as of 12:45 on May 1, 2020. At approximately 12:42, there was a prolonged deceleration on the electronic fetal monitor, which lasted approximately 5-6 minutes. At approximately 13:12, a nurse documented that the mother was being prepped for a cesarean section delivery. From 13:00 to 13:30, the fetal heart rate tracing was stable with a baseline of approximately 110 beats per minute with periods of minimal and moderate variability. According to the delivering doctor’s history and physical, which was authored at approximately 16:09 (and after the baby was eventually delivered via STAT cesarean section), the original plan of care was to proceed with prompt cesarean delivery at approximately 13:12. However, with the improvement of the fetal heart rate after the prolonged deceleration, the plan of care apparently changed. The doctor stated “Given FHT recovery to normal baseline at 110 with moderate variability, will attempt placement of epidural and obtain labs including CBC, CMP, coags, and COVID rapid testing and start Mg2O4 infusion. Anesthesia called to room at time of decel, Charge RN and labor RN present as well. IV now in place. Timing of delivery discussed with anesthesia and charge and labor RN with agreement in plan of care. IF FHT shows signs of distress will plan for more urgent delivery under [general anesthesia] if necessary.” Based on the revised plan of care, an epidural was placed from approximately 13:53 to 14:02. After the placement of the epidural, the fetal heart rate monitoring became non-reassuring. Beginning at approximately 14:03, the fetal heart rate monitoring began exhibiting persistent minimal variability. This continued until 14:22 when the fetal heart rate began spontaneously decelerating. There were decelerations at 14:25, 14:28, and 14:30. This ominous pattern of repetitive decelerations in the setting of persistent minimal variability continued through 14:50 when monitoring was discontinued to take the mother to the OR. The baby was born at 15:06 on May 1, 2020. Her Apgar scores were 0, 0, and 0 at one, five, and ten minutes, respectively. Blood gases after delivery showed severe metabolic acidosis. Placental abruption was suspected. In the newborn period, the baby was diagnosed with severe hypoxic-ischemic encephalopathy (“HIE”), which was confirmed by neuroimaging. Today, she suffers from brain damage, developmental delay, cerebral palsy, microcephaly, and other complications, which are attributed to severe HIE occurring at or near the time of birth.
The lawsuit alleges that the injuries were a result of the negligence of Grady Memorial Hospital and its employees in failing to properly and timely respond to concerning clinical signs.
The action is pending in the State Court of DeKalb County, Georgia.
