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L.B. v Anonymous Physician/Medical Center

Dr. Fagel obtained a $3,980,000 settlement on behalf of a 27 year old woman who sustained hypoxic brain damage after hospital staff failed to recognize and treat post-operative bleeding. The plaintiff delivered a healthy baby via Cesarean section and was then transferred to the recovery room. Following the delivery, the obstetrician went home but remained in contact with the hospital staff. At 10 p.m., about 20 minutes after being transferred, the plaintiff’s blood pressure began to drop. Her blood pressure slowly continued to drop for the next 25 minutes and a nurse finally notified the anesthesiologist, who ordered a stat blood count after speaking with the OB. The results were returned at 11 p.m. and showed a critically low level. The anesthesiologist spoke with the OB, who ordered that 4 units of blood be obtained and transfused as soon as possible and that the plaintiff should be transferred to the operating room. When anesthesiologist ordered blood for a type and cross match, which had not been done when the plaintiff had a C-section, the hospital stated that it would take at least 45 minutes to get blood. Surgery began at 11:40 p.m., but the plaintiff arrested five minutes later, just as the first unit of blood was being transferred. CPR continued for over 40 minutes and then the surgery was resumed. No source of bleeding was ever identified, but a complete hysterectomy was performed. Due to the severe brain injuries she sustained, the plaintiff is in a semi-comatose condition and remains in a high level chronic care facility.

The defense contended that all care was within standard and that blood could not have been available any earlier. Nevertheless, Dr. Fagel proved that blood could have been available earlier had the OB, anesthesiologist or hospital nursing staff recognized the plaintiff’s post-operative bleeding and ordered blood sooner. The undue delay in ordering and giving blood was therefore below the standard of care and contributed to the plaintiff’s arrest and subsequent hypoxic brain damage.