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Ashley Hughes, a minor v Pomona Valley Community Hospital

Dr. Fagel achieved a verdict of $460,000,000 on the behalf of a young girl who suffers total paralysis of all movement and function below the neck as a result of excessive forceps use during delivery. The mother was admitted to the defendant hospital at 8:30 a.m. for induction of labor because the pregnancy was overdue. The defendant obstetrician, Dr. Jouvenat, ordered that the mother be given Pitocin to augment labor at 11 a.m. The Pitocin was stopped at 6:45 p.m. due to fetal distress, and Defendant Jouvenat then artificially ruptured the membranes of the placenta and inserted an internal scalp electrode to measure the fetus’ heartbeat at 11:20 p.m. At about midnight, an x-ray and ultrasound revealed that the baby was large and had a large head. Based upon these findings, Dr. Jouvenat advised the mother that he was considering performing a C-section. However, immediately thereafter, Dr. Jouvenat inexplicably left the hospital and did not return until 14 hours later (2:13 p.m. the next day). At about 10 a.m. the next day, nurses noticed swelling of the cervix, which is a significant indication of cephalo-pelvic disproportion (baby’s head is too large for the mother’s pelvis), a condition that usually requires Cesarean delivery. At this time a nurse called defendant Jouvenat to request his presence, but he did not appear at the hospital.

At 12:40 p.m., the mother’s cervix was completely dilated and she went into the second stage of labor, which begins with complete dilation of the cervix and ends with delivery of the baby. The second stage is considered prolonged if it lasts more than one hour, yet Dr. Jouvenat did not arrive at the hospital until more than 1 ½ hours until the mother was completely dilated. When defendant Jouvenat arrived, he decided to attempt vaginal delivery using forceps. He applied forceps to the baby’s head and pulled so violently that the mother was almost pulled off the delivery table. Dr. Jouvenat used forceps for a period of 22 minutes, all the while exhibiting use of techniques and force that is unacceptable and well below the standard of care in any obstetrical practice. The defendant applied such excessive force that the ligaments and other structures supporting the infant’s spinal cord were severed, causing irreversible paralysis from the neck down.

When the umbilical cord was cut after the minor plaintiff’s birth, she immediately turned blue because she could not breathe on her own as a result of being fully paralyzed from the neck down. Her condition required immediate intubation and controlled breathing resuscitation, but Dr. Jouvenat failed to provide treatment of any kind. As a result of defendant Jouvenat’s negligent and reckless actions, the infant suffered the following injuries: total paralysis from the neck down, the inability to breathe on her own, a fractured collarbone, severe swelling of the entire head and a torn scalp.

In an attempt to deceive the mother of the true cause of her child’s condition and to cover up the negligence of Dr. Jouvenat, all the physicians present during the labor and delivery (all of whom were defendants in this case) worked together to intentionally hide the true facts surrounding the minor plaintiff’s birth. The defendants told the mother that the cause of the minor plaintiff’s paralysis was a genetic disorder inherited from her parents, known as Werdnig-Hoffman Syndrome. The statement was completely false and was known by all the defendants to be false.

Fortunately, Dr. Fagel was not only able to prove that Dr. Jouvenat’s careless actions caused the child’s severe injuries, but also that all the defendants conspired to hide Dr. Jouvenat’s negligence. In regards to Dr. Jouvenat’s actions during labor and delivery, he specifically ignored signs that his patient required a Cesarean section, including cervical swelling, a prolonged second stage of labor, abnormalities in the fetal heart tracing and an x-ray that showed a large baby and probable cephalo-pelvic disproportion. In addition, defendant Jouvenat intentionally and purposefully attempted a forceps delivery, knowing that it would require prolonged and excessive trauma to the child’s head and spinal cord. The defendant also ignored the recommendation of delivery room nurses to perform a Cesarean section, failed to respond to their first request for his attendance, and when he finally responded he did not arrive at the hospital for over 1 ½ hours.

Finally, to make the plaintiff’s case even stronger, Dr. Fagel discovered that defendant Jouvenat, prior to and at the time of the plaintiff’s delivery, knowingly consumed and used alcohol and cocaine to excess. Dr. Fagel also discovered that Dr. Jouvenat abused pain and sleep medications, including but not limited to Codeine, Halcion and Centrax. Dr. Fagel used these facts to his and Mrs. Hughes’ advantage, by arguing that the drug and alcohol abuse impaired the defendant’s medical judgment in caring for the minor plaintiff.

The $460,000,000 awarded by the jury will be used compensate for the minor plaintiff’s future loss of earnings and to cover the high costs of the child’s past and future medical expenses, which include continual assistance in all activities of daily life and basic functions such as eating and breathing.

To watch a local news clip regarding the unfortunate incident and featuring Dr. Bruce Fagel, click here.