Newborn Brain Injury Due To Delayed Delivery
Lawsuit Against University Of Maryland Shore Regional Health
On February 7, 2022, WVFK&N attorneys Mary Koch and Robert Lewis filed a medical malpractice claim on behalf of a baby who suffered an avoidable brain injury.
The complaint alleges that early in the morning, on February 8, 2019, the child’s mother awoke with concerns for preterm labor and reported leakage of fluid and likely rupture of membranes. The mother arrived at the hospital in the early morning on February 8, 2019, and was admitted. The mother was pregnant with twins. From 05:55 until 06:31, the twin fetuses were not monitored, and there are no notes to indicate whether there were any attempts to monitor the twin babies, collect blood or urine samples, or perform any interventions or provide any care at all. At approximately 06:31—36 minutes after arrival to the hospital—the electronic fetal heart rate monitor (“EFM”) began tracing. The initial tracing for FHR2 was concerning for variable decelerations, with the tracing becoming increasingly concerning by approximately 06:42. At 06:43, the nurse noted normal fetal movement, but that Baby “B” was breech and that Baby “A” fetal heart rate (“FHR”) was 125 BPM baseline, with moderate variability, but with no accelerations, variable decelerations present, and it was interpreted as Category 2. The mother was noted to be 6 cm dilated, 100% effaced, and -1 station. Anesthesia was not contacted at this time. At 06:50, the nurse midwife noted that she was called to triage and that the mother was “fully dilated and pushing with good effort.” She noted that the doctor was present for vaginal birth of twin “A” and that a second doctor was “present 4 min following delivery and assumed care of patient.” Twin “A” was delivered at approximately 06:58. Anesthesia was not contacted at this time. The second doctor then unsuccessfully attempted an external cephalic version (“ECV”) in triage after his arrival at 07:02. Anesthesia still had not been contacted. The decision was then made to transfer the mother to the OR “for delivery of second baby” at 07:08. While awaiting anesthesia (the time that anesthesia was called was not documented), a second unsuccessful attempt at the ECV was made in the OR by the second doctor at 07:12. At 07:13, the records indicate that the “Decision for emergent c-section made [at] 0714.” It is likely at this time that anesthesia was finally called. From approximately 0702 through the time of delivery, EFM was disconnected and the fetal heart rate was not recorded. At 07:27, a nurse noted that the neonatologist “is on her way,” but it is unclear what time she arrived in the OR. The anesthesiologist arrived to OR by approximately 0726, and anesthesia induction was noted at 0734. After the patient was prepared and draped, an ultrasound view of the heart rate revealed the presence of persistent fetal bradycardia as preparations for surgery were underway. The uterine incision was made at 0736, and the second twin was delivered at 0739. The code blue light was called to initiate the Rapid Response team at 0741. The baby was suctioned, given positive pressure ventilation, and chest compressions were initiated for several minutes. She was noted to be limp without heart rate, and Apgar scores were assigned as 0, 3, and 4 at 1, 5, and 10 minutes, respectively. Venous cord gas (noted as obtained an hour after birth) was documented as: pH: 6.74, PCO2: 59, PO2: 20, and Base Excess: -29. Arterial blood gas at 30-45 minutes of life was documented as: pH: 7.15, PCO2: 24, PO2: 155, and Base Excess: -19. These blood gas results indicate significant acidemia. The baby was transferred to University of Maryland Medical Center (“UMMC”) for therapeutic hypothermia treatment. A brain MRI was performed on February 16, 2019, which showed “findings consistent with hypoxic anoxic brain injury…” The baby now suffers permanent and severe injuries as a result of her injuries at birth, including permanent brain damage, physical and cognitive impairment, cerebral palsy, and will never be able to live independently or be employed.
The lawsuit alleges that the injuries were a result of the negligence of University of Maryland Shore Regional Health and its employees in failing to properly and timely respond to concerning clinical signs.
The action is pending in the United States District Court for the District of Maryland (Northern Division).
