Substandard Perinatal Care Results in Severe Birth Defects

In this case, an expectant mother came into the hospital complaining of contractions. After a two day hospital stay the mother began to complain of increased contractions, at which point one of the physicians notes “non-reassuring fetal testing” related to a possible infection in the mother. Nevertheless, the child was born via vaginal birth, with notes that the labor was spontaneous and rupture of membranes artificial. The physician’s notes state that complications experienced by the child during birth included fetal tachycardia and infection of the fetal membranes. In the period leading up to the birth, the patient was noted to be in distress and showing signs of illness, but no orders were given and the plaintiff wasn’t seen by the physician. The child now suffers from profound disabilities related to a birth defect, and the evidence suggested that the injury occurred in the days prior to birth.

Question(s) For Expert Witness

1. How often do you come across this clinical picture in your practice?

2. Does the scenario above reflect a departure from the standard of care?

Expert Witness Response E-008270

I would be happy to review the medical record and provide my opinion on the cause of injury and the extent to which the clinicians of record provided care that met the accepted standard. Fetal tachycardia is a typical consequence of this sort of infection, which is a not-uncommon complication of labor. This particular variety of birth defect is rare and tragic, and it is possible that there is some evidence in the fetal testing that was done of the onset of injury. The clinical scenario of labor with this infection is relatively common, and I have seen that many many times. Fortunately, this birth defect is relatively rare, and I have seen labor lead to this complication only a few times. From the description provided, it seems likely that the standard of care was departed from in the care of this patient, especially when one considers the distressing test results that emerged in the days leading up to birth.