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Did delay in delivery cause brain softening?

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A woman who fell at 34 weeks’ gestation was hospitalized and noted to have irregular contractions but no evidence of preterm labor or abruption. Three weeks later, during a regularly scheduled visit, a decision was made to induce labor based on ultrasound findings suggestive of intrauterine growth restriction.

After a difficult delivery, the infant had Apgar scores of 2, 6, and 7 and a cord blood arterial pH of 7.10. Initially limp with no respiratory effort and poor color, the infant was placed on continuous positive airway pressure and given sodium bicarbonate.

While in the neonatal intensive care unit, the baby had apneic episodes with decreased oxygen saturations and heart rate. He was observed to have increased tone and extension of the arms. A computed tomography scan revealed occipital/parietal and subarachnoid blood along with subdural bleeding. He was later diagnosed with encephalomalacia, a seizure disorder, and severe developmental delays.

In suing, the family blamed the child’s encephalomalacia and seizure disorder on a delay in delivery.

The obstetrician claimed the decision to induce labor was proper, that the infant was properly monitored throughout labor, and that interventions were appropriate.

  • The case settled for $1.7 million.
The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, of Nashville, Tenn (www.verdictslaska.com). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.
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Unknown Massachusetts venue

A woman who fell at 34 weeks’ gestation was hospitalized and noted to have irregular contractions but no evidence of preterm labor or abruption. Three weeks later, during a regularly scheduled visit, a decision was made to induce labor based on ultrasound findings suggestive of intrauterine growth restriction.

After a difficult delivery, the infant had Apgar scores of 2, 6, and 7 and a cord blood arterial pH of 7.10. Initially limp with no respiratory effort and poor color, the infant was placed on continuous positive airway pressure and given sodium bicarbonate.

While in the neonatal intensive care unit, the baby had apneic episodes with decreased oxygen saturations and heart rate. He was observed to have increased tone and extension of the arms. A computed tomography scan revealed occipital/parietal and subarachnoid blood along with subdural bleeding. He was later diagnosed with encephalomalacia, a seizure disorder, and severe developmental delays.

In suing, the family blamed the child’s encephalomalacia and seizure disorder on a delay in delivery.

The obstetrician claimed the decision to induce labor was proper, that the infant was properly monitored throughout labor, and that interventions were appropriate.

  • The case settled for $1.7 million.
The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, of Nashville, Tenn (www.verdictslaska.com). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.

Unknown Massachusetts venue

A woman who fell at 34 weeks’ gestation was hospitalized and noted to have irregular contractions but no evidence of preterm labor or abruption. Three weeks later, during a regularly scheduled visit, a decision was made to induce labor based on ultrasound findings suggestive of intrauterine growth restriction.

After a difficult delivery, the infant had Apgar scores of 2, 6, and 7 and a cord blood arterial pH of 7.10. Initially limp with no respiratory effort and poor color, the infant was placed on continuous positive airway pressure and given sodium bicarbonate.

While in the neonatal intensive care unit, the baby had apneic episodes with decreased oxygen saturations and heart rate. He was observed to have increased tone and extension of the arms. A computed tomography scan revealed occipital/parietal and subarachnoid blood along with subdural bleeding. He was later diagnosed with encephalomalacia, a seizure disorder, and severe developmental delays.

In suing, the family blamed the child’s encephalomalacia and seizure disorder on a delay in delivery.

The obstetrician claimed the decision to induce labor was proper, that the infant was properly monitored throughout labor, and that interventions were appropriate.

  • The case settled for $1.7 million.
The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, of Nashville, Tenn (www.verdictslaska.com). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.
Issue
OBG Management - 17(10)
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OBG Management - 17(10)
Page Number
60-62
Page Number
60-62
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Did delay in delivery cause brain softening?
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