Facts

On June 17, 2006, the patient, 30, was in labor and about to deliver her first child. She had an epidural anesthetic, which was increased in preparation for a c-section for failure to progress. Shortly after increasing the epidural, the plaintiff developed respiratory depression and decreased oxygenation (hypoxia). No nurse or physician was in the room. After several minutes, a nurse and the obstetrician entered the room and found the patient to be in a respiratory arrest, which quickly evolved into a cardiac arrest. She was resuscitated, and during resuscitation, she was moved to the operating room and a crash c-section was performed. The baby did well, but the mother suffered severe and permanent brain damage and is now in a vegetative state living in a skilled nursing facility.

PLAINTIFF'S CONTENTIONS:
The plaintiff contended that the epidural anesthetic used in preparation for the c-section was given in an inappropriately high dose, and may also have leaked into the intravascular or intrathecal (spinal) space, leading to respiratory depression. In either case, the patient should have been monitored closely after having been given the increased dose (bolus) of anesthetic.

Instead, the anesthesiologist left the room. The nurse also left (since it was change of shift). During this time, when respiratory depression was occurring, there was no health care provider present, contrary to the standard of care. It was not until the obstetrician, sitting at the nurse's station, observed that the fetal heart rate had fallen (due to the mother's hypoxia) that he returned the room. By then, it was too late to prevent the cardiopulmonary arrest.

DEFENDANT'S CONTENTIONS:
The defendant contended that the mother had a sudden and unexpected "amniotic fluid embolism," causing fetal distress and maternal respiratory compromise. This was a completely unpredictable and untreatable event that led to this catastrophic result. There was no substandard care and the respiratory arrest had nothing to do with the epidural anesthetic, as evidenced by the delay (approximately 20 to 25 minutes) between the increase in the epidural and the respiratory arrest. Had it been due to the anesthetic, it would have occurred in five to ten minutes at the most.

Specials in Evidence

$1.2 million for lost earnings and loss of earnings capacity; $3.5 million for future medical and nursing care;

Damages

$250,000 non-economic damages to plaintiff and $250,000 to her husband for loss of consortium.

Result

Settlement for $4.2 million cash.

Other Information

FILING DATE: Aug. 22, 2006.