Wrongful Death Due to Failure to Adequately Respond to Obstetrical Emergency
On February 5, 2024, WVFK&N attorneys Brian Cathell and Brendon Stern filed a medical malpractice claim on behalf of a newborn who suffered an avoidable death.
On November 26, 2021, the mother presented to the Emergency Department (hereinafter referred to as “ED”) at Nazareth Hospital to confirm that she was pregnant. The mother, whose pregnancy was confirmed, appeared well at this appointment, which conveyed that the baby’s gestational age was 6 weeks and 3 days. All fetal and maternal testing and signs were reassuring.
After she confirmed her pregnancy, the mother established her prenatal care at Ludmir Center for Women’s Health, where she consistently attended prenatal appointments throughout December 2021 and early 2022.
At 8:53 a.m. on April 13, 2022, at 26 weeks and 2 days gestational age, the mother presented to Nazareth Hospital’s ED due to her water breaking. After she arrived, she experienced cord prolapse. The mother was triaged as a Priority 1 and admitted under the care of attending physician Jason T. Kan, M.D., at 9:09 a.m. She was noted to have preterm premature rupture of the membranes and umbilical cord prolapse in the vagina.
The records indicate that no medical providers capable of carrying out a delivery, including a Cesarean-section, were present at Nazareth Hospital during the entirety of her time there. Dr. Kan documented that Christopher N. Uddoh, M.D. (an obstetrics and gynecology specialist who works for Trinity Health Corporation and was on call during the care at issue) was called and that, despite the mother experiencing cord prolapse, an obstetrical emergency, he would take 45 minutes to arrive at Nazareth Hospital. Dr. Kan also documented that “multiple” calls were made to Temple University Hospital for transfer acceptance. Those requests were declined. Neither Dr. Kan nor George C. Hobbib, M.D., a physician working alongside Dr. Kan in the ED, made any other efforts to find an obstetrician who was already present at Nazareth Hospital or an obstetrician who could arrive at Nazareth Hospital sooner than Dr. Uddoh. Additionally, neither Dr. Kan nor Dr. Hobbib made any efforts to contact any facilities other than Temple University Hospital about accepting the mother via transfer.
At 9:13 a.m., the medical record states, “[T]emple on their way,” indicating that Temple University Hospital sent an ambulance to Nazareth Hospital to transport the mother to Temple University Hospital so she could deliver her baby. At 9:28 a.m., the following note was recorded, “updated [patient] working on [operating room] for patient needing Cesarean- section for baby safety” and “mom agreed.” While the mother was in the ED, neither Dr. Kan nor Dr. Hobbib manually elevated the presenting part of the cord by vaginal digital examination. Further, they did not attempt to fill the mother’s bladder with saline via a urinary catheter, which would have elevated the mother’s baby and minimized the chance of compression. They also did not encourage the mother into a left lateral position or a knee-chest position, which would have reduced the pressure on the baby.
At 9:43 a.m., an ambulance arrived at Nazareth Hospital to transport the mother to Temple University Hospital for Cesarean-section delivery. At 10:00 a.m., the mother left Nazareth Hospital via ambulance en route to Temple University Hospital. The notes indicate that an ED physician, Dr. Hobbib, and an ED nurse accompanied the mother in the ambulance. As in the ED, during the ambulance transport, neither Dr. Hobbib nor the ED nurse did anything to prevent or mitigate the effects of cord prolapse on the baby. The mother arrived at Temple University Hospital at 10:16 a.m.
Upon arrival at Temple University Hospital, the umbilical cord was noted to be prolapsing out of the vagina, and the patient was immediately moved from the ambulance to the labor and delivery operating room for an emergent Cesarean-section. Further, the records indicate that Dr. Clyatt and Temple University Hospital declined patient transfer multiple times and that Dr. Kan, Dr. Hobbib, and Nazareth Hospital transferred the patient despite those declinations.
The baby was born via stat Cesarean-section on April 13, 2022, at 10:26 a.m. His APGAR scores were 2, 3, and 6. Serial blood gases from April 13, 2022, at 11:39 a.m. to April 17, 2022, at 8:42 p.m. showed significant acidosis. The baby required positive pressure ventilation immediately after he was delivered. He was intubated at 4 minutes of life, administered surfactant at 7 minutes of life, and admitted to the NICU, where he would require consistent mechanical ventilation and treatments for metabolic acidosis on the day he was born.
An ultrasound of the baby’s brain performed on April 14, 2022, showed a bilateral grade 3 intraventricular hemorrhage. An ultrasound of the baby’s brain performed on April 16, 2022, showed “Redemonstration of intracranial hemorrhage with Interval worsening of left interventricular hemorrhage and left germinal matrix hemorrhage with rightward mid line shift.”
Early in the morning on April 18, 2022, the baby was noted to have a drop in his blood pressure, oxygen saturation, and heart rate. The baby’s oxygen saturation was in the 60s, and while hand bagging was attempted (twice), there was no improvement in his oxygen levels. He was noted to be bradycardic, hypotensive, and hypoxic. At 5:14 a.m., the baby passed away. The autopsy showed “Fragmented and liquified fetal brain with intraparenchymal hemorrhage, hypoxic/ischemic injury and detached large blood clot … The postmortem brain autopsy finding is compatible with the clinical history of intraventricular and germinal matrix hemorrhage.”
The lawsuit alleges that the injuries were a result of the negligence of Trinity Health Corporation d/b/a Nazareth Hospital and its employees in failing to properly recognize and respond to an obstetrical emergency and failing to facilitate the timely delivery of the mother’s baby.
The action is pending in the Court of Common Pleas of Philadelphia County.
