Mom and her fetus were healthy, so the doctor rated the pregnancy as an “A” risk pregnancy, the lowest grade.
Mom was admitted to the hospital for the labour and delivery of her first child. A vaginal examination determined that she was 6 cm dilated. Her membranes were artificially ruptured. An internal scalp clip was applied to better monitor the fetal heart rate. This device fell off and was never re-attached.
Further vaginal examinations indicated that the progress of labour was slow, despite strong and regular contractions. This is a symptom of cephalo-pelvic disproportion (CPD), and under such circumstances a forceps delivery is contraindicated.
Later on, a vaginal examination by an intern determined that the cervix was at rim. The nurse advised the intern that the doctor was expected at the hospital shortly to perform a Caesarean section (C-section) on another patient, although that patient did not require urgent attention. When the doctor arrived he examined Mom and determined that she was now fully dilated. At this point, Mom had just entered the second stage of labour. Ordinarily, the second stage of labour is expected to last at least two hours in a first pregnancy. When the doctor removed his fingers following the vaginal examination, the fetal heart dropped. This deceleration lasted approximately five minutes but completely recovered.
The doctor attempted to deliver the baby by forceps, despite only one indication of the position of the fetal head, which placed it higher in the pelvis and unprepared for delivery. The operating room was not set up for an immediate C-section, as the standard of care required; the doctor in fact chose to perform the C-section in the labour room. Attempting a forceps delivery when the fetal head is high in the pelvis can cause grave injury to a mother and fetus. Mom’s chart had no indication of the station of the fetal head except in the doctor’s discharge note, which claimed Mom was fully dilated.
The baby suffered severe brain damage due to asphyxia during birth. He uses a wheelchair, has profound developmental delay and will always be dependent in all areas of self-care and daily living.
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