Medical Malpractice – Childbirth – Brain Damage
SETTLEMENT: A $4,000,000 settlement at the close of Pltf.’s case for a medical malpractice action arising from the events surrounding Pltf.’s birth on 7/3/73.
Apportionment: Good Sam $2,500,000; Dr. Pillitieri $1,000,000; Dr. Swierbutowicz $500,000.
VII/6-40 Medical Malpractice – Childbirth – Brain Damage
SETTLEMENT Christopher Loria, inf. by f/n/g Arthur Loria v. Good Samaritan Hospital, Ronald Housman, Peter Pillitieri, George Swierbutowicz, Lew Cibeu and Philip Mulholland 24402/79 Date of Settlement 2/14/89 Suffolk Supreme
Pltf. Atty: Harvey Weitz of Schneider, Kleinick & Weitz, Manhattan
Deft. Atty: N/A
It was uncontested that Pltf. suffered hypoxia caused by a prolapsed cord. Deft. alleged that the prolapse of the cord was impossible to diagnose during the minutes immediately prior to the child’s birth. Pltf. contended that the fetal distress caused by the prolapsed cord was secondary to multiple medical departures which preceded the episode, including the failure to properly and adequately monitor the labor. Pltf. contended that the fetal distress should have been detected sooner than it was, that the obstetrician failed to comply with accepted standards of medical practice even after recognizing that the fetus was suffering from hypoxia, that the Deft. anesthesiologist failed to properly resuscitate the infant and prolonged the hypoxic incident, and that Defts.’ subsequent treatment exacerbated the infant’s injuries through a failure to properly prescribe post-discharge treatment.
Mrs. Loria was an obese patient who had previously delivered a stillborn child and a healthy child. After being admitted to the hospital at 9 AM, Dr. Pillitieri prescribed 100 mgs. of Demerol, 50 mgs. of Sparine and 1/100 of a grain of Scopolamine. Demerol is a respiratory-depressing medication which crosses the placental barrier. Its use in conjunction with Pitocin raised the need for fetal heart rate monitoring. Deft. was increasing the strength and frequency of contractions while simultaneously depressing respiration. At 10:25 AM, Dr. Pillitieri performed an amniotomy. The performance of an amniotomy can cause prolapse of the cord. The mother was four centimeters dilated and the fetal heart rate was 140 and regular. Syntocinon or Pitocin was administered. Because Pitocin increased the -severity and frequency of the contractions, the compression of the cord and hypoxia resulted. The risks to the patient rendered use of the drug inappropriate unless there was some indication or medical need for its use. In this case, labor was proceeding normally with no indication that the drug was necessary.
From the time the Pitocin was administered until the time the heartbeat could no longer be detected, about 2 hours, the fetal heart rate was monitored only twice by a nurse. At 11:20 AM the nurse noted that the rate had dropped from 140 to 136 (still normal). One hour later, the rate had dropped to 128. By 12:45 PM no heartbeat could be detected. At 12:40 PM the anesthesiologist began administering anesthesia. The pediatrician was not notified that the fetus was in distress. At 12:50 PM, the heartbeat was 80 bpm, well below the normal range.
The infant was born at 12:56 PM. His Apgar score was 3 at 1 minute after birth and 3 after 5 minutes. The child was not breathing when he was born, and was allowed to remain breathless for 3 minutes after his birth. Defts. contended that they were attending to the mother at that time. There was also a premature separation of the placenta. The infant did not breathe spontaneously for the first 10 minutes of his life, and soon exhibited seizures. Injuries: spastic quadriplegia and athetoid cerebral palsy. Pltf. Experts: Dr. Leon Charash, pediatric neurologist, Wantagh (on damages); Dr. David Schonholz, ob-gyn, Manhattan (on liability ); Dr. Johannes Bartels, anesthesiologist, Manhattan (on liability). Deft. Experts: Dr. Edward Sinnott, anesthesiologist, Mineola, for Dr. Swierbutowicz; Dr. Vincent Mastrota, ob-gyn, Bayside, for Dr. Pillitieri.