A woman is awarded over $6.2 million after her baby is born with Cerebral Palsy.
An article published by Sommers, Roth & Elmaleh describes a case involving a pregnant woman whose newborn was diagnosed with cerebral palsy, resulting from negligent doctors and nurses. The woman, 31, was expecting her first child when she saw Dr. A regarding in vitro fertilization (IVF) treatment due to difficulty conceiving. IVF is a sophisticated set of procedures used to help with fertility and to aid in child conception. In IVF, mature eggs are removed from ovaries and fertilized in a laboratory with sperm.
After finding out she was pregnant, she was sent to Dr. B in Oakville. An ultrasound at 32 weeks of gestation revealed an extremely big fetus with an estimated weight of 2525g. Despite the fact that the patient was obese and had acquired a lot of weight throughout the pregnancy, Dr. B did nothing. In accordance with the accepted standard of care, Dr. B was required to schedule a further ultrasound to evaluate the fetal size at 36 weeks and the fetal growth at that time. This wasn’t completed.
The patient started having non-stress tests (NST) performed weekly in October and November of 1991. A typical prenatal test to examine a baby’s health is called a non-stress test. In this test, the infant’s heart rate is watched to assess how it reacts to movement. The phrase “non-stress” describes a test in which the baby is not put under any stress. She underwent a series of six NSTs while frequently visiting the defendant hospital.
The mishandling of the NSTs done in late November and early December in this patient violated the standard of care.
The NST’s characteristics led to a non-reactive result in late November, which meant there weren’t enough fetal heart rate accelerations lasting longer than 40 minutes. Additionally, there were reports of decreased fetal activity in the days and weeks that followed, which is consistent with fetal stress and early signs of hypoxia (a lack of oxygen). Dr. B, who was interpreting the NST at this time, ought to have understood the urgency of the situation and made plans for delivery on that day. This wasn’t completed.
The woman went to the defendant hospital after experiencing regular contractions and high blood pressure for 5 days in early December. Nurse A conducted another NST, which once more resulted in a non-reactive finding. Concerningly low variability and tardy decelerations were also present in the fetal heart rate. All of these alarming symptoms indicated the necessity for an urgent birth, and Nurse A ought to have called Dr. C, the most responsible doctor, right away. This wasn’t completed and Nurse A didn’t call Dr. C for 55 minutes after the abnormal NST was read.
An artificial rupture of the membranes (ARM), a process in which the membranes are ruptured with a long, crochet-like hook during a vaginal examination, releasing the amniotic fluid, was carried out when Dr. C eventually arrived. The ARM revealed thick, green meconium, which is an infant’s first feces, and it was decided to deliver the child through a C-section.
A disagreement over the mode of anesthesia broke out between Dr. C and the anesthetist, adding to the delay. While the anesthetist thought general anesthesia would be more suitable, Dr. C requested an epidural. In the end, it was decided to proceed with an epidural C-section.
The woman arrived at the hospital over three hours after the scheduled C-section delivery. When she was born, the baby weighed approximately 12 lbs., was purple, needed emergency resuscitation, and had to be intubated. The nurses had to wait until the equipment was transported from another hospital since the defendant hospital did not have a ventilator, therefore the infant required manual ventilation for almost a full day.
At delivery, the infant had severe metabolic acidosis. Fetal acidosis, which causes excessive levels of acid in the blood of an unborn child, often happens when a fetus is oxygen-depleted for a protracted period of time during or just before delivery.
A brain injury known as intrapartum hypoxic-ischemic encephalopathy (HIE), which happens when a baby’s brain does not receive enough oxygen during birth, was identified in the infant. A diagnosis of cerebral palsy, a movement disorder (cerebral refers to the brain, whereas palsy refers to weakness or issues using the muscles), was made at 7 weeks of age.
The fetal reserve and the baby’s capacity to tolerate the strain of labour were substantially reduced as a result of the aforementioned reasons and the subsequent 5-day period leading up to the presentation in labour. The harm could have been avoided if the infant had been delivered before labour started.
The additional wait of roughly 3 hours between the baby’s presentation to the defendant hospital and birth sealed the baby’s fate in this regard.
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From Sommers, Roth & Elmaleh