Top 25 Medical Malpractice Cases of a 25 Year Career – Negligently Managed Birth
In this series of articles BC and Alberta personal injury and medical malpractice lawyer Angela Price-Stephens describes her top 25 notable medical malpractice cases of her 25-year career to date. Her selection of cases is a representation of the breadth of her experience, the complexity of cases, the twists and turns in the evidence and the dramatic benefit to her clients and their respective families by successfully pursuing their claim with Angela and her team.
Angela has litigated cases across Canada and England and Wales. The names and distinguishing details of the cases referred to in this series of articles have been changed to protect the client. In all cases of settlement for medical malpractice the lawyers for the defendant healthcare providers insist on a confidentiality clause in which the existence of a settlement (payout of money to the former patient, irrespective of whether an admission of liability was made) must remain a secret.
In this eighth article in the series Angela reflects on the case of Jaeden and his mother Jennifer who were both severely damaged as a result of a negligently managed birth. Her first child was born by emergency C-section for failure to progress (which essentially means that while the process of labour started, with contractions and dilation of the cervix, this progress halted). The second pregnancy with Jaeden, two years later, was uneventful; all milestones in the pregnancy were met and labour was induced artificially at 41 weeks. Jennifer’s labour was long with the first stage lasting over 30 hours. Contractions stopped. Jennifer complained of extreme abdominal pain which was initially dismissed as normal labour pains. Unfortunately the fetal heart trace was either initially misread or simply not understood. The trace showed patterns of fetal heart rate which are entirely consistent with severe fetal distress. They were properly described as recurrent late decelerations and bradycardia; which in layman’s terms are a slow heart rate, slow to recover to a normal level. The student nurse noted the baby had moved ‘back’, losing the gains it had achieved moving towards the birth canal. The mother’s complaints of abdominal pain heightened to a pain scale which she described as “unbearable”. As a result of the severe pain, despite analgesic provided to the labouring mother and a nurse paged the on-call obstetrician. Evidence demonstrated that the nurses attending Jennifer has failed to read the fetal heart tracing correctly; failed to recognize the risk of uterine rupture following a previous C-section and the red flag of the baby losing ground in its entry to the world.
Essentially the catastrophe that was unfolding went unrecognized. Jennifer’s previous C-section scar had torn and her unborn child had been released into the pelvic cavity. Unfortunately the obstetrician on call did not arrive in a timely fashion and there were crucial minutes were Jaeden did not receive sufficient oxygen. Upon arrival of the obstetrician the ruptured uterus was recognized and Jennifer gave birth under general anesthetic. He was born ‘floppy’ and ‘blue’ and required considerable respiratory supported. Jaeden was later diagnosed with global hypoxic brain damage caused by lack of oxygen during the birth. The damage within Jennifer’s pelvis included damage to her bladder, left fallopian tube and a ruptured uterus requiring hysterectomy.
While the story thus far necessarily intimates negligence, claims against doctors, clinicians and health authorities are rarely straight forward. At the time Jaeden was born it was standard of care for a mother to have a trial of labour after caesarian section (VBAC). A ruptured uterus is a risk of labour and so, as with every other case of alleged negligence, is it essential to identify specifically what steps or failures caused or contributed to the devastating outcome.
With careful use of independent experts Angela demonstrated that there had been a breach of standard of care in inducing the labour, which increases risks of complications, with insufficient resources readily available to response to a potential emergency. It was also demonstrated the fetal heart trace was incorrectly read. Had the trace been understood and acted upon the baby would have been born by emergency C-section likely 42 minutes earlier than had actually occurred. The medical evidence supported the theory that had Jaeden been born at least 25 minutes earlier he would likely have avoided brain damage.
The tragedy of situations like Jaeden and Jennifer is that they affect everyone involved, for life. Jaeden will never live independently, go to school, university, enjoy a career, have a family of his own. The dynamics of Jennifer’s family have drastically changed. She and her partner try to provide a ‘normal’ life to their first child but there is simply never enough time. The divergent needs of both their children are irreconcilable and insurmountable. There are few marriages or partnerships that last such a catastrophic event and the continuing aftermath.
When seeking compensation for families affected by such catastrophic medical mistakes Angela and her team are careful to ensure the full picture of the loss is captured. Experts are engaged not just to demonstrate the loss but to support the family members while the litigation is ongoing. It is essential for those injured to have the best opportunity to receive both compensation and the support of an in tact family.
Jaeden and Jennifer’s claims were resolved for large sums which included the significant life-long care Jaeden would require to keep him safe and in a loving home (and out of an institution). Jennifer was also compensated for the psychological injuries sustained during the highly traumatic birth during which she feared for both her own life and the life of her unborn child and the chronic pain of her pelvic injuries.