Family of Disabled Boy Receives Millions of Dollars in Settlement After Nursing Staff Fails to Monitor Fetal Heart Rate
A disabled boy and his family have recovered millions of dollars in damages after hospital staff failed to respond to clear signs that he was in distress prior to delivery.
Mom was admitted to the hospital after an uneventful pregnancy. The fetal heart rate (FHR) rose steadily over the next 1 hour and 30 minutes from 140 beats per minute (bpm) to 180 bpm and greater, showing severe tachycardia. There were only 3 notations of the FHR during this time, despite fetal tachycardia being associated with hypoxemia and acidosis. In such cases, late decelerative changes can only be documented electronically, and are exceedingly difficult to detect by intermittent auscultation (using a stethoscope). Therefore, FHR monitoring was not only insufficient, but was done using an incorrect method. Continuous monitoring is always the standard of care when a fetus is tachycardic, since late decelerations cannot be accurately detected with a stethoscope. The basic standard of care required that this be done every 15 minutes once labour was established in the first stage.
Mom’s temperature rose steadily over 4 hours, and she became uncomfortable with the contractions and very tired. The doctor ruptured her membranes. Approximately 2 hours later the baby was born, covered with meconium from the lack of oxygen. He was suctioned and intubated, but clinical notes were vague. There is no indication of how, by whom and during what period the baby’s airway was handled, but the baby was clearly suffering from hypoxic ischemic encephelopathy. Oxygen was given and tracheal suctioning was performed, but at what point is unknown. An intravenous line was started at 40 minutes old, when the baby could still neither cry nor draw a breath.
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