Did delayed delivery result in infant brain damage?

Los Angeles County (Calif) Superior Court—On June 22, a gravida presented to a clinic complaining she had not felt fetal movement for the past week. On June 24, an ultrasound revealed marked oligohydramnios. The patient immediately underwent a nonstress test, which demonstrated a non-reassuring fetal heart rate (FHR) pattern at 3:30 p.m. As such, the family practitioner determined that the baby needed to be delivered by cesarean section and promptly contacted an Ob/Gyn. The physician was called again at 4:30 p.m. and arrived at 5:18 p.m. The baby was delivered via cesarean section at 6:08 p.m.

At delivery, the infant was heavily stained with meconium and the umbilical cord was wrapped around his neck 4 times. The child is now blind, microcephalic, tube-fed, and requires supplemental oxygen.

In suing, the parents contended that the Ob/Gyn was negligent for the following: not ascertaining the true nature of the fetal distress at 3:30 p.m., arriving at the hospital approximately 1 hour and 45 minutes after the initial call, and waiting 50 minutes to deliver the infant.

The physician maintained that the neurologic damage occurred 3 to 5 hours prior to delivery based on the presentation of the infant at delivery, the placental pathology, and the FHR tracing.

The jury returned a defense verdict.

The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts. While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.