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Child’s Brain Damage Blamed on Birth Injury Malpractice

newborn holding mother's handA Michigan grandmother has filed a medical malpractice lawsuit against the United States of America, on behalf of her four-year-old grandson, who she has legal custody of. The child was born at a federally qualified health center, which is why the lawsuit is directed to the U.S.

According to the suit, the boy’s natural mother was admitted to the hospital at 5:45 am on June 12, 2011 at 39 weeks pregnant. She was having contractions and an exam confirmed that she was dilated to 6 cm. Her water broke during the examination, the amniotic fluid was clear and the fetus was recorded as being in the vertex position. The mother was subsequently admitted to the hospital for delivery.

Delivery room negligence alleged

Thirteen hours later, at 6:45 pm, another sterile vaginal exam was performed by a certified nurse midwife, who determined that she was dilated to 7 cm. It was noted in the mother’s file that she had a slightly puffy cervix. An internal fetal monitor was placed at 8 pm and labor continued with no progress. The CNM consulted the on-call OB/GYN at 8 pm to discuss the lack of progress in delivery and charted that delivery would move toward C-section if the mother’s cervix was unchanged by 6 am the following day. The nursing staff would continue to closely monitor the mother and report any changes in her condition to the CNM.

Additionally, the CNM ordered a Pitocin augmentation at 9 pm and by 9:11 pm, the mother was given an epidural. At 11:45 pm, the CNM checked on the mother and ordered the Pitocin to continue. Shortly after, at 11:53 pm, a labor and delivery nurse noted a late deceleration and reported it to the CNM.

During a subsequent check at 12:48 am on June 13, the mother had a recorded temperature of 99.3 degrees, which was reported to the CNM. Nearly five and half hours later, at 6:20 am, a labor and delivery nurse informed the CNM that the mother was complaining of arm and chest cramps. Consequently, the CNM ordered the nurse to continue administering Pitocin at its current rate. Not long after, it was noted that the fetal heart rate was 135-130 with moderate variability, but there is no way to confirm that or uterine contractions because any fetal monitoring strip recordings were destroyed from 11:05 pm on June 12 to the baby’s birth.

Baby born with multiple birth injuries

The mother became fully dilated at 12:20 pm. An oxygen mask was placed on her for no apparent reason at 1:42 pm. The CNM on duty diagnosed her with primigravida, spontaneous rupture of membranes, morbid obesity, variable decelerations, fetal bradycardia, nuchal cord x 1, dysfunctional contraction pattern and strength and meconium stained fluid. The baby’s time of birth is unclear, as the CNM recorded a different time than the labor and delivery nurses on duty and the resuscitation team, who charted his birth at 2:23 pm on June 13th.

The baby boy was 8 lbs 14 oz at birth and cyanotic — blue or purple coloration of the skin or mucous membranes due to a lack of oxygen in the blood — with no respiratory effort. Resuscitation was successful with suctioning. A doctor was called at 2:25 pm and she successfully intubated the child. He was ultimately diagnosed with perinatal asphyxia and was transferred to another hospital for head cooling.

Four days later, on June 17, he was transferred to yet another hospital, where he was diagnosed with hypoxic ischemic encephalopathy, sepsis, bradycardia and an acute kidney injury.

Hypoxic-ischemic encephalopathy

Perinatal asphyxia, also known as hypoxic-ischemic encephalopathy is a brain injury caused by asphyxia. This is a very serious condition that is associated with high rates of mortality and long-term morbidity.

Babies who suffer from this condition at birth are at risk for severe life-long health issues, such as crippling cerebral palsy, epilepsy, development delay, motor impairment, blindness, severe hearing impairment and more. Often times, the depth of impairment cannot be fully determined until the child is three or four years old.

  1. U.S. District Court for the Western District of Michigan, Rita L. Jones vs. United States of America

  2., Definition of Cyanotic

  3. Medscape, Hypoxic-Ischemic Encephalopathy

  4. UCSF Benioff Children’s Hospital San Francisco, Neonatal Hypoxic Ischemic Encephalopathy