Many complications can occur during a pregnancy. One complication that is extremely serious and requires prompt action is fetal distress. Fetal distress often occurs when the unborn baby's oxygen supply is somehow cut off. Fetal distress is noted by monitoring the unborn baby's heart rate. Under certain circumstances, such as when the heart rate drops below a certain range, immediate action such as an emergency C-section is required. This article examines a malpractice case where the delay lasted about two hours.
In this case a pregnant woman who had fallen was admitted to a hospital to make sure that there had been no trauma to her unborn baby. An ultrasound was performed and showed no injury to the baby. The woman was still concerned that something was wrong and requested further monitoring. Since the hospital was not equipped with a fetal heart rate monitor she was transported to a second hospital, her obstetrician was notified that she was being transported and the obstetrician agreed to meet her at the second hospital.
Once at the second hospital a fetal heart rate monitor was connected to the woman. The labor and delivery nurse at this hospital read the strip as non-reassuring and indicating that the unborn baby was in fetal distress. The second hospital and the nurse had been informed that the woman's obstetrician had agreed to go to that hospital to handle the care of the patient and her unborn baby. Even though clearly having noted that the baby was in fetal distress, the nurse nonetheless concluded that she should wait for the obstetrician to handle the situation rather than take any steps on her own or even notify an on-call obstetrician.
For the next two hours the nurse kept putting off notifying another doctor that the baby was in fetal distress. It was only when the monitor showed that the baby's heart rate too a steep drop to alarmingly low levels that she finally notified one of the hospital obstetricians. Once appraised of the situation this obstetrician did not hesitate to perform an emergency C-section. On performing the procedure the obstetrician discovered that the baby went through a period without a sufficient oxygen supply (which accounted for the drop in the heart rate) due to a placental abruption.
The obstetrician knew the patient was being transported to the second hospital and expected her doctor to meet her there. However, rather than go to the hospital as he said he would do, the obstetrician went home. This would not have been a problem if the obstetrician had informed someone at the second hospital of this decision. Thinking the obstetrician was on the way the nurse at the second hospital, who might normally have immediately notified another doctor of the fetal distress, waited and continued to wait for two hours for a doctor that would never show up.
At birth the baby was non-responsive. Even though the medical staff attempted resuscitative measures they were not able to revive the baby whose Apgar scores were 0 and 0. As this case demonstrates, a physician who agrees to follow up on the care of the patient and does not may be liable for malpractice not to and a nurse who does not notify a physician or take other appropriate action immediately upon noting signs of a serious complication in the pregnancy may also be liable. Here the law firm that represented the family reported that the matter settled for $750,000.
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