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Caitlin Greenwell, a minor v John Muir Medical Center

Dr. Fagel achieved a verdict of $59.3 million on behalf of a 3-year-old girl who now has cerebral palsy as a result of asphyxia occurring during the birth process. Nurses noted that the plaintiff’s mother’s blood pressure was elevated 6½ hours after she was admitted to the hospital for induced labor but chose not the call the obstetrician. When the obstetrician examined the mother 4 hours later, he diagnosed her with pregnancy induced hypertension, making her a high-risk patient. Later in the afternoon, at about 2:45 pm, the nurse noticed negative changes in the fetal monitor strip and increased the amount of Pitocin administered to the mother, as directed by the obstetrician, to generate a better labor pattern. At a 3:00 pm shift change, the patient was placed under the care of another nurse who was still orienting herself to the labor and delivery unit. The obstetrician returned at 5:15 pm and attempted to deliver the baby vaginally but was unable. He ordered a C-section at 6:00 pm, and the baby was delivered at 6:23 pm with severe perinatal asphyxia.

Dr, Fagel proved that the nurses were negligent for increasing the Pitocin despite distressing fetal monitor strip readings, which interacted with the mother’s pregnancy induced hypertension to trigger an episode of acute asphyxia in the infant at about 5:50 pm. The obstetrician was also shown to be negligent for ordering the increased use of Pitocin at 2:45 pm. In addition, he and the hospital were shown to be negligent for not proceeding with a Cesarean section sooner, as Dr. Fagel demonstrated that the plaintiff would have been healthy if delivered before 5:50 pm. The delivery’s difficulties were also compounded by the 3:00 pm shift change, which placed the patient under the care of an un-experienced nurse, who herself stated at trial that she was unable to interpret the fetal monitor strip by herself.

Of the $59.3 million awarded by the jury, approximately $49 million ($6.43 million present cash value) was allocated to offset all past and future medical costs, $9.8 million (904,000 present cash value) was allocated to compensate for future loss of earning capacity, and $200,000 was rewarded to each parent for emotional distress claims.