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HOSPITAL LIABILITY FOR NURSING NEGLIGENCE DURING LABOR AND DELIVERY

Mar 14

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3/14/2015 7:57 AM  RssIcon

            In a typical situation, the nurses make an assessment of the mother and fetus, and use a fetal heart monitor to assess the well-being of the fetus.  The fetal heart monitor is the main tool to continuously assess that the fetus is tolerating labor in a healthy fashion.  At the outset, the fetal heart monitor will demonstrate the fetus is doing well (good variability, heart rate in the healthy range, and no ominous decelerations in heart rate).  Labor is often a lengthy process, and vigilant monitoring of the fetal heart tracings is extremely important.  The obstetrician is usually not present, and the obstetrician relies on the labor nurse to inform him/her if there are changes in the fetal heart tracing that indicate fetal distress.

            Fetal distress is a term used to signify that something is going on to cause the fetus to be unable to continue to tolerate labor.  Things that can happen to cause the fetus to become distressed include the following:  compression of the umbilical cord, placenta abruption, rupture of the uterus, placenta break down, and prolapse of umbilical cord.  If one of those conditions occurs, the fetus will not be getting adequate oxygen, and if the lack of adequate oxygen goes on long enough or is severe enough, the fetus can be compromised and suffer a brain injury.  The labor nurse has to timely recognize the signs of fetal distress, document them, and notify the obstetrician.  Time is of the essence.  If the fetal distress is severe and unrelenting, the usual course of action is to perform a Cesarean Section so the fetus can be resuscitated.

            In the case of unrelenting fetal distress (loss of variability, repetitive late decelerations, and fetal bradycardia) failure to timely deliver and resuscitate the fetus can lead to what is called hypoxic-ischemic encephalopathy (HIE), which is medical talk for brain injury due to lack of oxygen.  If the HIE is severe (metabolic acidosis), the brain injury leads to cerebral palsy.

            In many of the cases that I have handled, there was a failure of a labor nurse to either recognize the signs of fetal distress and/or to timely notify the obstetrician of the signs of fetal distress.  Most all hospitals have clear written protocols for the labor nurse to follow on recognition of the signs of fetal distress and responding to them.  Fetal distress also includes terms such as lack of fetal well-being.

            Most hospitals have the ability to perform a Cesarean Section within 10 minutes of the need to do so.  If the healthcare providers respond timely to signs of fetal distress, the outcome is usually a healthy baby.  If there is delay, the outcome is often a baby that ends up with cerebral palsy.

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VERDICTS AND SETTLEMENTS in which Rockne W. Onstad was Lead Counsel or Co-Counsel

Gross Amount Client Recovery Attorney Fee Expenses Nature
$13,650,000 $8,055,000 $5,460,000 $135,000     Product Liability, Apache Helicopter Gear Box, Spinal Injuries (settlement)
$9,200,000 $6,320,064 $2,760,000 $119,358     Product Liability, Defective Aircraft Carburetor, Wrongful Death (settlement)
$6,800,000 $4,473,334 $2,266,666 $60,000     Premises Liability, Brain Injury, Water Park Slide (settlement)
$5,000,000 $3,662,224 $1,250,000 $87,775     Obstetrical negligence, cerebral palsy, Federal Tort Claim Act case (settlement)
$4,980,000 $2,437,000 $2,490,000 $53,000     Obstetrical Negligence, Fetal Asphyxia, Cerebral Palsy (settlement)
$4,300,000 $309,000 $138,000 $13,000     Pilot Error, Airplane Crash, Wrongful Death (jury verdict)
$3,850,000 $2,373,000 $1,425,000 $52,000     Labor & Delivery Negligence, Fetal Distress, Cerebral Palsy (settlement)
$3,500,000 $2,028,000 $1,400,000 $72,000     Product Liability, Design Defect, Spinal Cord Injury (settlement)
$3,235,000 $2,361,250 $808,750 $65,000     Brain Injury, Federal Tort Claim, FAA Negligence (verdict) affirmed on appeal
$3,000,000 $1,724,000 $1,200,000 $76,000     Neurosurgical Malpractice, Cauda Equina Syndrome (settlement)
$2,950,000 $1,731,000 $1,180,000 $39,000     Defective Design of Helicopter, Paralysis & Wrongful Death (settlement)
$2,900,000 $844,000 $694,000 $26,000     Auto Accident, Spinal Injury & Ankle Injury (jury verdict/settlement)
$2,800,000 $1,864,667 $924,333 $12,000     Premises Liability, Hotel Fire, Wrongful Death (settlement)
$2,500,000 $1,644,667 $833,333 $22,000     Product Liablity, Defective Farm Tractor, Arm Loss (settlement)
$2,300,000 $1,399,000 $960,000 $41,000     Anesthesiologist Negligence, Brain Injury (settlement)
$2,300,000 $1,091,000 $920,000 $59,000     Product Liability, All Terrain Vehicle, Spinal Injury (settlement)
$2,200,000 $1,321,000 $733,333 $44,000     Cerebral Palsy, Obstetrical Malpractice, Preeclampsia (settlement)
$2,200,000 $1,267,000 $880,000 $53,000     Construction Negligence & Insurance Bad Faith, Spinal Injury(settlement)
$2,200,000 $1,191,000 $880,000 $129,000     Product liability, subdural hematoma (settlement)
$2,183,796 $1,426,334 $557,666 $163,796     Hospital Labor Nurse Negligence, Fetal Distress, Cerebral Palsy (settlement)
$2,000,000 $1,303,334 $666,666 $30,000     Anesthesia Malpractice, Esophageal Intubation, Wrongful Death (settlement)
$2,000,000 $1,106,887 $800,000 $93,111     Radiologist Negligence, Brain Catheterization, Stroke (settlement)
$2,000,000 $976,484 $976,482 $47,034     Obstetrician Malpractice, Forceps Delivery, Cerebral Palsy (settlement)
$2,000,000 $972,331 $972,669 $55,000     Obstetrical Malpractice, IUGR, Cerebral Palsy (settlement)
$1,900,000 $905,000 $950,000 $45,000     Clinic Failure to Supervise Impaired Physician, 4 Injured (settlement)
$1,900,000 $73,000     Pilot Error, Helicopter Crash, Wrongful Death (jury verdict-no insurance coverage)
$1,860,000 $978,518 $645,000 $137,480     Neurosurgeon Negligence, Infection, Cauda Equina Syndrome (settlement)
$1,700,000 $1,130,730 $565,363 $3,907     Product Liability, Defective Design, Burns (settlement)
$1,500,000 $847,000 $600,000 $53,000     Defective Aircraft Component, Military Aircraft, Wrongful Death (settlement)
$1,425,000 $900,310 $457,571 $67,119     Intraoperative Spinal Cord Monitoring Negligence, Spinal Cord Injury (settlement)
$1,400,000 $848,221 $503,552 $51,227     Obstetrician Malpractice, Group B Strep Infection, Cerebral Palsy (settlement)
$1,400,000 $718,689 $560,000 $130,522     Neurosurgeon Negligence, Infection, Brain Injury (jury trial & settlement)
$1,400,000 $818,000 $560,000 $22,000     Auto Trucking Accident, Spinal Injury (settlement)
$1,350,000 $926,394 $370,835 $52,769     Wrongful death. Unnecessary hysterectomy (settlement)
$1,300,000 $718,689 $520,000 $26,000     Neonatal Nurse Negligence, Visual Impairment (settlement)
$1,300,000 $285,000 $250,000 $33,189     Emergency Room Negligence, Wrongful Death (jury verdict and settlement))
$1,237,000 $718,689 $400,000 $30,000     Cardiologist Negligence, Brain Injury (settlement)
$1,200,000 $659,879 $395,666 $144,455     Prolapsed umbilical cord, Labor Nurse Negligence (settlement)
$1,167,000 $594,086 $417,000 $72,513     Emergency Room Negligence, Heart Attack, Wrongful Death (settlement)
$1,150,000 $727,667 $383,333 $39,000     Obstetrician Negligence, Group B Strep, Cerebral Palsy (settlement)
$1,111,000 $594,933 $444,400 $71,623     Product Liability, Heart Stent, Heart Damage (settlement)
$1,100,000 $770,000 $440,000 $25,996     Radiologist Negligence, Failure to Diagnose Breast Cancer, Death (settlement)
$1,060,000 $532,715 $478,991 $48,810     Obstetrician Negligence, Breech Delivery, Cerebral Palsy (settlement)
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