Newborn Brain Injury Due to Negligent Intubation
Lawsuit Against Johns Hopkins Hospital | June 4, 2021
The complaint alleges that following her birth on March 17, 2019, the child dealt with expected complications from omphalocele, which she was diagnosed with prenatally, but remained neurologically intact. The child was intubated on April 7 for respiratory distress. At that time, she was noted to be neurologically normal. On April 9, the child was extubated at 14:44. One minute later, at 14:45, the child was noted to have a pulse of 156, a respiratory rate of 23, and an Spo2 of 99%. From the records, it does not appear as though she was assessed between 14:46 and 15:10. At 15:10, the child was experiencing increased work of breathing, with a heart rate of 176, a respiratory rate of 46, and a Spo2 of 77%. Racemic epinephrine (“epi”) was administered at 15:38 and 15:39. A third dose was administered at 15:45. By 15:50, the child was on non-invasive positive pressure ventilator (“PPV”) support via a RAM cannula at 6 liters at 100% Fio2. Atropine was given for rapid sequence induction (“RSI”) at 15:54, and a fourth dose of racemic epi was also given at that time. A neonatologist was called at approximately 15:58 by the NICU NNP to come to the bedside. The decision was made to intubate. The first three attempts at intubation were unsuccessful. Chest compressions were started at 16:10, at which time epinephrine was given and the code bell was pressed. A normal saline bolus was given at 16:11, and a second dose of epinephrine was administered at 16:13. The Difficult Airway Response Team (DART) was not called until 16:14 – 16 minutes after the first unsuccessful intubation attempt. By this time, the child’s heart rate had dropped to 28, and her Spo2 had dropped to 55%. Multiple rounds of epinephrine and saline boluses were given from 16:16 through 16:35. At 16:21, the child’s heart rate was noted to be 0 – her heart rate was not restored until 22 minutes later at 16:43. By 16:30, in addition to having no detectible heart rate, the child’s Spo2 had decreased to 2%, and remained dangerously low. According to the records, the DART team did not respond until 16:37 – 23 minutes after they had allegedly been called. Upon arrival, the anesthesiologist noted that the child was blue, and was being bag mask ventilated with notable bleeding in her mouth. The anesthesiologist also noted that the attempted intubations were complicated by pulmonary hemorrhage. At approximately 17:00, the child’s heart rate, respiratory rate, and oxygen saturation finally stabilized. A series of brain imaging studies were performed following the code, which revealed significant brain damage that the interpreting radiologist concluded were the result of hypoxic ischemic injury secondary to cardiac arrest. The child is severely disabled, with cerebral palsy, an active seizure disorder, and a g-tube, among other disabilities that render her permanently dependent on others for her care.
The lawsuit alleges that the injuries were a result of the negligence of Johns Hopkins Hospital and its employees in failing to properly intubate the baby.
The action is pending in the Circuit Court for Baltimore City, Maryland.