Pitocin is a synthetic hormone that is used in obstetrics to speed up the process of labor by stimulating contractions of the uterus muscles. Pitocin can be dangerous because if doctors are not careful when administering it and monitoring the mother’s response to it, Pitocin can overstimulate the uterus which can seriously harm the baby.
What is Pitocin Used For?
Pitocin is basically an artificial version of a hormone called oxytocin. Oxytocin is the hormone that a woman’s body releases at the end of pregnancy to stimulate contractions in the uterus muscles and begin the childbirth process. When Pitocin is administered into a woman’s bloodstream, it triggers uterine muscle contractions the same way as the natural hormone does.
OB/GYN’s use Pitocin for 2 primary purposes: (1) to induce labor when a woman is long past her due date, and (2) to rapidly accelerate labor when things are not progressing fast enough. Pitocin is administered intravenously through an IV device that automatically dispenses a set dose of the drug as directed by the doctor. Pitocin is the most widely used method of accelerating labor.
Risks of Pitocin
Pitocin is unquestionably a highly useful drug. It helps speed up delivery and avoid the risk of infections and other complications. Pitocin does have some inherent risks, however, because it can sometimes overstimulate the uterus muscles. If uterine contractions are too strong and/or too frequent they can potentially harm the baby.
Since Pitocin stimulates contractions, doctors have to be very careful when using it. There are 2 main problems that arise with the use of Pitocin in the delivery room: (1) improper dosage, and (2) hyperstimulation.
- Improper Dosage of Pitocin
Administering the correct dosage of Pitocin is very important because too much of it can make contractions too strong. The tricky part for doctors is that women tend to respond quite differently to Pitocin, so the correct dose is very case specific and must be custom tailored to each patient. Some women a very sensitive to Pitocin and only require a small amount, whereas others require larger doses.
This is exactly why all hospitals have very strict protocol and procedures for administering Pitocin. They require doctors to start with a small dose then increase the amount gradually based on the patient’s response. The problem is that doctors and nurses in the delivery ward get busy and tend to just turn the Pitocin drip on and pay little attention to mother’s response until it is too late.
When too much Pitocin is administered, or if a woman over-responds it can cause a reaction known as “hyperstimulation” of the uterus. This involves uterus contractions that are much too strong and with not adequate rest time between contractions.
Each time a contraction happens it momentarily restricts oxygen to the baby because it compresses the placenta. When a hyper-stimulated uterus contracts too strongly and too frequently it can result in acute oxygen deprivation. Hyperstimulation from a Pitocin overdose can lead to very dangerous oxygen deprivation during childbirth. This can cause permanent damage to the baby’s brain and result in injuries such as cerebral palsy.
Hospital Pitocin Protocols
All hospitals have formal, written rules and strict protocols regarding how Pitocin should be used and administered during labor and delivery. These rules are primarily designed to protect the hospital from potential liability.
As a general rule, hospital rules for Pitocin require doctors to start out slowly with a low dose and then gradually increase the dose after monitoring the patient’s response. Most hospitals limit or prohibit the use of Pitocin when the mother is dilating, having strong contractions, or the baby is showing concerning signs on the fetal monitoring strips such as late or recurrent variable decelerations. Hospital Pitocin protocols also mandate that doctors and nurses continuously monitor a mother’s response to Pitocin once it is administered.
So what happens if the doctors or nurses violate or disregard the hospital rules for administering Pitocin? Does that mean that they are automatically negligent? Arguably yes, but don’t expect a doctor to admit that even in the face of clear evidence.
Negligent use or administration of Pitocin in birth injury cases can come in a variety of forms and circumstances. One of the most common situations occurs where the doctor orders Pitocin to push through a vaginal delivery despite early warning signs of potential dangers or complications. For example, if the fetal heart tracings are concerning, or the mother’s blood pressure is very high, administering Pitocin would probably be a breach of the standard of care.
The other very common type of medical negligence involving Pitocin occurs when the doctors and nurses start the mother on Pitocin and then get complacent and neglect to carefully and continuously monitor how the mother is responding. Monitoring the mother’s response to Pitocin is critical because some women tend to overrespond to the effects of Pitocin and have contractions that are too strong. The delivery team needs to look for warning signs of this and then discontinue the Pitocin to avoid harm to the baby.
Settlements and Verdicts in Pitocin Birth Injury Cases
Below are summaries of recent birth injury malpractice cases which involved the negligent administration of Pitocin.
$13,300,000 Verdict (Maryland 2022): A woman, experiencing high blood pressure, was admitted to Upper Chesapeake Medical Center in 2004 for labor induction. Pitocin was administered by the medical staff to help induce contractions, yet despite extended labor of over 17 hours and signs of fetal distress, including abnormalities on the fetal heart monitor, a vital cesarean section was not promptly performed. The delay led to the newborn suffering from intra-skull bleeding, resulting in permanent brain damage and intellectual disability. The verdict was inclusive of future medical care costs, compensation for pain and suffering, and potential loss of future earnings. The attending physician and nursing staff were found to be negligent for not obtaining informed consent during labor and for their improper administration and response to Pitocin-induced labor signs. The case highlighted the necessity of timely medical intervention and the impact of healthcare provider negligence on patient outcomes.
$20,0000 Verdict (Illinois 2022): Infant suffered permanent brain damage due to prolonged oxygen deprivation during labor and delivery. The lawsuit alleged that the defendants (hospital and OB/GYN) were negligent in failing to properly monitor a mother’s response after administering Pitocin and filing to discontinue the Pitocin when the fetal heart rate pattern showed warning signs. A jury in Cook County, Illinois awarded $20 million which included $16.5 million in future medical expenses.
$23,374,555 Verdict (Missouri 2022): Lawsuit alleged that the defendant OB/GYN negligently failed to decrease or discontinue Pitocin after electronic fetal monitors showed clear signs of excessive uterine contractions. The baby suffered hypoxic ischemic brain damage and was diagnosed with spastic quadriplegic cerebral palsy (one of the most severe types) with cognitive impairment. The $23.3 million verdict included $18.9 million for future medical expenses and $5 million for pain and suffering.
$1,500,000 Settlement (Nevada 2021): Baby suffered hypoxic ischemic encephalopathy (HIE) resulting in cerebral palsy within profound and permanent intellectual disability and impaired speech. The lawsuit alleged that the doctor negligently administered Pitocin by failing to follow the applicable hospital procedures for when Pitocin should be given and then failed to properly monitor the mother after it was given. The case was eventually settled for $1.5 million split between 2 defendants.
$5,700,000 Settlement (California 2021): Lawsuit alleged that under the hospital’s own policies and procedures, Pitocin should not have been administered when there was tachysystole, which the hospital itself defined as more than five contractions in a 10 minute period averaged over 30 minutes. Here, the mother showed clear signs of tachysystole almost immediately when the Pitocin was increased for the fourth time. As a result, the child suffered a severe and catastrophic brain damage as a result of hypoxic ischemic encephalopathy.
Getting a Lawyer for Your Malpractice Claim
If your child has suffered a birth injury as the result of excessive Pitocin or other mistakes during childbirth, our firm has the experience and resources to help you both get the compensation you deserve. Our birth injury attorneys are based in Maryland and most of our cases are here. But our law firm handles serious injury and death cases all over the country.
Call Miller & Zois today and speak to a birth injury medical malpractice attorney at 800-553-8082 or get an online case evaluation.