Facts

Donna Rodriguez underwent a vaginal birth after cesarean (VBAC) at Community Medical Centers in Fresno on Oct. 16, 1996. She was given Pitocin and Cervidil. In the early morning hours of October 17, Rodriguez started having severe pain in her uterus. After realizing that Rodriguez had dilated to three centimeters and was 60 percent effaced, a nurse gave her Stadol to relieve her pain. The nurse was following orders that were given by Rodriguez' doctor, Gail Mallard-Warren M.D.

Thereafter, Mallard-Warren arrived and made the decision to cease VBAC labor and to proceed with a cesarean section. Mallard-Warren left at that time. The fetus' heart rate dropped and then could no longer be traced. Labor nurses stop administering Pitocin to Rodriguez and attempted an intrauterine resuscitation. Upon her arrival after being paged, Mallard-Warren inserted a fetal scalp electrode to determine the fetus' heart rate. Rodriguez's membranes were ruptured during this process.

Shortly thereafter, Rodriguez underwent a cesarean section. Mallard-Warren determined that the uterus had been ruptured. The fetus had moved into the abdominal cavity just below Rodriguez's diaphragm. Consequently, Rodriguez's son, Moises Rodriguez, suffered neurological defects. Rodriguez filed a medical malpractice lawsuit against Community Medical Centers and Mallard-Warren on behalf of her son.

PLAINTIFF'S CONTENTIONS:
The plaintiff claimed the obstetrician's and the labor and delivery nurse's treatment fell below the standard of care. The plaintiff's expert in obstetrics claimed that the administration of Pitocin should have been stopped immediately upon discovery that the fetal heart rate had dropped precipitously. Further, the nurse failed to promptly notify defendant Mallard-Warren when the fetus' heart rate dropped below 90 beats per minute and the plaintiff's mother began complaining of severe pain in her uterus. According to the plaintiff's expert in pediatrics, if the defendant had been promptly notified and the cesarean section had commenced 10 minutes earlier, the injuries to the plaintiff could have been prevented.

DEFENDANT'S CONTENTIONS:
The defense challenged the claim that the defendants failed to meet the standard of care. Specifically, through its nursing and obstetrics experts, the defense claimed that severe pain is common when labor begins and the nursing staff was not required to page defendant Mallard-Warren at that time. Further, the drop in the plaintiff's heart rate also did not require notification nor did it necessarily require a stop in the administration of Pitocin. According to the nursing expert, the nurse who tended to the plaintiff's mother presumably followed protocol.

The defense claimed the damages sought by the plaintiff were excessive because he receives aid from Medi-Cal as well as assistance and medical equipment from California Children's Services and Central Valley Regional Center.

Settlement Discussions

The plaintiff demanded $1 million from Mallard-Warren and $1 million from Community Medical Centers. There were no offers.

Specials in Evidence

The plaintiff sought $5,134,708. $15,497,570.

Injuries

The plaintiff suffered hypoxic ischemic encephalopathy and choreoathetoid cerebral palsy. As a result, his cognitive abilities are limited and he requires round-the-clock care. The plaintiff required orthopedic surgery and due to his cognitive limitations, he requires and will continue to require physical therapy and speech therapy. In addition, a pump attached to his abdominal area continually supplies him with medication that treats his spasms.

Result

Defense verdict.

Deliberation

three hours

Poll

12-0

Length

16 days