Facts

The plaintiff was delivered vaginally at term without complication on May 11, 2007. A bilirubin level showed a level of 5.2, which was elevated. She was discharged home the next day with instructions to be seen within 96 hours (four days).

On May 14, the plaintiff was seen by a medical assistant at defendant Doe Pediatric Group, which ordered a stat bilirubin and directed the mother to take the baby to the laboratory in the building. The report of 15.3 was sent by dedicated printer to Doe Pediatric Group and was received the next day.

Upon receipt of the report that morning, Doe Pediatric Group called the mother and asked her to return to the office. Upon her return, the mother was given a laboratory slip and told to take it to the laboratory in the building for another stat bilirubin level. The laboratory reported a level of 14.6, which was reported to Doe Pediatric Group on May 16. The mother was then called and told that because the level was dropping, she could be seen in follow-up on May 24.

On the morning of May 21, the mother noticed that the baby had stopped feeding, was fussy and yellow. The mother called Doe Pediatric Group and she was given an appointment at 1:30 p.m. When the mother brought the baby into the office, she was seen by a doctor who noted severe jaundice. The mother was sent to the laboratory for another stat bilirubin level. The blood was drawn and sent to a collection center and then to a processing laboratory where the test was done at 8:21 p.m. The test showed a level of 46.2.

The laboratory technician attempted to enter the value into his computer, which should identify the level as a critical value, resulting in a report to the central call center, which would then immediately notify the physician. The computer would not accept any value over 30. The technician opened another window and entered the value, but he did not know at the time that the computer would read the blank value as a non-critical value and therefore the call center would not be called. The defendant doctor never called the laboratory to find out the value that night.

The next morning, May 22, the mother noticed the baby was arching her back so she took her back to Doe Pediatric Group, where the doctor spent the next two hours trying to locate a tertiary care facility which could take her patient for an emergency exchange transfusion. The baby was finally sent to the hospital where a double exchange transfusion was started at 3 p.m. Upon admission, the bilirubin level was 40.1 and after the transfusion it dropped to 20.

The baby was subsequently diagnosed with cerebral palsy due to kernicterus and hyperbilirubinemia.

DEFENDANT'S CONTENTIONS:
Doe Pediatric Group claimed that since the bilirubin level was decreasing, there was no indication for phototherapy treatment, and that the high level on May 21 could not be predicted.

Both Doe Pediatric Group and Roe Laboratory claimed that since the baby showed neurologic symptoms before she could have been treated with an exchange transfusion, there was no causation.

Settlement Discussions

The plaintiff made a C.C.P. Section 998 demand of $1 million (policy limits) from Doe Pediatric Group, which was accepted at the mediation. The plaintiff demanded $6 million from Roe Laboratory, which was self-insured to $5 million. Roe Laboratory offered $1 million, and later agreed to pay $4 million if Doe Pediatric Group paid $1 million.

Specials in Evidence

All past care paid for by private health insurance. $1 million to $1.2 million based on parent's level of education. $4.5 million, annuity cost for plaintiff's life care plan; $3 million annuity cost for defendant's life care plan.

Injuries

The plaintiff suffered cerebral palsy and developmental delay.

Result

The case settled at mediation before Jay Horton, Esq. for $5 million cash.