Experts: Obstetrician should have discussed shoulder dystocia risks – $900,000 Settlement

In 2004, plaintiff began receiving prenatal care. During the course of prenatal care, the history, physical examinations, and tests showed the plaintiff had an increased risk for encountering shoulder dystocia during a vaginal delivery, including but not limited to, excessive maternal weight gain, fundal heights greater than dates, and a third-trimester ultrasound estimating the fetal weight to be above the 90th percentile at 38 weeks gestational age. Plaintiffs’ standard of care experts opined that the defendant obstetrician was required to discuss with the plaintiff her increased risk of encountering shoulder dystocia and the delivery options, including a cesarean section.

In May 2005, plaintiff was admitted to the hospital for labor. Once the mother plaintiff was completely dilated she began pushing. After only two minutes of pushing the defendant obstetrician applied a vacuum to deliver the head, expediting the second stage of labor and preventing the fetus from naturally rotating into the optimal delivery position. Plaintiffs’ experts again opined that a discussion was required with the plaintiff regarding the risk of shoulder dystocia with the use of a vacuum and the option of a c-section.

During delivery, shoulder dystocia was encountered with the baby’s right arm being the anterior shoulder.  At birth, the baby’s right arm was noted to be injured with a brachial plexus injury.  The baby was also born with bruising on his face and arms. The defendant claimed that the shoulder dystocia was an unpredictable and unpreventable obstetrical emergency. The defendant also claimed that all the standard obstetric maneuvers were employed such as McRoberts and suprapubic pressure, however the delivery nurses did not recall performing these maneuvers nor did they document the maneuvers were done.

Plaintiffs’ experts opined that the standard of care required a physician delivering a baby to refrain from using any traction on the fetal head in delivery of an impacted shoulder regardless of the maneuvers used.  Plaintiffs’ experts opined that the defendant deviated from the standard of care in the delivery by applying more than gentle traction to the fetal head when the shoulder was still impacted.  In deposition, the family members present for the delivery described the defendant obstetrician as pulling, tugging and twisting on the baby’s head.  Plaintiffs’ experts claimed that the severe permanent injury to the baby’s right brachial plexus was caused by the excessive lateral traction utilized by the defendant at delivery and that the injury would have been avoided had a cesarean section been performed.

The defense claimed that the injury occurred due to the maternal forces of labor before the defendant touched the baby.  Plaintiffs’ experts opined that this mechanism of maternal forces injuring a brachial plexus nerve has never been visualized by any physician and, “was an unproven hypothesis based on unreliable statistical studies and unreliable mathematical models having no application.” In addition, the basis of the defense’s theory had no connection to the particularities of this baby in this delivery with this injury.

Plaintiffs’ damage experts opined that the baby suffered from right brachial plexopathy which involved C5, C6 and C7 nerve roots and muscles. The injuries were evident from the abnormal EMG study and on MRI. The baby plaintiff underwent two surgeries and extensive physical and occupational therapy to help improve his range of motion.

Plaintiffs’ experts opined that the injury was permanent regardless of intervention and therapy and that it would affect activities of daily living, ability to participate in activities such as leisurely and competitive sports, employment opportunities, and would have a psychological impact as the child got older.

[12-T-066]

Type of action: Medical malpractice
Injuries alleged: Brachial plexus injury
Verdict or settlement: Settlement
Amount: $900,000
Attorneys for plaintiffs: Judith Cofield, Virginia Beach; Charles J. Zauzig and Melissa G. Ray, Woodbridge