Facts

Doe Minor Plaintiff was born at Roe Hospital on Nov. 9, 2016. Plaintiff's mother (born Aug. 18, 1992) had a normal, uncomplicated pregnancy until the date in question. Around midnight on Nov. 9, 2016, the mother presented to Roe Hospital with contractions and was admitted to labor and delivery. The fetal heart tracing starts at 12:46 a.m. and shows a strong heartbeat with a baseline around 150 with normal, moderate variability.

At 6:57 a.m., the mother's water broke. Again, the child's monitoring strips were normal and there was a strong, healthy heartbeat with moderate variability with a baseline of 130. At 8:37 a.m., a nursing vaginal examination showed a dilation at 8.0 cm and effacement. Pitocin was started at 9:50 a.m. at 2 milliunits as recorded by the labor and delivery nurse. At 10:20 a.m., the Pitocin was increased to 4 milliunits, the nurse then increases the Pitocin again to 6 milliunits at 11:03 a.m. By 12:39 p.m., the nurse again increases the Pitocin to 8 milliunits at 12:39 p.m. One minute later, the nurse's examination shows that the mother is at 8.5 cms dilation and 100 percent effacement, but remains at only -2 station.

At 4:03 p.m., the Pitocin was turned off and the mother was instructed to turn on her side and given oxygen and hydration. The baby's heart rates plummeted below 90 and was severely bradycardic.

Roe OBGYN delivered minor plaintiff vaginally at 5:12 p.m. Minor Doe Plaintiff was 8 pounds, 5 ounces. Minor Doe Plaintiff had Apgars of 1, 4, and 7 and was noted to be flaccid, blue, and pale at birth. There was no reflex. Minor Doe Plaintiff's heart rate at delivery was 40 without any respiratory effort, cry, or tone.

PLAINTIFF'S CONTENTIONS: Plaintiff claimed that the administration of Pitocin and failure to follow the hospital's own policy was far below the standard of care. Pitocin is synthetic oxytocin that stimulates contractions during labor. Pitocin is considered to be a "high-alert medication" because of the high likelihood of significant patient harm when used in error. Under Roe Hospital's own policy and procedure, Pitocin should not have been used when there was Tachysystole, which the hospital itself defined as more than 5 contractions in a 10 minutes period averaged over 30 minutes. Here, the mother showed clear signs of tachysystole almost immediately when the Pitocin was increased for the fourth time at 12:39 p.m. However, the nurses failed to follow the hospital's own policy until 4:03 p.m.
By 4:03 p.m., the strips should have caused a full-blown emergency. However, instead of getting the doctor involved and obtaining a Caesarean Section, the patient was ordered to push even though the baby at this point was under extreme fetal stress and was pre-terminal.
At this time, there was still time to deliver a healthy baby. Instead, the nurse instructed the mother to push. The labor and delivery nurse completely failed to notify Roe OBGYN, of the concerning fetal monitoring strips and the extremely poor progress of labor. As described above, Roe OBGYN testified that she was so surprised at the child's poor outcome that she went over the strips and believed that she should have been notified long before of the concerning strips.

Roe Hospital also did not have a NICU team ready to resuscitate the child immediately after birth. The 2-3 minute delay in the NICU team response and intubation was critical following birth and violated Roe Hospital's policy that required the neonatal resuscitation team to be present at delivery.
Against Roe OBGYN, the physician admitted that she did not regularly evaluate the strips and only looked at it closely following the delivery when the child was born moribund.
Plaintiff contended that it was below the standard of care to solely rely on the nurses. Indeed, Roe OBGYN admitted at her deposition that she was very upset because this outcome was "avoidable" and that she would have performed a C-Section over an hour and 12 minutes earlier if she had been aware of the obvious abnormalities noted on the fetal heart rate tracing. Plaintiff contended that Roe OBGYN had an independent obligation to be aware of her patient's fetal heart rate tracings. Plaintiff sued the Roe
Medical Group as Roe OBGYN was a partner of the group and acting as their agent.

DEFENDANT'S CONTENTIONS: Roe OBGYN contended that she was not timely informed by the nurses of the fetal distress. She claimed that she did not have a duty to continue to evaluate the fetal monitor strip as she had a right to rely on the nursing staff to do so. She was not notified by the nurses until approximately 5:00 p.m., at which time she acted quickly and delivered the child within minutes.

Damages

It was undisputed that the child had severe and catastrophic brain damage as a result of hypoxic ischemic encephalopathy, would never be able to work or engage in any meaningful conversation, and would require supervision for the rest of his life. However, the amount of care needed was hotly in dispute.

Result

The case settled for $5.7 million.