Mom, an MBA from a top Toronto university, became pregnant with her second child, a boy.
Following her pregnancy, Mom went into labour and presented to Hospital.
At about 4:50 pm, she was seen by the triage nurse, who immediately brought her to Labour and Delivery. The nurse did not check Mom’s cervical dilation or assess the fetal wellbeing.
When Mom arrived at Labour and Delivery she was met by a second nurse, ‘Nurse D’. Nurse D. checked Mom’s blood pressure, but failed to assess Mom’s cervical dilation or the fetal heartrate[ The fetal heartrate is an important indicator of the baby’s wellbeing.]. The first record of fetal heartrate was at 5:30- about 45 minutes after Mom first presented to the Hospital.
It was only at 5:43 pm, that Nurse D. performed a vaginal examination. She found Mom’s cervix to be fully dilated and her membranes were bulging. Nurse D. ruptured Mom’s membranes, which was in breach of the standard of care for an Ontario nurse.
Following the rupture of the membranes, Nurse D. began checking the fetal heartrate intermittently with a stethoscope (otherwise known as “auscultation”).
At 6:00pm Nurse D. noted that Mom was having excessive contractions and that the baby’s heartrate was very close to being bradycardic (abnormally low)[ An abnormally low fetal heartrate can associated with fetal compromise, and should be monitored closely. ]. Despite these findings, she neglected to switch to an Electronic Fetal Monitor (EFM) which would have allowed continuous monitoring of the baby’s heartrate.
This continued despite, despite three separate findings of an abnormally low fetal heartrate over the next hour or so.
The baby was born at 6:59pm. He had no heartrate and was unresponsive.
Bag and mask compressions were started in the delivery suite and a code pink was called. The baby was rushed into the Neonatal Intensive Care Unit (NICU) where he was intubated and resuscitative measures were continued. His first heart rate was at 7 minutes, his first gasps were at 10 minutes, and did not move spontaneously until 1 hour after birth.
He was discharged home nine days later with a diagnosis of Hypoxic Ischemic Encephalopathy (HIE), Perinatal Depression and Acute Tubular Necrosis (ATN).
The baby, now a young boy, sustained permanent brain injury and has been diagnosed with Cerebral Palsy. He has right hemiplegia, an unsteady gait, and learning and articulation difficulties. He has difficulty using eating utensils, he struggles with zippers, and occasionally gets stuck donning a sweatshirt. As he gets older, he will probably have difficulty maintaining friendships due to poor social skills, and will likely require assistance and supervision due to his handicaps.
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