Personal Injury Lawyer Blog
(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)
6) Substandard care to have given Terbutaline at 10:20 am, whether ordered by Dr. U. or not, given the likelihood that the placenta was abrupting (based on irritable uterus, abdominal pain and frequent, small decelerations occurring every minute), as this medication causes a vaso-dilation which aggravated perfusion to the fetus, contributing to ischemia of the fetus. From this point until delivery, the fetus was under increasing fetal distress and hypoxia from decreased placental perfusion.
7) L&D nursing notes indicate that the anesthesiologist was at the patient’s bedside at 10:32 am. At deposition, Dr. X. denied having seen the patient in L&D. Yet, spinal analgesia was not administered until 11:08 am, 36 minutes after the note suggests that the anesthesiologist was at bedside. L&D nursing personnel had an absolute duty to discuss the case with Dr. X., to obtain a surgeon and run the CRASH Cesarean section given circumstances in which they obligated Dr. U. to deliver the breech patient without having informed Dr. D. of his commitments, and having failed to contact other available OB/GYNs to avoid any further delay in the delivery of Ms. Cruz.
8) Failure to properly interpret the fetal monitor tracing at 10:52 am, leading to a reticence on the part of L&D nursing personnel to pursue the Cesarean delivery of Ms. Cruz on a CRASH or STAT basis. In fact, the external monitor demonstrated a doubling of the FHR (as it was known to do when the FHR became exceedingly low) while L&D personnel assumed that the FHR was once again within normal limits. While L&D personnel acted as if the fetus had recovered, the fetus was likely becoming further de-compensated with a baseline of 65-75 bpm at that time, culminating in an absent FHR at 11:07. If, at 10:52 am, L&D nurses informed Dr. X. that the FHR had stabilized with variability in the range of 130-155 bpm” causing him to defer anesthesia or to assume he had the time to administer spinal analgesia, then they fell below the standard of care in the community. Further, there was a failure to actively monitor the fetus following transfer from L&D. Between 10:52 am and 11:10 am, a period of 18 minutes, no fetal monitoring was conducted. During this period, there is a total absence of the mother’s pulse documented in the chart, suggesting that L&D nursing personnel never considered that the apparent change in the fetal heart rate was in fact evidence of the mother’s heart rate instead..
9) L&D nursing failure to consistently and adequately document the mother’s chart.
Martha deteriorated over a period of at least 1 hour and 45 minutes during which time the abruption worsened, evidenced by a consistently decreasing baseline, loss of variability until it was absent, and an increase in the severity of decelerations and finally no heart rate at all. Regional Medical Center had waited so long to deliver Ms. Cruz that the minor Plaintiff, Martha Cruz, suffered severe and irreversible brain damage during the final minutes before delivery. (See Part 10 of 11.)
For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.