This is a medical malpractice birth injury case on behalf of an infant, "Baby L", and his parents, a married couple.
Plaintiff’s mother was a 27 year old primagravida in 2011. In April 2011, she started her prenatal care with defendant obstetrical medical group, and had an uneventful prenatal course. Her prenatal care was managed by defendant Dr. F, an obstetrician employed by the defendant medical group. The medical group was owned and operated by defendant Dr. D. As the owner of the defendant medical group, Dr. D had devised a schedule which resulted in a single obstetrician employed by the medical group to be simultaneously on-call to both the Labor and Delivery Unit and the Emergency Unit at the defendant hospital and the Labor and Delivery Unit at another hospital approximately 15 to 20 minutes away from the defendant hospital.
On August 17, 2011, at approximately 3:30 a.m., the mother had a spontaneous rupture of membranes at home. She was at term. At about 4:30 a.m., she arrived at the Labor and Delivery unit at the defendant hospital. Dr. D, the obstetrician on call at the time admitted her by telephone order at 5:27 a.m. and gave orders for Pitocin augmentation of labor.
At 7:00 a.m., Dr. D ended her shift. Defendant Dr. F then went on-call and assumed the care of the mother. By 7:30 a.m., the mother was in active labor. Dr. F. and the hospital nurses then managed the mother’s labor throughout the day and into the evening. During that period of time, Dr. F. was preoccupied with rendering obstetrical care to two other high risk obstetrical patients at the defendant hospital. In addition to the three patients that Dr. F was managing at the defendant hospital, Dr. D had arranged for Dr. F to cover the care of another obstetrical patient at the other hospital that Dr. F was assigned to cover. By 8:38 p.m., Dr. F knew that the mother was in the second stage of labor. At about 9:00 p.m., Dr. F decided to leave her high risk patients including Plaintiff’s mother at the defendant hospital in order to perform an elective non-urgent Cesarean section delivery on the patient at the other hospital. Dr. F contacted Dr. D to inform her that she intended to go to the other hospital and to determine who would be covering the high risk patients at the defendant hospital. Dr. F understood that a nurse midwife would be available to respond to any calls on Dr. F’s patients during her absence.
Plaintiff’s mother had a desultory labor even with Pitocin augmentation. She did not become fully dilated despite strong and frequent contractions until 8:37 p.m., some thirteen hours after she was found to be in active labor. The fetal heart monitor strips started out as reassuring, but by late afternoon were showing signs of fetal intolerance to labor and of a deteriorating fetal status. Before she left to attend to the patient at the other hospital, Dr. F did not know about the worsening status of the mother’s baby. The hospital nurse attending to the mother had failed to appreciate the significance of the worsening fetal heart monitor strips, and thus failed to inform Dr. F of the severely worsening status of the fetus. Dr. F herself had forgotten to review the heart monitor strips between 5:30 p.m. and when she left the hospital at 9:00 p.m.
At about 9:42 p.m., while she was at the other hospital about to start the elective Cesarean section, Dr F received a telephone call from the nurse at the defendant hospital. That nurse informed Dr. F about the non-reassuring status of the fetal heart rate tracing and interventions for the mother’s unborn baby. Notwithstanding this call, Dr. F did not render any orders. Then, six minutes later, the nurses from the defendant hospital called Dr. F again and informed her that the fetal heart rate was in prolonged bradycardia for the last 8 minutes. Dr. F instructed the nurses to contact Dr. D. The nurses complied and contacted Dr. D. After being apprised of the situation, Dr. D contacted another obstetrician at home. That obstetrician went to the defendant hospital and performed an emergency Cesarean section. At 10:09 p.m., Plaintiff was delivered but had suffered a significant hypoxic ischemic event. He was transferred to Loma Linda University Medical Center and admitted to the Neonatal Intensive Care Unit for cooling therapy. He remained there for twenty five days. An MRI at Loma Linda confirmed permanent brain damage caused by an acute hypoxic ischemic event occurring shortly before birth.
Following the delivery of the Plaintiff, Dr. F returned to the defendant hospital. She then reviewed the fetal heart monitor strips and realized that if she had known about the worsening status of the fetus, she would not have left the mother’s bedside at 9:00 p.m. that evening to attend to the patient at the other hospital.
Plaintiff has been diagnosed with cerebral palsy secondary to hypoxic ischemic encephalopathy. He has a near normal life expectancy and will require life long medical and attendant care.
Plaintiffs contend that the defendant hospital knew, advocated and supported a physician on-call schedule that permitted physicians to effectively abandon their obstetrical patients. Moreover, the nurses employed by the defendant hospital failed to properly interpret and assess fetal heart tracings and thereby failed to appreciate a non-reassuring fetal heart rate pattern that warranted a timely and emergent Cesarean section delivery to be performed.
Plaintiffs contend that defendant Dr. F acted negligently in the care of the mother and her baby by failing to review the fetal heart monitor strip prior to leaving the mother’s bedside; failing to procure other obstetricians to assist her in providing care for the numerous other patients that evening; and abandoning the mother while in the second stage of labor.
A partial settlement of the case has been reached with the defendant hospital and Dr. F for a total of $9,000,000.00.