Facts

In April 2011, plaintiff's mother, 27, started her prenatal care with defendant obstetrical medical group, and had an uneventful prenatal course. Defendant Dr. F, an obstetrician, employed by defendant medical group, managed her prenatal care. The medical group was owned and operated by defendant Dr. D. As the owner of 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 defendant hospital and the Labor and Delivery Unit at another hospital approximately 15 to 20 minutes away from defendant hospital.

On Aug. 17, 2011, at 3:30 a.m., the mother, who was at term, had a spontaneous rupture of membranes at home. At 4:30 a.m., she arrived at the Labor and Delivery unit at 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 a.m., Dr. D ended her shift. 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 defendant hospital, Dr. D had arranged for Dr. F to cover the care of another obstetrical patient at the other hospital that Dr. F be assigned to cover. By 8:38 p.m., the mother was in the second stage of labor. At about 9 p.m., Dr. F decided to leave her high-risk patients including plaintiff's mother at defendant hospital in order to perform a 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 prolonged labor even with Pitocin augmentation. She did not become fully dilated despite strong and frequent contractions until 8:37 p.m., some 13 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.

At about 9:42 p.m., while Dr. F was at the other hospital about to start a cesarean section, she received a telephone call from the nurse at defendant hospital. The nurse informed her about the non-reassuring status of the fetal heart rate tracing and interventions for the mother's unborn baby. However, Dr. F did not render any orders. Six minutes later, the nurses from defendant hospital called Dr. F again and informed her that the fetal heart rate was showing a severe slow heart rate for the last eight 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 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 for 25 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 plaintiff, Dr. F returned to 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 p.m. that evening to attend to the patient at the other hospital.

PLAINTIFF'S CONTENTIONS:
Plaintiffs contended that the 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 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.

Injuries

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.

Result

A partial settlement was reached with the hospital and Dr. F for a total of $9 million.