$7.5 million Delay in c-section | Los Angeles County

Case Report: $7.5 million plus assumption of $300,000 past medical care lien

Case Number: BC486066

Judge: Alan Rosenfield, Dept. 31, LA Superior Court

Plaintiff Attorney: Bruce G. Fagel, Law Offices of Bruce Fagel & Associates Defense Attorney: David O’Keefe, Bonne, Bridges, Mueller, O’Keefe & Nichols, Los Angeles David Weiss, Law Office of David Weiss, Santa Monica Insurance: Self-insured County.

Facts: On April 9, 2012, Plaintiff Dyrene Loftis, age 24, was taken by ambulance from Union Rescue Mission (a homeless shelter where she was living with her two other children, then ages 2 and 4) to Defendant LAC-USC Medical Center with a complaint of severe abdominal pain. Plaintiff had a history of two prior c-section deliveries and had pre-natal care at several different locations. She was uncertain about her exact gestational age. When she was examined at the L&D unit at the hospital, based on her last menstrual date, she was diagnosed as 36,5 weeks gestational age. Plaintiff was examined by a CNM and a 4th year obstetrical resident who diagnoses the plaintiff with uterine contractions as the cause of her pain, although she was not in pre-term labor. After 11 hours under observation in the triage area of the L&D unit she was discharged to return to the homeless shelter. The attending obstetrician did not see the plaintiff, although the resident claimed that she discussed the case her attending and that he told her that the patient could be discharged if her pain was gone. Approximately 12 hours later, at 7:00 AM on April 10, the plaintiff was again taken by ambulance to LAC-USC. She was seen immediately where a diagnosis of fetal distress was made and the plaintiff was taken to the OR for an emergency c-section with delivery 35 minutes after admission to the hospital. At delivery, the baby was determined to be 38-39 weeks gestational age. The baby was diagnosed with severe hypoxic ischemic encephalopathy and was sent to Children’s Hospital LA for brain cooling and placement of a g-tube for feeding.

Plaintiff contentions: Plaintiff should not have been discharged from the hospital on April 9, and instead should have been admitted and delivered by c-section. If delivery occurred on April 9, minor plaintiff would not have suffered any brain injury. Although minor plaintiff is ventilator dependent, his life expectancy is at least 20 additional years.

Defense contentions: Plaintiff should have given her correct EDC, which was in her pre-natal records based on an early ultrasound, also, Union Rescue Mission should have called an ambulance earlier on the morning of April 10. The mother’s pain had improved with one dose of Nifedipine and it was within the standard of care to discharge mother on April 9. The minor plaintiffs life expectancy was limited to 4-5 additional years.

Injuries/Damages: Minor plaintiff has severe anoxic brain injury. He currently resides in a long term care facility and is ventilator and g-tube dependent.

Settlement: On first day of trial, Defendant Los Angeles County, as the operator of LAC-USC Medical Center and employer of the OB resident, agreed to pay $7.5 million in cash, plus assume the MediCal lien for past medical care costs which were in excess of $300,000. Settlement was approved by the Court on Oct. 30, 2013, and by the LA County Board of Supervisors on Nov. 5, 2013.