Type of action: Medical malpractice
Injuries alleged: Permanent brachial plexus injury
Date resolved: 7/07/2020
Special damages: Life care plan – $400,000; past medical bills – $200,000
Verdict or settlement: Settlement
Attorney(s) for plaintiff (and city): Charles J. Zauzig III and Melissa G. Ray, Woodbridge
Description of Case: On Nov. 2, 2012, plaintiff was admitted to a hospital to be induced at 39 weeks because of the estimated fetal weight and gestational diabetes. This was plaintiff’s delivery of her ninth child and four of her previous children had all weighed more than 9 lbs. at birth. Labor progressed with a planned vaginal delivery. At the time the head delivered there was a turtle sign, and the rest of the body did not follow, so shoulder dystocia was suspected by the defendant obstetrician who was delivering. The defendant obstetrician testified during her deposition that she used downward traction on the baby’s head after she suspected a shoulder dystocia, but before any other maneuvers were done. The defendant obstetrician estimated that the traction was applied for two to three seconds against resistance from the anterior shoulder. Plaintiff was then placed in McRobert’s position by a nurse with the assistance of her husband, suprapubic pressure was applied by another nurse, and a second attempt at delivery was done by the defendant using downward traction. The defendant claimed at her deposition that she had only used gentle traction in attempting to deliver the baby. The anterior shoulder was still impacted on the mother’s pubic bone so the defendant then performed a rotational maneuver, which released the shoulder, and the baby was delivered. Thirty seconds elapsed from the time the baby’s head delivered until the delivery was completed. The injury to the baby’s left arm was noticed immediately after birth.
Plaintiff baby suffered permanent injuries at the levels of C5-C8. During the repair nerve grafting surgery, the surgeons found a large neuroma at C5-C6 and that C7 was completely avulsed. During the repair the surgeons did not dissect down to visualize C8, however, a pre-operative MRI had been performed that showed a pseudomeningocele between C7 and T1 which indicated the C8 nerve root was avulsed. Plaintiff baby’s range of motion and activities of daily living have been and will continue to be impacted by her permanent injuries. There is no surgery or therapy that will return her function to normal.
The defense defended the suit in the usual manner, blaming the maternal forces of labor as the cause of the injury, arguing that the shoulder dystocia was an unpredictable and unpreventable obstetrical emergency and that the delivering obstetrician used standard acceptable obstetric maneuvers such as McRoberts, suprapubic pressure, and a rotational maneuver to resolve the shoulder dystocia, without applying anything more than gentle traction.
Plaintiffs’ experts opined that the standard of care required an obstetrician delivering a baby to use no more than gentle traction in the face of a shoulder dystocia and that gentle traction can only be used once the obstetrician believes that a maneuver has released the shoulder. If there is any resistance during the use of gentle traction, this would indicate to the obstetrician that the shoulder dystocia still exists, so the traction must cease immediately, and new maneuvers need to be instituted to free the shoulder. Plaintiffs’ experts opined that the defendant deviated from the standard of care in the delivery by applying more than gentle traction to the baby’s head when the shoulder was still impacted. Plaintiffs’ experts claimed that the severe permanent injury to the baby’s left brachial plexus was caused by the excessive traction utilized by the defendant at delivery in a downward direction.
Finally, plaintiffs’ experts opined that the maternal forces of labor theory argued by the defense as the cause of this baby’s permanent injury has never been visualized by any physician and is an unproven hypothesis based on unreliable statistical studies and unreliable mathematical models having no application.
The plaintiffs in this case were the baby, and then mom and dad for medical expenses as the family did not pursue this case before the statute of limitations had run on the mom’s individual claim.