Newborn Brain Injury Due To Delayed Delivery
Lawsuit Against Carroll Hospital Center
On June 2, 2023, WVFK&N attorney Keith Forman filed a medical malpractice claim on behalf of a baby who suffered an avoidable brain injury.
The complaint alleges that in the early morning hours of February 20, 2023, the baby’s mother began experiencing what she believed were labor pains. She was full term at 39 weeks and 1 day gestation. She presented to labor and delivery at Carroll Hospital at approximately 1:30 a.m. At approximately 2:12 a.m., she was connected to an electronic fetal monitor and tocodynamometer. From the records, it appears as though the nurse was almost immediately concerned about the fetal heart rate as there is a notation by the nurse at 2:16 a.m. indicating that the charge nurse was “called to the bedside.” Further evidencing concern regarding the fetal heart rate tracing, at 2:19 a.m., intrauterine resuscitative measures were instituted. At approximately 2:22 a.m., the nurse called the OB hospitalist at Carroll Hospital, “for FHR tracing.” At approximately 2:27 a.m., the doctor was at the bedside performing a sterile vaginal exam, which revealed that the cervix was 2 centimeters dilated, 40-50 percent effaced and that the baby was in the -1 station. The mother was therefore remote from a vaginal delivery as of 2:30 a.m. on February 20, 2023. However, the doctor did not document that from approximately 2:12 a.m. through 2:30 a.m., the fetal heart rate tracing exhibited recurrent late and variable decelerations requiring intervention. At approximately 2:53 a.m., the nurse documented the presence of tachysystole, and that the FHR was showing “recurrent” and “late” decelerations. At this same time (i.e., 2:53 a.m.), the nurse performed additional intrauterine resuscitation efforts. In response to the tachysystole, the midwife ordered terbutaline at approximately 2:56 a.m. The terbutaline was administered at approximately 2:59 a.m. Thereafter, at approximately 3:20 a.m., the nurse again documented the presence of late decelerations with moderate variability, which necessitated additional position changes. At approximately 3:45 a.m., the nurse documented “late” and “variable” decelerations. Inexplicably, at approximately 3:45 a.m., the nurse disconnected the fetal monitoring to allow the mother to walk to the Family Birth Place for admission to her labor room. When the fetal monitoring was reconnected at approximately 3:59 a.m., the fetal heart rate tracing was bradycardic. The bradycardia was unresponsive to position changes. At approximately 4:01 a.m., the doctor was called and notified of the bradycardia despite the position changes. The doctor arrived at the bedside shortly thereafter and a STAT cesarean section was “called” at 4:04 a.m. The baby was delivered by emergency cesarean section at 4:22 a.m. on February 20, 2023. According to the operative note, there “appeared to be a large clot in the placenta.” This was consistent with a placental abruption, which was confirmed post-delivery. At birth, the baby was apneic and severely depressed with Apgar scores of 1, 4 and 6 at one, five and ten minutes, respectively. The cord blood gases showed metabolic acidosis with a pH of less than 7 and a base excess that was “incalculable.” The first arterial blood gas after delivery, and after resuscitation, showed a pH of 6.74 with a base excess of -30. Passive cooling for presumed hypoxic-ischemic encephalopathy (“HIE”) was initiated at Carroll Hospital in anticipation of transfer to Johns Hopkins Hospital in Baltimore. Post-cooling neuroimaging showed a significant hypoxic-ischemic brain injury that will likely leave the baby disabled for the rest of her life.
The lawsuit alleges that the injuries were a result of the negligence of Carroll Hospital Center and its employees in failing to properly and timely respond to concerning clinical signs.
The action is pending in the Circuit Court for Carroll County, Maryland.