Brain Injury Due to Delayed Delivery
Lawsuit Against Allina Health System | March 22, 2021
On March 22, 2021, WVFK&N attorney Keith Forman filed a medical malpractice claim on behalf of a child who suffered an avoidable brain injury.
The complaint alleges that the child’s mother presented to Allina Health – Bloomington Clinic for her 40-week prenatal care visit. At this appointment her blood pressure was reported as hypertensive and she was diagnosed with gestational hypertension. A non-stress test was performed and reported as reactive. Consistent with her doctor’s plan of care, the mother presented to the Maternal Assessment Center at Abbott Northwestern Hospital the next morning on September 15, 2015. On arrival her blood pressures were elevated. She was admitted to The Mother Baby Center at Abbott Northwestern Hospital for cervical ripening secondary to severe preeclampsia. A doctor reported the presence of occasional spontaneous uterine contractions and a Category I fetal heart rate tracing evidencing, more likely than not, a neurologically intact fetus. The plan was to start magnesium sulfate, IV medication, and Cervidil placement for cervical ripening. The doctor also performed a sterile vaginal examination and noted that the mother was 1 cm dilated, 70% effaced, -2 station, with a Bishop score of 5 consistent with an unfavorable cervix. The first cervical ripening agent, Cervidil, was placed at 12:20 p.m. on September 15th. The mother’s blood pressures improved. At 1:22 a.m. and 4:31 a.m. on September 16th, two doses of the second cervical ripening agent, Cytotec, were administered. The mother reported that the “ripening process [was] ‘taking a toll on [her].'” Because the mother’s cervix was not ripening quickly, the doctor placed a third dose of the ripening agent at 8:59 a.m. At 4:36 p.m. that afternoon, a nurse confirmed the plan to start oxytocin administration with periodic catheter assessments to evaluate cervical ripening. On September 17th at 1:30 a.m., the nursing staff reported minimal cervical progress and oxytocin augmentation was initiated per hospital protocol. At 8:10 a.m. on September 17th, a doctor presented to the bedside to evaluate the mother who once again reported feeling “tired of the long induction.” The cervix remained essentially unchanged from an examination performed nearly 24 hours earlier. The doctor’s plan included continuation of magnesium sulfate, placement of a second Cervidil, and labor precautions were discussed. A second Cervidil for cervical ripening was administered at 10:56 a.m. on September 17th. At 10:57 p.m. on September 17th, the doctor authored a note detailing the multiple failed attempts to ripen the mother’s cervix. At 7:17 p.m. on September 18th, the doctor entered a progress note documenting that the mother had been at The Mother Baby Center for “3 days now for induction…” Subsequently, at 9:21 p.m., the doctor authorized placement of epidural at which time the mother was noted to be 5 cm dilated, 70% effaced, -1 station, OT. At 2:08 a.m., on September 19th, the mother was becoming febrile as her temperature had risen to 100.2. The mother was still remote from delivery and oxytocin administration continued despite documented variable decelerations. Around 7:00 a.m., there was an 8-minute prolonged deceleration in the fetal heart rate tracing consistent with a fetus growing intolerant to the prolonged induction process. The fetal heart rate began exhibiting recurrent decelerations with nearly every contraction. Despite indications of deteriorating fetal status, a malpositioned baby, and clinical signs of chorioamnionitis, the doctor failed to counsel the mother on the option of cesarean delivery or the risks of continued attempts at induction of labor. At 10:10 a.m., there was second prolonged deceleration lasting approximately 5 minutes resulting in maternal oxygen, IV fluid bolus, and discontinuation of oxytocin augmentation. In response, a fetal scalp electrode was placed showing a rising baseline and periods of minimal-to-absent variability. During this time, the mother remained febrile, tachycardic, and hypertensive. Following placement of the fetal scalp electrode, the nurse continued to document further evidence of fetal intolerance to labor including fetal tachycardia, decreased variability, and recurrent, late, and variable decelerations. Ultimately, a cesarean section was called at 11:06 a.m. on September 19th – 5 days after the mother first presented to The Mother Baby Center at Abbott Northwestern Hospital. At the time of birth, the baby was flaccid and had no detectable heart rate. Immediate neonatal resuscitative efforts were implemented including intubation with an ETT, epinephrine, and chest compressions and the baby’s heart rate was not obtained until 14 minutes of life. Umbilical cord blood gases collected at the time of birth showed severe metabolic acidosis. During his admission to the NICU, the baby was diagnosed with hypoxic-ischemic encephalopathy and exhibited seizure activity which was confirmed by EEG studies. An MRI showed findings consistent with hypoxic-ischemic injury to the cerebral hemispheres, corpus callosum, bilateral thalami and occipital lobes.
The lawsuit alleges that as a result of the substandard care of Allina Health System and its agents, the child suffers from neurocognitive deficits and global developmental delays among other permanent injuries and damages.
The action is pending in the Fourth Judicial District Court for Hennepin County, Minnesota.
