A Cesarean section, also known as a C-section, is a surgical procedure in which a baby is delivered through an incision in the mother’s abdomen and uterus. It is often necessary when there are complications during delivery that make vaginal delivery too risky. However, when a healthcare provider fails to perform a C-section in a timely manner, it can result in birth injuries that may have long-lasting consequences for the baby and the family.
Birth injury lawsuits are complex and every case is very different. But it is amazing how many birth injury lawsuits follow a pattern of a fetal heart rate that shows a child that is likely struggling to get needed oxygen to feed vital organs and a doctor that does not respond to these alarms by taking immediate steps to deliver the child.
This article will explore the legal implications of a failure to perform a C-section when a baby is in fetal distress and needs to be delivered and explains how birth injury lawsuits work.,
What is a Failure to Perform a C-Section?
A failure to perform a C-section occurs when a healthcare provider fails to deliver a baby via C-section when it is medically necessary to do so. There are many reasons why a C-section may be necessary, including:
- Fetal distress: This is the number one fact pattern in a failure to perform a Cesarean section lawsuit. The fetal heart monitor shows the baby needs to be delivered immediately. So, very often, a baby is in distress during delivery and it is necessary to perform a C-section to deliver the baby quickly and safely.
- Abnormal presentation: If the baby is in a breech position or in another abnormal presentation, a C-section may be necessary.
- Prolonged labor: If labor is not progressing, it may be necessary to perform a C-section to deliver the baby.
When a healthcare provider fails to perform a C-section in a timely manner, it can result in birth injuries, including brain damage, cerebral palsy, and other neurological injuries.
Why Doctors Fail to Perform a C-section When Indicated
There are several reasons why a healthcare provider might fail to perform a C-section when it is necessary:
- Misdiagnosis or failure to recognize complications: Medical professionals may fail to identify signs of fetal distress, maternal complications, or other issues that warrant a C-section. This can occur due to inadequate monitoring, misinterpretation of test results, or lack of experience. Adding to the problem are too many OBs who constitutionally refuse to “panic” and take immediate action. Events develop quickly during labor and delivery and some doctors are too slow in evolving when conditions change.
- Delayed decision-making: Sometimes the doctors and nurses indentify the fetal distress and realize there is a problem. And then they inexplicably dawdle and delay. Even when complications are recognized, healthcare providers may hesitate to decide on a C-section, hoping for a vaginal delivery instead. This delay can lead to critical minutes passing, causing harm to the baby and mother.
- Communication breakdown: Inadequate communication between healthcare providers can result in crucial information being overlooked or not relayed in a timely manner. This can delay the decision to perform a C-section, increasing the risk of birth injury.
- Staffing issues or hospital policies: Sometimes, failure to perform a C-section is due to staffing shortages, lack of available operating rooms, or restrictive hospital policies that limit the ability to perform a C-section quickly.
When a C-Section Is Necessary
The fetal heart rate is how the fetus talks to us. It is how the child says that it needs oxygen and needs to be delivered right now. In 2009, the American College of Obstetricians and Gynecologists (ACOG) published guidelines based on the 2008 recommendations from the National Institute of Child Health and Human Development (NIHHD) and the Society for Maternal-Fetal Medicine. These guidelines focused on the review of fetal heart rate assessment terminology and the description of a three-tiered system for electronic fetal monitoring (EFM) classification.
ACOG released additional related guidelines in 2010, aiming to offer a framework for obstetric care providers to evaluate and manage intrapartum EFM patterns based on the new three-tiered categorization. ACOG prefaced both sets of guidelines with qualifications, emphasizing that the information should assist practitioners in making decisions about suitable obstetric and gynecologic care without dictating a single course of treatment or procedure.
Heart Rate Interpretion System
ACOG’s “Fetal Heart Rate Interpretation System” features three distinct fetal heart rate (FHR) classifications, each with corresponding assessment criteria and explanatory terminology:
Category I: Category I tracings are considered normal and not associated with fetal acidemia. Category I is smooth sailing. These tracings indicate an absence of fetal acidosis and do not necessitate intervention. They can be managed routinely with continuous or intermittent monitoring. Management changes may only be needed if Category II or Category III features arise.
Category II: Category II tracings encompass all FHR patterns not classified as Category I or Category III and require evaluation, ongoing surveillance, initiation of appropriate corrective measures when indicated, and reevaluation.After identification, these tracings may necessitate more frequent evaluation, documentation, and continued surveillance unless they revert to Category I.
Category II tracings: (1) are indeterminate; (2) do not predict abnormal fetal acid-base status without sufficient evidence to classify them as either Category I or Category III tracings; and (3) require evaluation and ongoing surveillance and reevaluation depending on the entire associated clinical circumstances Category II tracings can range from monitoring predictive of clinically normal to rapidly developing acidosis. Reversible causes can be addressed, and intrauterine resuscitation can be provided for Category II tracing abnormalities, which may include stopping uterine-stimulating agents like Pitocin, a reocccuring them in failure to perform a C-section cases.
Category III: Category III tracings are abnormal and indicate an elevated risk for fetal acidemia during observation.These tracings have been linked to an increased risk for neonatal encephalopathy, cerebral palsy, and neonatal acidosis. If unresolved, Category III FHR tracings typically require prompt delivery.
The battlefield in birth injury lawsuits is how serious are the Category II tracings and what should be done to monitor and accelerate delivery.
Birth Injury Lawsuits
When a baby suffers a birth injury due to a failure to perform a C-section, their family may be able to file a lawsuit against the healthcare provider responsible. Birth injury lawsuits are typically filed under medical malpractice law, which is a type of personal injury law that allows individuals to seek compensation for injuries caused by the negligence or recklessness of a healthcare provider.
In order to prove a medical malpractice claim, the plaintiff (the injured party or their family) must demonstrate that the healthcare provider breached their duty of care and that this breach caused the injury. In the case of a failure to perform a C-section, this means demonstrating that the healthcare provider knew or should have known that a C-section was necessary and that their failure to perform the procedure caused the baby’s injuries.
Proving a medical malpractice claim can be complex and requires a thorough understanding of both medical and legal issues. For this reason, it is important to consult with an experienced birth injury lawyer who can help navigate the legal process and advocate for the injured party.
Compensation in Birth Injury Lawsuits
If a birth injury lawsuit is successful, the injured party or their family may be awarded compensation to cover medical expenses, ongoing care, lost wages, and pain and suffering. The amount of compensation awarded in a birth injury lawsuit can vary widely depending on the severity of the injury, the ongoing medical needs of the child, and other factors. But, as you see in the settlement and verdicts section, the payouts can be extremely high because caring for these injuries for a lifetime can cost a fortune.
In some cases, the healthcare provider may be covered by malpractice insurance, which can help to cover the costs of any settlement amount or jury payout. But hospitals and insurance companies are often reluctant to pay out large settlements and may try to minimize the extent of the injuries and argue that the healthcare provider was not at fault. They also argue, shamelessly at times, that the child has a short life expectancy.
What Is the Average Birth Injury Settlement?
The average settlement payout for a birth injury lawsuit involving a child with a brain birth injury is just over $1 million. Every birth injury malpractice case is different and involves highly unique factual circumstances. All of these circumstances can have an impact on the potential settlement value of the case.
Regardless of the other circumstances in the case, there are 2 factors that tend to drive the settlement value of all birth injury cases. The first is the severity of the child’s injury. If the child suffers a massive brain injury that leaves them in a wheelchair or severely disabled for life, that case is going to have a very high potential value at settlement. The second factor is whether the medical negligence was clear and obvious. If the doctor or hospital staff made a very clear mistake, the case will be much harder for them to defend and it will have a much higher value.
Verdicts and Settlements Involving Failure to Perform a C-Section
Summarized below are publicly reported settlements and jury verdicts from actual birth injury malpractice cases involving an allegation that the defendants were negligent in failing to perform a timely C-section.
$450,000 Settlement (South Carolina 2023): Mother went to the hospital at 32 weeks pregnant with symptoms consistent with preeclampsia but was sent home after medical providers disregarded and failed to document her symptoms and failed to admit her to the hospital for further monitoring. She came back the next day and had an emergency C-section but it was too late and the baby died from a brain injury.
$20,000,000 Settlement (Illinois 2022): Infant suffered brain damage during childbirth. The lawsuit alleged that the doctors and staff at the hospital were negligent because they should have done an emergency C-section when the fetal heart tracings warned that the baby was under stress. Instead, they continued the mother on Pitocin in an effort to speed up the vaginal delivery, which only made things worse.
$2,700,000 Settlement (New Jersey 2022): A 28-year-old mother went to the hospital with signs of a potential uterine rupture. Lawsuit alleged that these symptoms should have warranted an immediate C-section, but that option was delayed for a long time period. As a result, the baby suffered carcinogenic shock, perinatal asphyxia and metabolic acidosis. The case settled for $2.7 million, part of which went into a trust for the future care of the infant.
$2,200,000 Settlement (New York 2022): A newborn male, allegedly suffered hypoxic encephalopathy caused by perinatal asphyxia during childbirth at Rochester Medical Center (Highland Hospital). The lawsuit alleged that his injuries were caused by the defendants’ failure to order and perform a timely emergency C-section and failure to properly interpret and respond to signs of fetal distress.
$97,402,549 Verdict (Iowa 2022): The baby suffered brain damage and developmental delays leaving him severely disabled for life. The lawsuit alleged that the hospital nursing staff was negligent in failing to report signs of fetal stress on the monitoring strips to the attending doctor. Instead of advising the doctor of these signs, which would have prompted an emergency C-section, the nurses said nothing and the doctor ended up doing serious damage to the baby’s skull while using forceps and a vacuum in an effort to deliver the baby. The doctor was allegedly negligent in not recognizing vaginal delivery should be abandoned in favor of an emergent C-section in light of non-reassuring signs the fetus was being deprived of oxygen.
$995,000 Settlement (Pennsylvania 2021): a male infant, reportedly suffered hypoxic ischemic encephalopathy with complications including metabolic acidosis, impaired brain function and neonatal depression during his delivery and birth at defendant Albert Einstein Medical Center. The plaintiffs contended the defendants failed to abandon the pursuit of a vaginal delivery after a 74-hour stage one of labor with maternal tachycardia and severe preeclampsia and failed to perform a non-emergent C-section as their own documented plan dictated.
$3,900,000 Settlement (Michigan 2021): Baby was born with a hypoxic brain injury resulting in permanent sensorineural hearing impairment, borderline speech delay, delayed gross motor milestones and hypertonia of the trunk and all extremities and has been rendered permanently incapable of independent living. The lawsuit alleged that the defendants were negligent in failing to timely offer a C-section in the presence of non-reassuring fetal heart tones over vaginal delivery.
Contact Us About Birth Injury Malpractice
The medical malpractice lawyers at Miller & Zois handle birth injury cases all across the country. If you have a potential birth injury lawsuit call us today at 800-553-8082.