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    OB ignores nursing supervisor, fractures infant’s skull


    Ms Collins is an attorney specializing in medical malpractice in Long Beach, California. She can be reached at [email protected].



    OB ignores nursing supervisor, fractures infant’s skull

    A woman in her mid-20s was admitted to a Texas medical center for delivery of her baby at term. After she had labored most of the day, the nurses determined that the fetal heart rate (FHR) showed the fetus was in distress. The head labor nurse notified the obstetrician, who disagreed with the nurse that the FHR showed distress. That prompted the nurse to notify the supervisor, who confronted the obstetrician 2 hours later with the FHR strip showing fetal distress and told him it was a serious concern that required discontinuing oxytocin. The obstetrician again disagreed and ordered another nurse to increase the oxytocin dose. About 3 hours later, the FHR monitor showed severe decelerations and the obstetrician decided to deliver the patient. Thirty minutes later he attempted a forceps delivery with 3 attempts during the next 17 minutes, all of which were unsuccessful. The infant was delivered by cesarean and was limp, lifeless, and unresponsive. She was diagnosed with skull fractures and hypoxic-ischemic encephalopathy (HIE) and subsequently taken off life support. The autopsy found that the severe HIE was caused by bleeding in the brain due to the skull fractures.

    A lawsuit was filed and alleged that the nursing staff should not have continued the oxytocin when the FHR showed fetal distress, and asserted that the supervising nurse should have contacted her supervisor and continued up the chain of command until the issue was resolved. The lawsuit also alleged that the obstetrician was so reckless in using the forceps because it caused the skull fractures, which compressed bone into the brain. It was alleged that a cracking sound was heard on the second forceps attempt and that on one attempt at delivery with forceps, the obstetrician had his leg on the bed to increase the force he was using and he attempted to rotate the fetal head with the forceps.

    The obstetrician denied all allegations, blaming the traumatic skull injuries and bleeding in the brain on the patient’s pushing for hours and the long labor.



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