Newborn Brain Injury Due To Delayed Delivery | May 13, 2022
Lawsuit Against United Hospital
On May 13, 2022, WVFK&N attorneys Keith Forman and Jermaine Haughton filed a medical malpractice claim on behalf of a baby who suffered an avoidable brain injury.
The complaint alleges that at 12:34 p.m. on January 30, 2016, when the baby’s mother was 40 weeks pregnant, she placed a 911 call stating that she was in labor and needed transportation to the hospital. At 1:15 p.m., a nurse at United Hospital documented: “Arrived via ambulance with [Spontaneous Rupture of Membranes]. Thick meconium noted.” Fetal heart rate monitoring was not concerning at that time. A cervical assessment performed at approximately 1:40 p.m. showed the cervix to be 3 centimeters dilated, 80% effaced, with “soft” consistency. Her baby was noted to be in vertex position but at a “high” station. Taken together, this information conveyed to the providers that she was remote from delivery (i.e., vaginal delivery was not imminent). At approximately 2:00 p.m., the nurse described the fetal heart rate as having “moderate variability” with “absent” accelerations and “variable” decelerations. At 3:00 p.m., the nurse documented moderate variability of the fetal heart rate with absent accelerations. However, for the first time, the nurse documented the presence of “late” decelerations. Late decelerations are evidence of fetal intolerance to labor and can indicate that a fetus is not receiving adequate oxygenation in utero. The fetal heart rate tracings did not improve over the next hour. At 3:56 p.m., the mother was placed in the “sitting” position for placement of a labor epidural. At 3:57 p.m., one minute after the epidural infusion began, there was a bradycardia of the heart rate which continued for approximately 10 minutes (3:57 p.m. to 4:07 p.m.). This indicated clear and obvious fetal distress. Nevertheless, the nurse failed to recognize or report this significant abnormality to the anesthesia staff or to the attending obstetrician. At or around 4:07 p.m., the fetal heart rate slowly returned to baseline indicating that the mother had been repositioned allowing for the reinstitution of blood flow and oxygen to the fetus. Thereafter, the fetal heart rate tracing showed further obvious signs of fetal distress and non-reassurance with repetitive late decelerations occurring with nearly ever contraction. This change in the fetal heart rate tracing following placement of the epidural, and the 10-minute bradycardia, indicated a fetus who was likely experiencing ongoing and injurious hypoxia and ischemia. Yet, no appropriate or timely interventions were taken to rescue the fetus from this hostile intrauterine environment. At 5:10 p.m., the nurse noted that the doctor was in to discuss a cesarean section delivery with the mother due to the deteriorating fetal heart rate. Despite obvious concerns for fetal distress, and an order for “urgent” cesarean section, it was not until 6:35 p.m. (1 hour and 10 minutes later) that the mother was transferred to the operating room for the cesarean section. The baby was delivered via cesarean section at 6:56 p.m., over three hours after fetal distress was first noted, and 1 hour and 46 minutes after an “urgent” cesarean section was ordered for fetal distress. At birth, the baby had “no spontaneous respirations.” His arterial cord blood gasses showed a pH of 7.10 and a base excess of -9.8, signifying that he was suffering from metabolic acidosis. In the immediate newborn period, he also had a low temperature and was hypoglycemic. The baby eventually developed seizures. The doctors concluded that his seizures were “due to hypoxic ischemic encephalopathy” and that he “[l]ikely has seizures related to fetal stress shortly prior to delivery.” Hypoxic ischemic encephalopathy (HIE) is a type of brain damage that occurs when the brain does not receive enough oxygen or blood flow for a period of time. The suspicion of HIE was confirmed by an MRI performed on Day 3 of life showed: “Extensive restricted diffusion in the cortex, subcortical white matter and deep white matter throughout the brain, as described in detail above, representing hypoxic ischemic injury.” The baby suffers from a severe hypoxic-ischemic brain injury, seizures, permanent physical and mental impairments, and cerebral palsy.
The lawsuit alleges that the injuries were a result of the negligence of United Hospital and its employees in failing to properly and timely respond to concerning clinical signs.
The action is pending in the District Court of Ramsey County, Minnesota.