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Chloee Cuenca, a minor v Mitchell Adler, MD; Torrance Memorial Medical Center

Dr. Fagel and his associates achieved a $13,050,000 verdict in favor of 19-month-old child who suffered severe brain damage after employees of the Friendly Hills Medical Group (Torrance, CA) failed to recognize and properly treat fetal distress during delivery, resulting in acute perinatal hypoxia. The labor process was relatively stable until fetal heart decelerations began when the mother began pushing. Decelerations continued with each pushing contraction, but little or no deceleration occurred with regular contractions, leading the defendant obstetrician to believe the fetus was tolerating delivery and could be delivered vaginally. The defendant then left an OB nurse to watch the mother while he delivered twins in a neighboring room. About 30 minutes after the obstetrician left, the fetal heart rate (FHR) tracing began to show prolonged deceleration and the defendant obstetrician was called back in. By the time he arrived, 6 minutes after being called, the FHR showed a dangerously low fetal heart rate. The defendant obstetrician determined the fetus was in severe distress and needed to be delivered immediately. He then attempted vaginal delivery with a vacuum, but was unable to deliver the infant on two attempts. He then attempted using forceps, but was unable to deliver the infant, once again. The then ordered a stat C-section and the baby was finally delivered, appearing bluish and apneic with a low pulse rate and a nuchal cord around her neck.

The defendant contended that the fetal monitor strip was reassuring up until the fetus descended into the birth canal, at which time the defendant called for immediate delivery. The defendant also contended that there is no way to diagnose a nuchal cord, and since the nuchal cord was the cause of the infant’s hypoxia, the plaintiff’s injuries were unpredictable and unpreventable. Finally, the defendant claims that the obstetrician did not abandon the mother because he left her with a qualified nurse and was immediately available if needed; the defendant highlighted the fact that when the obstetrician returned to the mother, he immediately recognized the need for delivery and accomplished delivery within 15 minutes.

However, Dr. Fagel and his associates proved that the obstetrician was negligent in failing to diagnose and treat fetal distress much earlier in the labor process. Had the defendant properly interpreted the fetal monitor strip and delivered the infant via C-section, all significant injuries could have been prevented. Furthermore, the defendant misread a cranial ultrasound that revealed edema in the plaintiff, which is indicative of acute perinatal hypoxic brain injury. Therefore, the injuries were indeed preventable, as a nuchal cord, which generally leads to chronic hypoxia, could not have been the cause of the plaintiff’s injuries. Due to the obstetrician’s failure to properly react to fetal distress, the plaintiff now suffers severe cerebral palsy and mental retardation. The jury awarded $13,050,000 ($5,224,000 in present cash value) to cover all past and future medical costs and to compensate for the plaintiff’s expected future loss of earnings. $250,000 was also allocated to compensate for the plaintiff’s mother’s emotional distress.