In 2013 a first time mother started her pre-natal care at a clinic in Los Angeles. The clinic utilized a local hospital and its family practice residents to manage laboring clinic patients. A family practice resident is a physician training to become a "GP" or general practitioner. Residents are not specialists in managing laboring patients or understanding fetal heart monitor tracings to assess fetal well-being. An attending obstetrics and gynecology physician (OB/GYN) would supervise laboring patients if called upon by the family practice resident.
In this case the mother had pre-natal care at the clinic. She was admitted to the hospital in January 2013, as directed. She was not in labor but was 9 days past her due date. The plan was to induce labor and deliver the baby vaginally. Induction was started at 1035pm on the day of admission. Little progress was made and two days later, Pitocin, a medication used to augment labor, was started. Slow progress was then made in opening the cervix but the fetus was not tolerating the labor-it was showing signs of distress. She was now 11 days late and 24 hours in efforts to start active labor.
Despite what should have been obvious distress of the fetus, the residents continued the Pitocin -off and on -over the next 12 hours. Finally the baby was delivered vaginally at midnight after 53 hours in labor. The newborn was born asphyxiated and transferred to a local children's hospital. He was diagnosed with an ischemic brain injury (too little blood and oxygen to his brain] occurring during this long labor.
Today he has severe neurologic injuries including delays in development, self-control, learning and motor deficits. He will need attendant care his entire life.
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