This is an example Baltimore birth injury lawsuit that claims negligent obstetrical care that resulted in permanent neurological injuries to the child.
The plaintiff, a woman from Anne Arundel County, Maryland, presented to St. Agnes Hospital at 40 weeks and four days pregnant. Despite clear signs of fetal distress, such as minimal variability decelerations in the fetal heart rate and a deterioration in the fetus’ condition, the defendants—an OB/GYN doctor, two nurses, and the hospital—allegedly failed to provide proper medical intervention.
The claim centers around the failure to act on fetal heart rate decelerations and tachycardia. Medical professionals are expected to monitor fetal heart tones (FHT) closely, and early decelerations should have prompted quicker intervention (e.g., performing a C-section).
Lucarino v. Saint Agnes Hospital: Summary of Plaintiff’s Allegations
This is a birth trauma medical malpractice action involving the negligent obstetrical care of an Anne Arundel County woman that resulted in permanent neurological injuries to her child.
An Anne Arundel County woman is 40 weeks and four days pregnant. Early one morning, she goes into labor and presents to St. Agnes Hospital in Baltimore City.
A vaginal exam is performed at 4:36 a.m. The exam shows that the woman has bulging membranes and is 6 centimeters dilated. Another vaginal exam is performed at 6:23 a.m. following a drop in the woman’s blood pressure and several minimal variability decelerations in the fetus’ heartbeat. The woman still has bulging membranes and is now 6.5 centimeters dilated. An anesthesiologist is called, who provides the woman with a dose of ephedrine.
At 7:05 a.m. the woman comes under the first Defendant nurse’s care. Over the next 1 hour and 25 minutes, the fetus’ condition continues to deteriorate. At 8:30 a.m. the Defendant doctor assumes care for the woman and performs a vaginal exam. The woman is 7 centimeters dilated. Following the exam, the Defendant doctor ruptures her membranes (breaks her water).
At 9:54 a.m. the woman calls out to a nurse that she is feeling vaginal pressure and contraction pain. Another vaginal exam is performed at 10:00 a.m. The woman is now 9.5 centimeters dilated. Throughout all of these assessments, the fetus’ heart rate has continued to have early decelerations and decreased variability. The nurses and doctors should have recognized that to prevent injury to the fetus, it needed to be delivered promptly.
However, at 11:08 a.m. the epidural is re-dosed by the Defendant doctor to delay the labor process. It is not until 1:15 p.m. that the Defendant doctor orders the woman to begin pushing. The woman continues through labor with no rest to evaluate the fetal heart tone (FHT).
The second defendant nurse assumes care for the woman at 2:33 p.m. She notes that the fetus is experiencing tachycardia at 3:30 p.m. However, she and the Defendant doctor continue to allow the woman to push, a decision that will certainly be scrutinized.
At 3:55 the NICU is called to the delivery room after the fetus’ FHT drops significantly. A baby girl is delivered at 4:12 p.m. and is immediately handed off to the NICU. Upon delivery, the baby displays no respiratory effort, has poor muscle tone, and requires intubation. The next day, she begins to suffer unusual rapid breathing and abnormal arm and leg movements.
St. Agnes can no longer provide the care the baby requires, so she is transferred to Hopkins. The baby remains at Johns Hopkins for 19 days. Multiple brain MRIs and EEGs are performed. The baby has brain damage and suffers seizures.
The baby’s parents file a medical negligence lawsuit in Baltimore City, alleging that the Defendants violated the standard of care by failing to (1) recognize the signs of fetal distress and properly respond to those signs, (2) properly interpret the mother’s symptoms and limit her number of pushes between contractions, and (3) properly monitor the labor progression, recognizing the fetus’ deteriorating condition and providing proper medical intervention. As a result of the Defendants’ negligence, the child has sustained extreme pain and suffering and has suffered serious and permanent injuries.
Negligence
- Failed to recognize signs of fetal distress and properly treat
- Failed to properly interpret the mother’s symptoms and limit her number of pushes between contractions
- Failed to properly monitor labor progression, recognizing the fetus’ deteriorating condition and providing proper medical intervention
Specific Counts Pled
- Medical Negligence: Against doctor and nurses
- Respondeat Superior: Against Saint Agnes Hospital (Physicians and Nursing Staff), Saint Agnes Hospital, The Women’s OB/GYN Group, and Seton Medical Group, Inc.
Plaintiff’s Experts and Areas of Specialty
- Jane Payne, BSN, RNC, C-EFM: registered nurse licensed to practice in Virginia since 1985. Certified in inpatient obstetrics and electronic fetal monitoring by the NCC. An AWHONN fetal monitoring instructor as well as an instructor in neonatal resuscitation.
- Jeffrey C. Hammer, M.D.: an OB/GYN at the Virginia Center for Women
Why Birth Injury Lawyers Are Eager to Name the Hospital as a Defendant
Having a hospital defendant in a birth injury lawsuit is a big deal for several reasons. First, hospitals typically have vicarious liability for the actions of their employees, such as doctors, nurses, and other medical staff. This means that if a healthcare provider employed by the hospital was negligent in providing care, the hospital itself can be held responsible under the legal doctrine of respondeat superior. This is important because it ensures that plaintiffs are not limited to seeking compensation solely from individual providers, who may have limited financial resources or insurance coverage.
Second, hospitals often have systemic policies and protocols that play a significant role in patient care. Juries can get there arm around systemic breakdowns in care and it makes relevant all the dumb things that were done in delivering the child. In birth injury cases, failures in hospital policies, such as inadequate staffing, poor communication among medical teams, or insufficient training, can directly contribute to medical errors. By naming the hospital as a defendant, plaintiffs can address these institutional failures and not just the individual actions of healthcare providers.
Third, juries sometimes find it easier to blame a hospital than to blame an individual for something as awful as a birth injury. By including the hospital as a defendant, the case presents the failure as a broader institutional issue, rather than a mistake by an individual who may be perceived as more sympathetic or overburdened. This approach not only makes it easier for juries to assign fault but also strengthens the case for higher damages, as juries may be more willing to award substantial compensation when they believe a large, well-funded organization is responsible.
Finally, and most importantly, having a hospital as a defendant can increase the likelihood of adequate compensation for the injured child and their family. Hospitals typically carry larger insurance policies and have greater financial resources than individual doctors, making it more likely that a settlement or judgment will cover the extensive costs associated with a birth injury, including ongoing medical care, rehabilitation, and other long-term needs.
Additional Comments
- The key to any case like this is going to lie in the electronic fetal monitoring (“EFM”) strips. The EFM is the primary tool healthcare practitioners use to evaluate the status of a fetus in utero. The EFM places a belt around the mother’s abdomen. The belt has two sensors that pick up the baby’s heart rate and the mother’s contractions. The results are sent to a computer that shows the findings. The computer also typically projects the sound of the tracings.
- The merits of this case are hard to ascertain from the Complaint. The expert report from the physician expert is a single page and there is no mention of the specific extent and scope of the injury.
- The plaintiffs allege negligence in the delay of delivery. The decision to re-dose the epidural and prolong labor despite signs of distress may be seen as inappropriate, leading to the deterioration of the fetus’ condition.
- If the mother was not adequately informed of the risks associated with prolonged labor, the failure to obtain informed consent could be another legal issue.
- The challenge of bringing a claim against the nurses in these types of cases is the fact that there is a doctor right there directing the care. One of the allegations of negligence against the nurses is the failure to report the condition of the child up the “chain of command” when the nurse saw the deviation in the standard of care. That may be a hard sell to a jury.
- Update: This case, defended by Pessin Katz Law, P.A. for the hospital, appears to have settled before trial.
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More Malpractice Claim Information
- Looking for co-counsel for your case? Learn about what we can do for you and your client?
- The maximum you can get for a medical negligence claim in Maryland for pain and suffering and why these caps matter less in birth injury cases.
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