Mom, a Peterborough native, was a 29-year-old pregnant woman who was initially seen by her family doctor and was also referred to an obstetrician. A few weeks prior to Mom’s projected due date, she told her obstetrician that her baby was not moving much. The obstetrician informed her that the baby was not very big for that stage in the pregnancy and told her to go to the hospital. Twice Mom attended the Peterborough area hospital for fetal heart monitoring before she went into labour and both times the tests were normal.
One morning, Mom noticed that her baby was moving even less. She went to the hospital and the nurses performed a non-stress test (NST) which indicated that the baby was in serious distress (the NST was “non-reactive” and decelerations were noted). In light of this, Mom was admitted to the hospital as a high-risk patient (she was 41 weeks gestation). The obstetrician performed an artificial rupture of membranes (ARM), with no amniotic fluid attained. This should have been concerning to the obstetrician, but it was not. Shortly thereafter, the obstetrician ordered induction of labour by way of administering a drug called oxytocin. Considering that there was decreased fetal movement for several hours prior to admission, that Mom was post-term, that intrauterine growth restriction (IUGR) was suspected, that no fluid was obtained when the ARM was performed and that the NST was non-reactive, Mom should have never been induced. Instead, a Caesarean section (C-section) should have been performed.
To make matters worse, the obstetrician left the hospital and returned to his office after the induction was ordered. But it was not only the obstetrician who was negligent when he ordered the induction- the nurses were also negligent for carrying it out. The nurses should have refused to carry out the induction regardless of the doctor’s orders. The nurses should have expressed their concerns about the induction and ought to have insisted that the obstetrician remain in the hospital to ensure there was proper back-up for a C-section before the oxytocin was started. In addition, in light of the circumstances, the nurses were negligent, as one-to-one nursing care was not provided and no primary nurse took responsibility for mom, who would have a view of the entire process.
Once the induction was started, the nurses repeatedly documented fetal heart rate abnormalities in the form of decelerations and the lack of heart rate variability, despite having Mom change positions and giving her oxygen. The obstetrician was notified of this by telephone, but instead of attending immediately and delivering the baby by C-section, the obstetrician gave different orders. The induction should have never been ordered; however, once the induction was started, at the first sign of fetal distress, the obstetrician should have delivered the baby, and this was not done. The obstetrician finally attended over an hour later and performed a C-section, due to the significant fetal heart rate abnormalities.
The baby was born in very poor condition after been asphyxiated and covered in green meconium. That night, the baby began to develop seizures. There was also evidence that the baby suffered renal failure and liver dysfunction. It was determined that the baby suffered a hypoxic-ischemic insult to the brain which occurred prior to birth and was subsequently diagnosed with cerebral palsy.
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