Failure to Order Caesarean Section Results in Negligent Forceps Delivery — MD to Pay $12 Million

Mom arrived in Canada and moved to Etobicoke, Ontario when she was approximately 6 months pregnant. She had seen an obstetrician in her former country, who confirmed that her pregnancy was normal.

A doctor referred her to a specialist, after finding out that Mom had gestational diabetes. An ultrasound showed increased amniotic fluid and that her fetus’ abdominal circumference was large relative to its head circumference. The specialist incorrectly noted that Mom was at 38 weeks’ gestation. She was referred to another specialist because of suspected polyhydramnios, (excess amniotic fluid) and microcephaly, and was told she may have to undergo a Caesarean section (C-section) when she delivered.

When Mom was admitted to the hospital, she was only 3 cm dilated and the head was not ready for delivery. Even though orders were given by an intern consistent with preparing her for a C-section, the doctor seemed to favour vaginal delivery and an Oxytocin increase to speed up labour as Mom’s contractions got stronger. Eventually the doctor administered oxygen and the fetal heart rate (FHR) began to go down. Mom was transferred to the delivery room when she was 8 cm dilated, but still the doctor did not order a C-section. An hour later, the fetal head began to rotate, slowly, indicating that delivery was slowing down.

Mom became fully dilated. The fetal head quickly crowned and the baby was delivered vaginally, without an episiotomy just over 9 hours after Mom’s membranes ruptured. Cardiac compressions were given to the baby since his heart was not beating. The baby had shoulder dystocia (failure of shoulders to deliver after the fetal head) from being stuck in the birth canal without oxygen for about 15 minutes. Even though it was clear that the baby should have been delivered by C-section, the nurses only noted that the delivery was spontaneous, despite the Oxytocin that had been administered, and there were forceps markings found on the baby’s arm and face.

The baby sustained hypoglycemia and hypoxic ischemic encephalopathy from being asphyxiated in the birth canal, and developed renal failure soon after birth. He had an acute brachial plexus lesion on his left arm where the forceps had lacerated his spinal nerves, leaving him unable to move his left side. His left side remains severely damaged, as a result of the doctor bending his neck from side to side while trying to extract him from the birth canal, a process which never should have happened since the need for a C-section was obvious.

Please see the News & Events section of our website for the Toronto Star article relating to this case.

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