The pre-natal course was uneventful for the mom and baby. The mom was brought in for induction because of the pregnancy induced hypertension and suspected large baby. She was completely dilated at 23:00 hours and began pushing. She had adequate pushing with downward descent of the head. After about an hour of pushing she was noted to be tiring. A Vacuum was placed on the fetal head. There is no indication in the medical records that doctor informed the patient of the risk of the use of a vacuum in light of the patient’s obesity and suspected large for gestational age infant. In. particular, the increased risk of shoulder dystocia. The vacuum was placed without difficulty. Over four contractions, over a time of approx. 13 minutes, the head was brought to the perineum. It was approx. 60 seconds with each pull. After delivery of the head, there was almost immediate retraction of the head and a severe shoulder dystocia was apparent. Multiple methods were tried to resolve the dystocia including McRoberts, suprapubic pressure, an episiotomy was done.
The delivering doctor subsequently fractured the right humerus to deliver the posterior shoulder and then subsequently delivered the anterior shoulder and the infant was delivered. The approximate time between delivery of head and body was three minutes. Apgars were 2 at one minute. Weight was 9 pounds, 12 ounces. At delivery the baby was noted to be limp and apneic. The heart rates were noted to be in the 120’s. The bay was intubated and then extubated shortly thereafter with adequate respiratory effort. The right humerus was noted to be fractured. A right brachial plexopathy was noted at birth. There appeared to be pseudomeningoceles at C 6-7, C 7-T1 and T 1-2 levels. There was also significant bruising of the scalp and chest wall. The impression was a Klumpke’s palsy with trauma to all of the roots of the brachial plexus and nerve root avulsion.
The child underwent a left brachial plexus exploration, external neurolysis of the upper trunk, nerve harvesting and nerve grafts. It was found that C 5-6 seemed destroyed and was seemed partially disconnected. C 6 was non-existent. The child has a permanent brachial plexus injury.
After two days of deliberations the jury returned a verdict in the amount of $1,750,000.00.