Virginia Lawyers Weekly

A baby who was large for her gestational age (birth weight of 9 pounds, 10 ounces) suffered a stretch injury to her brachial plexus, the nerves that lead to the shoulder girdle, arm, wrist, hand and fingers (C5, 6, 7, 8, T1). At birth her shoulder became impacted on the mother’s pubic bone (shoulder dystocia).

Plaintiff’s experts, all of whom were deposed, were prepared to testify at trial that a vaginal delivery should not have been attempted and that the defendant obstetrician should have more accurately estimated the fetal weight and performed a planned cesarean section.

The mother’s prior medical history included several factors that heighten the risk of shoulder dystocia, including gestational diabetes and the previous birth of a large for gestational age baby. These experts would have testified at trial that the maternal history and the fact that an early ultrasound indicating a large baby indicated that a third trimester ultrasound was necessary.

They would have testified that even though an ultrasound has a margin of error of 10 to 15 percent, it would have shown the baby to be large for gestational age.

The experts would have testified that the defendant obstetrician was obliged to counsel, recommend, plan and implement a non-emergent c-section at approximately 39 weeks. They would have testified further that an ultrasound could have been performed on admission, followed by c-section.

The experts on the standard of care, including the labor and delivery nurse, would have testified at trial that the nursing staff was negligent in inappropriately applying fundal pressure. Finally, the experts would have testified that the obstetrician applied negligent and excessive lateral pressure to the fetal head, widening the angle between the shoulder and neck, stretching and injuring the brachial plexus.

Plaintiff’s pediatric neurologist was prepared to testify that the child had permanent impairment and dysfunction with the affected upper extremity including shoulder displacement, inferiorly and anteriorly; “winging” of the scapula; hypertrophic left trapezius muscle; and atrophy of the deltoid, biceps, triceps, with absent external rotation of the shoulder.

The child’s surgeon would have described the neuroplasty and internal neurolysis procedures that were designed to eliminate scarring of the brachial plexus. A life-care planner was prepared to discuss the child’s future needs for physical and occupational therapy.

The case settled several days following a mediation session.

[09-T-095]

Type of Action: Medical malpractice
Injury: Brachial plexus injury
Name of the Case: Confidential
Tried Before: Mediation
Name of Mediator: Diane M. Strickland
Verdict or Settlement: Settlement
Amount: $975,000
Plaintiffs’ Attorneys: Lewis T. Stoneburner, Thomas J. Schilling and Bellamy Stoneburner, Richmond

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