A baby boy residing in the, Town of Ajax, in the Regional Municipality of Durham, will suffer from permanent and devastating cerebral palsy after a doctor’s improper use of forceps sent him into severe distress. The plaintiffs were successful at trial obtaining a judgment of $8 million dollars against the negligent physician.
Mom’s family doctor was overseeing her first pregnancy, which was normal, so an ultrasound was thought to be unnecessary. When she was admitted to labour and delivery at a hospital in Ajax, Ontario, the fetus was in a transverse lie, where the shoulders were positioned sideways and closest to the cervix. Despite Mom being 6 centimetres dilated already and having adequate contractions, for some reason there was concern with the “slow” progress of the labour. The doctor ruptured her membranes and started Prostine tablets to stimulate contractions.
Five hours later, the fetus was not in distress, but was still in a transverse lie. Mom was fully dilated, so she was advised to push by the obstetricians. Mom wanted a Caesarean section (C-section) performed, but the obstetrician decided to try forceps instead. He did not prepare a C-section room since there was no emergency, which was contrary to protocol.
After examining Mom and finding the baby still positioned improperly, the doctor applied the forceps despite knowing that cephalopelvic disproportion was possible and that forceps could harm the fetus for this reason. The doctor’s first attempt to rotate the fetal head caused it to twist inside the Kjielland forceps, which are generally appropriate to rotate the fetal head a small distance but have little traction otherwise. He changed to Haig Ferguson forceps and applied traction for 45 seconds, after which the fetal head started to turn back towards a transverse position. He applied traction again, and the FHR plummeted. A profound bradycardia set in. Throughout this forceps process, the nurse could not find the FHR, since no scalp clip had been applied before the forceps were used. Since the C-section room had not been prepared in advance, despite the clear signs that it should have been, the baby was born severely asphyxiated due to the delay.
The baby has cerebral palsy with spastic quadriparesis and is fully dependent in all aspects of daily life.
Please see the News & Events section of our website for the Toronto Star article relating to this case.
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