On September 19, 1974, at 11:30 in the evening, a 41 year-old woman was admitted into the maternity ward at the hospital where she worked as a board certified physician, to deliver her second child. A New York Injury Lawyer said the woman was monitored upon her arrival by a nurse who determined that the infant was at -2 station and that his heart rate was 140 and regular. Her obstetrician was notified of her labor and advised that he would drive in to the hospital immediately. The nurse continued to monitor her labor. At 1:35 a.m. the nurse notified the obstetrician that the mother’s contractions were arriving at three-minute intervals and that the infant’s heart rate was 140 and regular. The obstetrician was not yet at the hospital, he prescribed several drugs to be administered to the mother over the telephone. One of those prescribed drugs was Demerol, a powerful painkiller.
The obstetrician arrived at the hospital at two in the morning. Her checked the woman and found that she was in her second stage of labor. At that point, the doctor noticed that the contractions had slowed and were four minutes apart. The woman had just been given the Demerol. He noted that the infant was at station -2. Station -2 means that the infant’s head is two centimeters above the pelvic spines that form the entrance to the birth canal. The obstetrician did not order an x-ray to determine if the infant’s head would fit through the woman’s pelvic spines. He ordered a Pitocin drip to speed labor. He testified in court that he had ordered the Pitocin because the labor had slowed from three minutes between contractions, to four minutes between contractions.
There was medical testimony at trial that Pitocin can cause the umbilical cord of the infant to be squeezed by the stronger contractions that it produces which can block the flow of blood and oxygen to the baby. A Nassau County Personal Injury Lawyer the law requires that if a physician prescribes Pitocin during a delivery, they must monitor the mother and child constantly while the drip is in progress. This monitoring is to ensure that the oxygen supply to the baby is not cut off which would cause a birth injury including cerebral palsy. The Pitocin drip in this case was on for more than an hour following the prescription to the actual delivery of the infant. According to the hospital delivery records, the Pitocin immediately increased the labor contractions to between two and three minutes apart and moderate in strength. At 2:30 a.m. the fetal heart rate was 136. All of the medical chart entries regarding this delivery were made by the nurse who stated that she was monitoring the woman every ten minutes, but that she had to leave the room several times to get items that would be needed for the delivery of the child.
At 2:45, the obstetrician left the labor and delivery area and went to the hospital cafeteria. In the cafeteria, he had a conversation with the patient’s husband, who was an anesthesiologist and was scheduled to anesthetize his wife for the delivery if it was required. A Manhattan Personal Injury Lawyer said the obstetrician first testified in court that he was in the cafeteria for only five minutes, he later testified that it could have been upwards of thirty minutes. When he did return to the labor and delivery area, he did not return to the woman’s room as prescribed by law. He testified in court that he monitored her labor from the hallway outside of her room.
At 3:00 a.m., the mother was taken to the delivery room. The Pitocin drip was still going. Her husband administered general anesthesia to her at 3:08 a.m. Everyone involved in the delivery was present in the delivery room for about 15 minutes prior to the child’s delivery. However, no one monitored the heart rate of the infant. The child’s father, who was the anesthesiologist, admitted in court that it was his responsibility monitor the baby’s heart rate so that he could correct any hypoxia that could result from anesthesia. Hypoxia means that the brain is deprived of oxygen which can cause cerebral palsy. At 3:16 a.m. the baby, who was named Hippocrates was delivered in obvious respiratory distress. At one minute following birth, he had no muscle tone, reflexes, or respiration. He was blue in color and his heart rate was 160. His Apgar score at one minute after birth was 3 out of 10.
There was no one in the delivery room with an expertise in infant resuscitation. The obstetrician cut the umbilical cord and turned his attention to delivering the placenta. The infant was left in the care of the nurse and the anesthesiologist. The anesthesiologist waited one minute to take the Apgar score before attempting to suction the baby’s airway and clear it so that the infant could breathe without obstruction. The anesthesiologist opted to use an ambubag to force air into the lungs of the child rather than intubate him. He took the child and put him on his mother’s chest and attempted to bag him while he was on his mother’s chest. Testimony at trial confirmed that bagging the infant does not ensure that any air goes into the child’s lungs, the air can go into the stomach or escape from around the edges of the mask that fits over the baby’s face. It is a much less effective method of getting oxygen directly to the lungs than intubation is.
It is important to note that the placenta and the umbilical cord appeared normal at birth. That means that oxygen depletion to the infant occurred as a result either of compression of the cord due to the Pitocin drip, or lack of oxygen at delivery due to bagging rather than intubation. It should also be considered that both could have been present in this case. The delivery record states that the baby suffered from protracted apnea which means that there was a long time with no respiration. The baby was not breathing. Four minutes after he was born, at 3:20 in the morning, Hippocrates took his first breath. He breathed before that for about two to three minutes according to testimony, but the records to not indicate a breath before that time. The anesthesiologist prescribed a drug called nalline for the baby. Although in court he adamantly denied that he had ever prescribed the drug. The nurse administered the drug, which is used to counteract the effects of Demerol.
In court, the nurse testified that she was the one who suctioned the child and that she had placed the child into a crib and attempted to give him oxygen through a forced pressure tube. She stated that she did not use an ambubag, and that there was no initial response to the pressurized oxygen. After that oxygen was administered, the child began shallow breathing on his own. The notations in the hospital log were made by the nurse and she testified that they were accurate. They described the resuscitation actions according to her testimony and described the infant as flaccid with irregular respiration and no crying. His color improved after the administration of the nalline. His muscle tone was described as apptonic. He demonstrated tremors and she notified the obstetrician who responded to the infant. The nurse testified that she had handled the resuscitation of Hippocrates until she had to leave the room, and the anesthesiologist took over. She was told by the obstetrician to go telephone the pediatrician on call, to respond to the baby.
At about four in the morning, the pediatrician came to the delivery room. His notes on the examination of the little Hippocrates, noted that his cry was weak or absent even after stimuli. His muscle tone was considered poor. His heart beat was regular. His reflexes were poor. His color was fair. He noted in the record that at the time of his examination, the infant was displaying tremors in his lower and upper left extremities that lasted for fifteen to twenty seconds at a time. The pediatrician noticed that the baby was flaring his nose, which indicated to the pediatrician that the child was trying to get more oxygen. The pediatrician noted in the chart in three different places that he believed that the child had suffered from hypoxia or lack of oxygen to his brain. He checked the baby for infections and did not find any. He checked the baby for metabolic imbalance and did not find any that would explain the condition of little Hippocrates.
He ordered that the child be transferred to a different hospital that had an intensive care nursery. The infant was also placed in an incubator under 40% oxygen. He did not order a blood PH test for acidosis. Acidosis is excessive carbon dioxide buildup in the brain. He had noted in his examination notes that one should be performed, but never informed anyone to do it. At five in the morning, the nurse noted in her report that the baby’s respiration was shallow but regular, his color was pink and his cry was weak. The tremors remained the same lasting twenty seconds at a time. The nurse feared for the baby’s life and baptized him. At 5:30 a.m. his tremors were more pronounced. At six in the morning, he began to improve and his color was pink. At 6:10 in the morning, the pediatrician cut off the oxygen and it was not restarted for about an hour. The pediatrician denied ordering that the oxygen be cut off when he testified in court. It was noted that at this time, the tremors were generalized throughout the baby’s body.
At 7:30 the infant was transferred to New York Hospital. The oxygen had been resumed at 7:10 a.m. The final diagnosis that the baby received was generalized tremors brought on by hypoxia. When he arrived at New York Hospital, they diagnosed him with perinatal hypoxia. By April 4, 1979, the infant was diagnosed with athetoid cerebral palsy.
The parents of the infant who are both physicians filed a medical malpractice lawsuit due to the fact that the hospital staff had departed from accepted medical procedures during the delivery of their child. The trial jury found in favor of the parents and awarded them compensation in the amount of $7,500.00. The defendants appealed the verdict because they claimed that some of the theories of negligence that were reported at trial were not supported by the evidence. The Supreme Court agreed and demanded that the verdict be overturned and a new trial ordered.
At Stephen Bilkis & Associates, New York medical malpractice attorneys can help you formulate your claim for recovered damages. We are located in convenient offices throughout New York and the Metropolitan area. A New York birth injury lawyer can evaluate your case and help you make the best decisions for you and your family.