Obstetrician’s Negligent Care During Childbirth Results in $73.1 Million Award

Case Overview

Case Name: Lorenza Botello and Alvaro Botello, Individually and as Parents of Jonathan Botello, and Amy Manning, as Conservator of Jonathan Botello, a minor v. Jerry D. McLaughlin MD; Marva Johnston RN; CHSPSC, LLC; Community Health Systems Professional Services Corporation; and Pecos Valley of New Mexico, LLC

Case Type: Medical Malpractice – OB-GYN; Dystocia; Childbirth; Birth Injury; Brain Injuries; Failure to Test; Wrong Site/Procedure

Injury:

• arm
• brain – brain damage
• other – laceration; scar and/or disfigurement
• shoulder
• urological – rectum
• hand/finger – hand, deformity
• neurological – brachial plexus; nerve damage/neuropathy; nerve, severed/torn
• gynecological – vagina
• pulmonary/respiratory – anoxia

Plaintiff Attorney(s):

• Kent Buckingham; Buckingham Barrera Law Firm
• Rick Barrera; Buckingham Barrera Law Firm
• Michael Newell; The Newell Law Firm

Defense Attorney(s):

• Michael J. Dekleva; Madison, Mroz, Steinman & Dekleva, P.A.
• Rebecca S. Kenny; Madison, Mroz, Steinman & Dekleva, P.A.

Case Outcome: Verdict – Plaintiffs

Award Amount: $73,100,000

What Happened?

Lorenza Botello, a 36-year-old woman who had diabetes, gave birth to her son Jonathan Botello on March 24, 2013. The birth, which had complications, happened at Pecos Valley Medical Center under the direction of Dr. Jerry McLaughlin, an obstetrician. During the vaginal delivery, a birth complication known as shoulder dystocia occurred. This condition, considered a medical emergency, happens when one or both of a baby’s shoulders get stuck inside the mother’s pelvis during the delivery. Shoulder dystocia can cause serious problems for the mother and the baby.

Jonathan also suffered a brachial plexus birth injury during the birth. Brachial plexus injuries can transpire if a baby’s neck is stretched to one side during the delivery. Damage can be done to the network of nerves that gives us feeling and control over the muscles in the arm, shoulder, and forearm as well as in our hands and fingers. One factor in brachial plexus injuries is a baby’s shoulders being too wide to fit through the mother’s birth canal.

When Jonathan was stuck in the birth canal, Dr. McLaughlin used a vacuum-extraction device to pull the baby out. However, the baby was deprived of oxygen for about 10 minutes when his head was stuck in the birth canal. The mother, Lorenza Botello, endured severe lacerations running from her vagina to her rectum during the procedure.

Allegations and Testimony

Lorenza Botello and her husband, Alvaro Botello, acting individually and as Jonathan’s parents, and Amy Manning, acting as Jonathan’s conservator, brought a negligence suit against Dr. McLaughlin, Pecos Valley of New Mexico, LLC (McLaughlin’s employer), a delivery room nurse, Marva Johnston, and Community Health Systems Professional Services Corp.(CHSPSC, LLC) who operated the hospital. In the lawsuit, the plaintiffs alleged that McLaughlin’s negligence in Jonathan’s delivery was medical malpractice. The plaintiffs also claimed that Pecos Valley Medical Center was vicariously liable for McLaughlin’s actions.

During the legal proceedings, nurse Johnston and CHSPSC were dismissed from the case. In an odd turn, Dr. McLaughlin passed away before the trial, resulting in his dismissal too. The lawsuit went on to a trial solely against Pecos Valley of New Mexico.

The family claimed that Jonathan’s shoulder dystocia during the delivery caused a brachial plexus injury to his right shoulder and arm. The parents also stated that the baby suffered head injuries during the birth. Moreover, they contended that their son has a birth deformity that took away the functioning of his right hand.

Additionally, they alleged that Jonathan suffered brain damage from oxygen deprivation while his head was stuck in the birth canal. This damage will require him to need lifetime assistance with basic activities including feeding himself, according to the Botellos.

In addition, Lorenza Botello claimed to have suffered vaginal and rectal injuries from the delivery. Lorenza also alleged that the childbirth left her with ongoing emotional trauma.

Standard of Care Departure

Lawyers for the plaintiffs maintained that Dr. McLaughlin departed from the standard of care and treatment required for Lorenza Botello and her baby before and during the delivery. Counsel pointed to McLaughlin’s failure to order a series of ultrasonographies before the delivery when a diabetic mother was to give birth. Medical experts for the plaintiffs’ stated that because of Lorenza Botello’s diabetic condition and her age, there was a known risk that the baby might be larger than normal. Furthermore, the expert asserted that McLaughlin’s estimate that the baby weighed only eight pounds was inaccurate. The actual birth weight was 11.5 pounds.

Had McLaughlin ordered ultrasonographies, the experts contended, the child’s size would have been apparent. The expert noted that the protocol would have been to perform a Cesarean delivery. Further, the standard of care required that the obstetrician not use a vacuum device when the mother is diabetic. The plaintiff’s experts also gave their medical opinion that Jonathan did suffer brain damage from the 10 minutes of oxygen deprivation.

On the other hand, the defendant argued that Jonathan Botello did not have a brain injury. Furthermore, the defendant asserted that Jonathan’s brachial plexus injury was not very severe or debilitating. However, the defendant’s own liability expert admitted during his deposition that the case “is indefensible.”

Pecos Valley of New Mexico finally admitted that Dr. McLaughlin performed an improper delivery and conceded liability during their closing argument. During this time, the defendant indicated that the jury should write “yes” on the questions of liability.

Who Won the Case?

After an eight-day trial and six hours of deliberation, the jury awarded the plaintiffs $73.1 million in damages.

The award for the baby, Jonathan Botello, was $13.3 million in compensatory damages for personal injury. The mother, Lorenza Botello, received $40 million in punitive exemplary damages and $19.8 million in compensatory damages.

Expert Specialities

The plaintiffs retained expert witnesses in:

• Pediatric Neurology
• Neuropsychology
• Vocational Rehabilitation

The defendants retained expert witnesses in:

• Physical Medicine
• Neuropsychology
• Pediatric Neurology
• Legal Nurse Consulting

Key Takeaways

Here, the plaintiffs’ medical experts’ opinions were clearly so strong and the counsel’s story on the facts and law was so compelling leading up to closing arguments that the hospital caved. The parties and the court were spared the expense and time of a long trial when the defendants admitted liability, leaving damages the sole subject before the jury.