Newborn Brain Injury Due To Delayed Delivery
Lawsuit Against John Hopkins Bayview Medical Center
On August 10, 2023, WVFK&N attorneys Brian Cathell and Brandon Stern filed a medical malpractice claim on behalf of a newborn who suffered an avoidable brain injury.
The complaint alleges that the mother established prenatal care in January 2020 when she was 8 weeks and 6 days of gestation. Her pregnancy was complicated by anemia, morbid obesity, previous gastric sleeve placement, uterine fibroids, mild asthma, and a history of gestational diabetes and gestational hypertension in a previous pregnancy. She had one previous delivery ending in a cesarean section at 39 weeks in 2011 for fetal intolerance. Her blood pressure readings were normal until June 1, 2020, when the mother was instructed to self-monitor her blood pressure which was 155/86 at this visit. On June 12, 2020, the mother notified the office of “really swollen” hands and feet that hurt with movement. She also reported headaches. Her home blood pressure read as 143/84. Beginning at 32 weeks’ gestation, on June 26, 2020, the mother began undergoing fetal non-stress tests (NST) due to her morbid obesity, increasing hypertension, and her gestational diabetes in her current pregnancy. On June 29, 2020, at 32 weeks 3 days’ gestation, the mother had another appointment where her blood pressure was elevated at 153/88. She also had 1+ proteinuria. At this appointment, she made the decision to have a repeat controlled cesarean section at 39 weeks instead of a Trial of Labor After Cesarean (TOLAC). Her NSTs were all normal throughout the remainder of pregnancy. Her blood pressures remained well-controlled until July 27, 2020, at a routine prenatal visit. At that appointment, the mother presented with severe hypertension at 174/92. She also had 1+ proteinuria. She was instructed to go to labor and delivery right away at Johns Hopkins Bayview Medical Center (“Bayview”). She was 36 weeks 3 days’ gestation. She was discharged to return home after her blood pressure readings returned to normal. The mother returned to Bayview’s labor and delivery with complaints of decreased fetal movement on August 3, 2020. She was 37 weeks 3 days’ gestation. Although the NST of the fetus passed, the mother’s blood pressure was elevated at 144/93 at 03:27. Her pressures remained elevated at 141/84 at 06:00, 145/89 at 06:15, and 144/82 at 06:30. She, nonetheless, was subsequently discharged. That same day, she had a routine prenatal visit. On this visit, she presented with an initial severe blood pressure of 165/96 at 13:32. Despite her elevated pressures at Bayview’s labor and delivery earlier, the mother was not sent to Bayview’s labor and delivery to deliver her child. Four days later on August 7, 2020, at 38 weeks’ gestation, the mother presented to White Marsh for an NST. At this appointment, her blood pressure was exceedingly elevated at 156/94 at 08:07 and 150/100 at 08:43. She was immediately sent to labor and delivery to be evaluated. She was admitted at 09:59 at Bayview’s labor and delivery. She had additional complaints of a headache. She was placed on fetal monitoring. The fetal status remained reassuring while monitored. She remained on the monitor until 13:40, and inexplicably stayed unmonitored for almost four hours. A progress note at 15:23 states that the decision was made to deliver the baby due to the mother’s worsening hypertension and mild headache that was not improved with medications. She was counseled and decided to proceed with a repeat cesarean delivery. She was taken to the operating room for a cesarean section at 15:23. At this point the only monitoring done on the fetus was a brief check to confirm fetal heart tones prior to the procedure. No other monitoring of the fetus was performed during the procedure. At 16:26, a skin incision was made. The uterine incision was not made for another 43 minutes at 17:09, with the baby’s subsequent delivery at 17:12 — 109 minutes after the section was called at 15:23. The baby was born with forceps assistance due to a floating fetal head. There was meconium-stained fluid – a sign of fetal stress. His APGAR scores were 3 and 6 at 1 and 5 minutes. He weighed 3340 grams. He was floppy and pale at birth. His arterial cord gases were a pH of 6.86, with a base excess of -18. A nuchal cord was present with a true knot. He was sent the same day to the NICU for further management of respiratory distress and encephalopathy. An MRI of the brain on August 12, 2020 showed a “focal infarct in the left basal ganglia centered in the posterior part of the caudate body and most posterior aspect of the putamen representing a perinatal ischemic stroke” and other permanent and severe neurological injury. Today, the baby remains permanently and severely disabled as a result of the permanent and severe neurological injury and sequelae and requires extensive care and treatment as a result.
The lawsuit alleges that the injuries were a result of the negligence of Johns Hopkins Bayview Medical Center and its employees in failing to timely respond to concerning clinical signs and failing to timely deliver the baby.
The action is pending in the Circuit Court for Baltimore City, Maryland.
