(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)
Due to absence of comprehensive nursing notes on Ms. Cruz while she was in L&D, exceedingly poor memories of the witnesses whose depositions have been taken to date, and a lack of access to the chart on the breech patient, the facts relating to both Ms. Cruz and the breech patient while each were in L&D and the OR remain somewhat uncertain.
Ms. Cruz was a 42-year-old mother of six when she first began receiving prenatal care from Dr. U. at Universal Health Clinic on April 18, 2002. An OB sonogram revealed a due date of October 23. Ms. Cruz had no complaints until August, 2002. During the month of August, Ms. Cruz developed headaches, weakness and sweats. Later that month, a 3-hour glucose tolerance test (GTT) found excess sugar so she was referred to a high-risk OB to manage those problems. During the months of August and September her systolic blood pressure rose to 140. Late in September, Ms. Cruz was seen by a high-risk OB and ante-partum testing was begun on October 1. On October 1, a non-stress test (NST) revealed a healthy, reactive fetus. The systolic pressure on Ms. Cruz remained borderline at 140. No physician thought it necessary to place Ms. Cruz on anti-hypertensive medication or on magnesium sulfate based on these borderline values. Her pressures never increased from that level for any significant period of time.
At approximately 6:00 am on October 5, 2002, Ms. Cruz woke with cramping, abdominal pain at home and took a taxi across town to Regional Medical Center, where she understood that Dr. U. delivered his patients. Accompanying her was her 17-year-old daughter, Amanda Cruz, who spoke English well. (See Part 4 of 11.)
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