For eight years in the 1990s, Attorney Charles Ware hosted the extremely popular legal advice radio program "The Lawyer's Mailbox"; the Number One (#1)legal advice radio program in the Mid-Atlantic Region,on WEAA - 88.9 FM, Morgan State University Radio in Baltimore, Maryland.
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Thursday, August 21, 2014

CHARLES WARE'S OB/GYN MEDICAL MALPRACTICE UPDATE FROM MARYLAND

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Charles Jerome Ware, Attorneys & Counselors, LLC, is a premier Maryland-based nationally-respected and highly-regarded medical malpractice law firm.  For an initial courtesy consultation, call us at (410) 730-5016 or (410) 720-6129.

$9,600,00 JURY VERDICT: GROSS – MEDICAL MALPRACTICE – OB/GYN – FAILURE TO MEASURE FUNDAL HEIGHT IN PRE-NATAL VISITS, OBSERVE LACK OF FINAL MONTH FETUS GROWTH, AND DIAGNOSE PLACENTAL INSUFFICIENCY – PROFOUND BRAIN DAMAGE – CO-DEFENDANT MATERNAL-FETAL SPECIALIST FOUND NEGLIGENT BUT WITH ABSENCE OF PROXIMATE CAUSE. [and see, JVRA August Medical Expert Update/8-20-2014/www.jvra.com/verdict_trak/article].

In this medical malpractice case, the plaintiff -- a mother -- contended that the initial defendant, an ob/gyn, negligently failed to take measurements of fundal height, which the plaintiff maintained should be conducted at every visit after the first trimester. The plaintiff contended that this failure resulted in the initial defendant not realizing that there was an absence of fetal growth during the final month of the pregnancy. The plaintiff also maintained that the initial defendant did not appreciate that this absence of growth, taken together with the mother’s hypertension and the persistent presence of 2+ protein in the urine were strong signs of placental insufficiency and probable pre-eclampsia. Had these problems been detected through proper testing, labor would have been induced before any injury occurred.

When the plaintiff mother reported that the fetus stopped moving at 39 weeks, the initial ob/gyn defendant sent the plaintiff to the hospital where the co-defendant maternal-fetal physician performed a non-stress test. The initial defendant did not advise the co-defendant about the history of persistent 2+ protein in the urine or elevated blood pressures. This co-defendant’s nurse reported to the referring ob/gyn that the test was non-reactive, but not that it showed absent fetal heart rate variability, or that the mother had a persistent headache and high blood pressures. There was no doctor-doctor communication regarding the patient.

The plaintiff contended that the findings on the non-stress test were indicative of fetal hypoxia, that an emergency C-section was mandated upon completion of the non-stress test and that under these circumstances, even a short additional delay caused damage to the baby.

A C-section was conducted by the referring ob/gyn several hours after the mother presented for the non-stress test and the baby was born with cerebral palsy, meconium aspiration syndrome, spastic quadriplegia and cortical blindness and will require 24-hour per day care permanently. He is non-verbal.

The plaintiff maintained that the defendant ob/gyn deviated from the established standard of care in failing to take simple measurements of fundal height. The plaintiff contended that if he had, he would have ascertained an absence of growth during the final month and delivered the baby several days earlier.

The baby was small for gestational age at birth. The plaintiff maintained that this factor, taken with the finding of hypertension of the mother and protein in the urine, indicated placental insufficiency, and would have properly conveyed the emergent nature of the condition to the initial defendant and prompted an earlier C-section on the day of the delivery.

The plaintiff also contended that the co-defendant should have appreciated the emergent nature of the condition. The plaintiff maintained that the non-reactive test and clinical findings mandated an emergency C-section. The time stamped tracings of the non-stress test, which showed the condition of the fetus during different portions of the test, were apparently mislaid, and there were no other records precisely pinpointing the time these portions of the test were taken. The plaintiff maintained that when dealing with placental insufficiency at term, failure to remove the baby from a hostile uterine environment can result in catastrophic injuries. The plaintiff contended that the jury should draw an adverse inference from the absence of these records and if available, would probably establish that a timely C-section would have prevented the brain damage that occurred during the two hours between the non-stress test and the delivery.

The maternal-fetal specialist denied that this position should be accepted, and maintained that it was likely that by the time the mother presented for the non-stress test, it was already too late to prevent the injury. This defendant contended that the loss of these records was inadvertent and the court held that in the absence of evidence of intent to hide the records, an adverse inference instruction would not be appropriate. The evidence reflected that the non-stress test was commenced in the late afternoon and that the mother was sent to labor and delivery immediately thereafter. Although there were no fetal heart rate decelerations on the non-stress test report, decelerations developed when the patient was on labor and delivery, which indicated a worsening of the baby’s condition.

The child was delivered by C-section two hours after the mother arrived at labor and delivery. The plaintiff maintained that the child was born with cerebral palsy, spastic quadriplegia and cortical blindness. The evidence reflected that the child will need 24-hour-per day care for life. The plaintiff maintained that with proper care, the child could reach the sixth decade of life. The defendant contended that it is doubtful that the child will live beyond approximately age 30.

The plaintiff offered evidence of pecuniary loss that was contained in approximately 15 scenarios as testified by a life care planner and an economist. These scenarios were based on factors such as whether the child, whose father is a policeman and mother a homemaker, would have gone to college, various possible life expectancies and whether his future care was furnished at home or in an institution. The plaintiff’s financial proofs ranged from approximately $7 million in costs to approximately $20 million in costs.The jury assessed gross damages at $9,600,000, found that the defendant ob/gyn was causally negligent, attributed 65% of the gross damages to his negligence and 35% to the preexisting condition under Scaffidi. The jury also found that although the maternal-fetal specialist was negligent, there was an absence of proximate cause as to his negligence.

[For more information, contact Zarin's Jury Verdict, JVPA August Medical Expert Update]

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