Medical Causation Expert Witness and Birth Injury Expert Witness Properly Barred, 8th Circuit Finds

Case:

Dawn Lawrey v. Good Samaritan Hospital, et al., No. 12–3863, Eighth Circuit U.S. Court of Appeals; June 4, 2014

Background:

Aubree Lawrey was born with a permanent brachial plexus injury to her right shoulder and arm. The injury resulted from a posterior shoulder dystocia. During delivery, her shoulder became stuck behind her mother’s tailbone before her head crowned.

Aubree’s mother, Dawn, sued Dr. Dawn Murray claiming the injury was caused by negligent use of lateral traction on Aubree’s head. She also asserted a claim for lack of informed consent. Murray had failed to warn of the possibility that a vaginal delivery could result in a permanent nerve injury.

A jury in the U.S. District Court for the District of Nebraska returned a verdict in favor of Murray and the hospital defendants.

Medical Causation Expert Witness / Birth Injury Expert Witness:

The plaintiff presented a medical causation expert witness and a birth injury expert witness. He opined that Aubree’s injury resulted from Murray’s application of excessive lateral traction to her head. Both the medical causation expert witness and birth injury expert witness said that maternal forces of labor can never cause such permanent nerve injuries. Consequently, such injuries are always the result of excessive physician-applied traction.

The District Court granted Murray’s motion to exclude the medical causation expert witness and birth injury expert witness. They found in the absence of any evidence that Murray applied any traction to Aubree’s head or neck during delivery, that the experts were essentially advancing a theory of res ipsa loquitur. The case proceeded to trial solely on the theory of lack of informed consent.

Admissibility of Medical Causation Expert Witness:

The Eighth Circuit U.S. Court of Appeals panel found that the District Court did not abuse its discretion in excluding the experts’ testimony. Further, it found Murray had no duty to inform Lawrey of the possibility of permanent injury to her child if she chose vaginal delivery.

Regarding the medical causation expert witness and birth injury expert witness, the panel said their testimony did not fit the specific facts of the case.

“Aubree’s injury resulted from a posterior shoulder dystocia which, as previously noted, occurs before a baby’s head has crowned,” the panel said. “This means the force which caused Aubree’s injury must have been applied while her head and neck were still in the birth canal. Lawrey’s experts failed to explain how Dr. Murray could or did apply traction to Aubree’s head and neck while her head and neck were still in the birth canal.”

Additionally, the experts failed to explain how any traction Murray allegedly applied after Aubree’s head and neck exited the birth canal could have caused an injury which occurred before her head had crowned, the panel said.