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N. H., a minor v Anonymous Physician/Hospital

Dr. Fagel achieved a settlement of $4,200,000 on the behalf of a child who now suffers spastic diplegic cerebral palsy after hospital staff failed to treat a placental abruption in a timely fashion. The mother was admitted to the defendant hospital for induction of labor four days prior to her expected delivery date. The labor progressed slowly on Pitocin without any complications until the fetal monitored showed a sharp drop in heart rate at 1:42 a.m. Nurses began arriving to the room three minutes later and performed a variety of actions to treat the problem, including stopping the Pitocin, increasing IV fluids and shifting the mother’s position. Despite their attempts, the fetal monitor continued to show a severe persistent bradycardia (low heart rate). At 1:57 a.m., the charged nurse asked another nurse to call the OB, who was at home, and inform him that he needed to come to the hospital to deliver the patient. However, the nurse never told the OB about the severity of the situation or even mentioned the need for an emergency Cesarean section. The OB arrived at the hospital 20 minutes after he was called, and the minor plaintiff was delivered at 2:22 a.m. with dangerously low Apgar scores. The OB also noted a 75 percent placental abruption and delivery and had to perform an emergency hysterectomy because of continued bleeding from the uterus. The baby was transferred to the Neonatal Intensive Care Unit with a diagnosis of hypoxic brain injuries and was later determined to have spastic diplegic cerebral palsy.

The defense argued that the nurses called the OB as soon as required by the standard of care and that the hospital was not negligent because delivery of the infant was accomplished within five minutes of the OB’s arrival. Furthermore, the defense claimed that the standard of care allowed the OB to be at home on a low-risk patient, and because of the severity of the placental abruption, an earlier delivery would not have led to a better outcome. However, Dr. Fagel contended that unnecessary delays in the delivery significantly contributed to the plaintiff’s injuries. For example, the nurses should have called the OB as soon as the fetal monitor displayed the abrupt heart rate deceleration. The nurse who called the OB at home was also negligent for failing to mention that the situation was an emergency and required an immediate C-section. All in all, because the cause of the plaintiff’s injuries was an acute placental abruption, an earlier delivery clearly would have improved the baby’s condition.