subject: Doctor Sued For Malpractice For Failure To Monitor Fetal Vital Signs Properly [print this page] One type of high risk pregnancy occurs when the mother is carrying twins in a single amniotic sac, a condition called monoamniotic-monochorionic twins. This type of pregnancy carries the known risk of umbilical cord entanglement. If this happens the oxygen supply to the babies can be cut off. Oxygen is necessary for the babies to develop normally. Exposure to a prolonged of oxygen insufficiency can lead to brain damage or even to the death of the babies. Given that this is a known complication of a monoamniotic-monochorionic twin pregnancy the expectant mother's doctor must carefully monitor the pregnancy for any signs of umbilical cord occlusion. Doctors generally agree that in order to protect the life and health of the babies the medically appropriate course of action is an emergency C-section as soon as signs of this complication appear.
The report of the case examined below indicated that the mother was carrying monoamniotic-monochorionic twins. As of the twenty-sixth week in the pregnancy the physician started monitoring the vital signs of the twins with non-stress testing two times a week. Doctors generally agree that under these circumstances the mother should be admitted to the hospital and monitored every day. The physician did not do so in this case. On baby died and the other suffered severe brain damage in between the monitoring sessions scheduled by the physician.
The father and mother sued for medical malpractice. While the parents had suffered a tragic loss, the defense did not settle the claim. The law firm that represented the family took the case to trial where a jury awarded $3.0 million for the loss suffered by the parents and for the future medical expenses of caring for their brain injured baby. Any relief the parents experienced with their success at trial was soon lost when the Appeals Court overturned the award.
To be successful on a medical malpractice claim, a plaintiff must show that a doctor's negligence, more likely than not, caused the injury to the patient and that the doctor breached the standard of care that all patients should receive in that particular scenario. On appeal, the state's Appeals Court found that doctor had not violated a standard of care as it could not be determined whether that standard required weekly, bi-weekly or daily monitoring of twins. The Appeals Court also found that it was impossible to establish whether the twin died in the time between the doctor visits and that it could not conclude that more frequents monitoring would have prevented the death of one twin and the brain injury to the other.
It is difficult to imagine how hard it would be for the parents to continue beyond this point. The parents nonetheless decided to take the decision to the state's Supreme Court which disagreed with the Appeals Court decision and required them to reinstate the award of $3,000,000 to the family.
In the Appeals Court's second opinion, they cited numerous studies and articles which stated that to ensure the safety of both twins it is required to admit the mother around the 26th week of pregnancy and to conduct non-stress tests at least daily, if not two to three times daily, to monitor the twins vital signs. The physician set up a monitoring schedule for only twice a week despite the generally accepted practice of more frequent monitoring. Given that the physician failed to note signs of distress, and that one of the babies was a stillborn and the other suffered severe brain damage, the original $3.0 million was found appropriate.
