Verdict California defense verdict. A posttrial motion was pending.
Did mother’s behavior cause preterm births?
A woman pregnant with twins first sought prenatal care at 12 weeks’ gestation, at which time she was smoking half a pack of cigarettes a day. At 27 weeks, ultrasonography indicated that both twins were growing normally, although twin B had duodenal atresia and polyhydramnios. It also showed that the mother had a shortened cervix. To avoid preterm delivery, she was placed on strict bed rest. She presented at the hospital a few weeks later with vaginal pressure with contractions. She was placed on a fetal monitor, given tocolytics to stop contractions, and prescribed betamethasone to mature the twins’ lungs. Later records indicated that she had been non-compliant regarding bed rest and smoking cessation. She was discharged with no sign of contractions. Several weeks later, she was admitted to the hospital with diarrhea and contractions. Again she was administered tocolytics and betamethasone; a fetal monitor was placed and biophysical profiles were obtained. On day 4, the fetal monitor showed nonreassuring signs and did not always monitor both twins, so a cesarean section was scheduled for 4:10 pm. The delivering OB arrived at 5:20 pm and delivered the twins, now at 30 weeks’ gestation. Both showed signs of decreased oxygenation and were placed in the neonatal intensive care unit. Twin A developed meningitis 9 days later; a brain scan indicated hypoxic–ischemic encephalopathy. Twin B was discharged after 44 days, and twin A after 66 days.
Patient’s claim The babies suffered metabolic acidosis, so they should have been delivered a few days earlier. The fetal monitors were not functioning properly all of the time. Also, the mother was compliant while she was hospitalized.
Doctor’s defense Because of the twins’ prematurity, an earlier delivery was contra-indicated. Twin A’s brain injury occurred 10 to 14 days before birth. The twins’ deficits were due to both genetics and the mother’s smoking and noncompliance. Twin B had no brain injury, and her mild condition was a result of prematurity.
Verdict $2,250,000 Michigan settlement.
Midwife and nurse deliver CP baby
A 20-year-old primigravida went to the hospital in labor at term. A midwife and nurse examined her, conducted fetal monitoring, and administered oxytocin to enhance labor. The child was delivered about 24 hours later. He was diagnosed with spastic quadriplegic cerebral palsy, is almost blind, and will remain in diapers.
Patient’s claim Failure to recognize signs of fetal distress and summon an obstetrician was negligent. Oxytocin contributed to a fetal heart rate deceleration, at which time an obstetrician should have been called and oxytocin discontinued.
Doctor’s defense An obstetrician was not needed. The fetal heart rate never decreased to an unsafe level, and oxytocin did not affect the fetus. An infection caused the cerebral palsy, the onset of which occurred 24 hours prior to birth.
Verdict Pennsylvania defense verdict. A posttrial motion was pending.