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Did hydrocephalus stem from failure to follow protocol?

Los Angeles County (Calif) Superior Court

A woman presenting to a hospital at 36 4/7 weeks’ gestation successfully delivered an infant son. The next day, however, the child developed respiratory distress. He was transferred to another hospital where he was diagnosed with group B streptococcus (GBS) meningitis. He was treated with intravenous antibiotics for 3 weeks and then discharged.

Nine days later, he was readmitted to the hospital with coarse breathing sounds, congestion, and fever. Magnetic resonance imaging results were read as normal; the attending doctor believed the symptoms were related to the resolving GBS infection.

Approximately 7 weeks later, during a routine examination, the child was noted as macrocephalic. Computed tomography confirmed a diagnosis of hydrocephalus.

In suing, the infant patient claimed his meningitis and hydrocephalus stemmed from improper treatment of the GBS. He argued that since his mother presented for delivery at less than 37 weeks’ gestation, she should have received prophylactic intravenous antibiotics—as recommended by the American College of Obstetricians and Gynecologists (ACOG) in a protocol announced 3 months prior to his birth. The child, now 6 years old, has been assessed as borderline mentally retarded, which he claims is due to the events following his birth.

The doctor and staff maintained that the standard of care did not require intravenous antibiotics, as the ACOG recommendations were too recently announced to have become routine practice. They further argued that the hydrocephalus was congenital and not related to GBS, and thus antibiotics would not have altered the outcome.

  • The case settled for $3 million.
The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts (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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Los Angeles County (Calif) Superior Court

A woman presenting to a hospital at 36 4/7 weeks’ gestation successfully delivered an infant son. The next day, however, the child developed respiratory distress. He was transferred to another hospital where he was diagnosed with group B streptococcus (GBS) meningitis. He was treated with intravenous antibiotics for 3 weeks and then discharged.

Nine days later, he was readmitted to the hospital with coarse breathing sounds, congestion, and fever. Magnetic resonance imaging results were read as normal; the attending doctor believed the symptoms were related to the resolving GBS infection.

Approximately 7 weeks later, during a routine examination, the child was noted as macrocephalic. Computed tomography confirmed a diagnosis of hydrocephalus.

In suing, the infant patient claimed his meningitis and hydrocephalus stemmed from improper treatment of the GBS. He argued that since his mother presented for delivery at less than 37 weeks’ gestation, she should have received prophylactic intravenous antibiotics—as recommended by the American College of Obstetricians and Gynecologists (ACOG) in a protocol announced 3 months prior to his birth. The child, now 6 years old, has been assessed as borderline mentally retarded, which he claims is due to the events following his birth.

The doctor and staff maintained that the standard of care did not require intravenous antibiotics, as the ACOG recommendations were too recently announced to have become routine practice. They further argued that the hydrocephalus was congenital and not related to GBS, and thus antibiotics would not have altered the outcome.

  • The case settled for $3 million.
The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts (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.

Los Angeles County (Calif) Superior Court

A woman presenting to a hospital at 36 4/7 weeks’ gestation successfully delivered an infant son. The next day, however, the child developed respiratory distress. He was transferred to another hospital where he was diagnosed with group B streptococcus (GBS) meningitis. He was treated with intravenous antibiotics for 3 weeks and then discharged.

Nine days later, he was readmitted to the hospital with coarse breathing sounds, congestion, and fever. Magnetic resonance imaging results were read as normal; the attending doctor believed the symptoms were related to the resolving GBS infection.

Approximately 7 weeks later, during a routine examination, the child was noted as macrocephalic. Computed tomography confirmed a diagnosis of hydrocephalus.

In suing, the infant patient claimed his meningitis and hydrocephalus stemmed from improper treatment of the GBS. He argued that since his mother presented for delivery at less than 37 weeks’ gestation, she should have received prophylactic intravenous antibiotics—as recommended by the American College of Obstetricians and Gynecologists (ACOG) in a protocol announced 3 months prior to his birth. The child, now 6 years old, has been assessed as borderline mentally retarded, which he claims is due to the events following his birth.

The doctor and staff maintained that the standard of care did not require intravenous antibiotics, as the ACOG recommendations were too recently announced to have become routine practice. They further argued that the hydrocephalus was congenital and not related to GBS, and thus antibiotics would not have altered the outcome.

  • The case settled for $3 million.
The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts (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 - 16(03)
Issue
OBG Management - 16(03)
Page Number
70-73
Page Number
70-73
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Did hydrocephalus stem from failure to follow protocol?
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