Statistically, 27 out of every 1000 babies suffer a birth injury. There are many complications that can arise during the pregnancy as well as during labor and delivery. Some of these complications can threaten the health and even the life of the baby and the mother. One such complication is a placental abruption. A placental abruption occurs when the placenta which encases the unborn baby separates from the mother’s uterus. When this happens the blood vessels in the area are torn apart. The resulting loss of blood causes a drop in the oxygen supply reaching the unborn baby. A lack of necessary levels of oxygen for an extended period of time can cause brain damage and can even result in a stillbirth
While many birth injuries are unavoidable, a number of them are the result of medical malpractice. In one reported case there was a delay in diagnosing a placental abruption and the baby was born with drain damage, a known risk of a placental abruption. As the report indicates there was a settlement between the defendants and the parents resolving a claim filed by the parents claiming medical malpractice.
A 19 year old woman pregnant with her first baby was admitted at the hospital in early stage of labor. The expectant mother complained of constant abdominal pain. She was examined by an obstetrics nurse who documented a hard abdomen and constant uterine contractions. Soon after, the mother began to have vaginal bleeding, which was so severe that it required constant changing of towels underneath her. Instead of immediately advising a doctor, the nurse showed the mother where the linen closet was in her room so that she could replace the towels herself.
Four to five hours after her admission to the hospital, the expectant mother began having extreme pain. Again, the nurse did not notify a doctor. The nurse just gave drugs to the mother, merely masking the pain.About five minutes later, the fetal heart rate went flat.The nurse concluded this was merely due to a response to the pain medication. The nurse again did not notify a doctor and did not make any attempt to awaken the baby to make sure hypoxia was not involved. She finally contacted a doctor approximately fifty minutes after the baby’s heart rate went flat.
The doctor arrived, found the presence of meconium, and then noticed that the heart rate monitor showed progressive deep decelerations. The attending obstetrician then also arrived and decided to perform an emergency C-section. No anesthesiologist was available at the time and so the doctor performed the C-section using only local anesthesia. The doctor noted that placental abruption had occurred. The baby exhibited signs of hypoxic-ischemic encephalopathy (damage caused to the central nervous system due to a lack of oxygen) which testing later confirmed.
The child was later diagnosed with developmental and mental retardation. Given his injuries the child needs occupational therapy, speech therapy, and physical therapy, and will permanently require life care. The child is expected to live into his 40’s. The law firm that handled the case on behalf of the parents and the child was able to report that they achieved a settlement of ,100,000, of which ,000 was for the parents, and the remainder was for the child. Part of the settlement was structured so that the child would have a steady income stream into the future.
Analysis:
In this case the nurse was left to monitor the pregnant woman’s condition without a doctor’s supervision. Common signs of a placental abruption in a late-term pregnancy are severe abdominal or lower back pain and persistent vaginal bleeding. The expectant mother exhibited both and yet the nurse did nothing. In addition the nurse missed the significance of the tracings from the fetal heart rate monitor going flat. The first physician did nothing after observing the presence of meconium and the progressive deep decelerations of the baby’s heart rate – two signs that the unborn baby was in severe fetal distress. It took the arrival of the attending obstetrician for the decision to perform an emergency C-section to be made. By then the damage had been done. The lack of responsiveness to signs of complications formed the basis of the parent’s claim of malpractice. The result: a settlement for $1.1 million.