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Philadelphia County, PA

The plaintiff alleged that the two defendant doctors, both maternal fetal medicine specialists, negligently mismanaged the plaintiff mother’s pregnancy, which was complicated by gestational diabetes. The plaintiff claimed that the mismanagement led to a large for term birth weight, shoulder dystocia and a brachial plexus injury to the newborn. The defendants maintained that the plaintiff mother’s prenatal care met the required standard of care and complied with published guidelines. The defense argued that the shoulder dystocia was not predictable and was properly managed by the delivering defendant. The hospital where the prenatal testing was performed and where the baby was born was also named as a defendant in the case on vicarious liability theory.

The plaintiff argued that an ultrasound taken on April 3, ________, showed that the baby’s size was at the 95th percentile, based on gestational age. The plaintiff contended that the defendant doctors were negligent in failing to schedule a follow-up ultrasound before the baby was delivered on April 16, ________. A follow-up ultrasound would have showed additional fetal growth, placing the birth into the category for an elective Caesarean delivery, according to the plaintiff’s claims. The plaintiffs alleged that the defendants were negligent in failing to counsel the plaintiff mother regarding the possibility of a Caesarean section, given the large size of the fetus.

The baby weighed nine pounds and 14 ounces at birth (________ grams). A shoulder dystocia was encountered during the delivery, which the plaintiff’s experts testified caused a brachial plexus injury to the newborn. The infant underwent two surgeries, but has been left with permanent nerve damage, according to her physicians.

The minor plaintiff, currently age nine, appeared briefly at trial. The plaintiff’s physician demonstrated that the child has restriction of movement of her left arm. Testimony indicated that the little girl’s use of the arm is limited and that there is a slight difference in arm length. The plaintiff’s doctor testified that the arm length discrepancy will become more pronounced with growth. The plaintiff’s vocational expert testified that the child will be precluded from many fields of employment and has suffered a loss of future earning capacity as a result of her disability.

The defendant doctors argued that they complied with the guidelines published by the American College of Obstetrics and Gynecology. The guidelines call for serial ultrasounds to be performed in the later part of pregnancy at intervals no closer than two weeks, according to the defense. The defendants’ experts testified that ultrasounds less than two weeks apart are of no significance because there would have been no appreciable fetal growth in such a short period of time. Evidence showed that the baby was born on the day before the next follow-up ultrasound was scheduled.

The defense argued that the estimated weight of the fetus was always below ________ grams (approximately 10 pounds) and that the obstetric guidelines list ________ grams as the threshold weight for consideration of a Caesarean section in a pregnancy complicated by gestational diabetes. The defendant’s experts testified that the plaintiff mother had a quick delivery and that the shoulder dystocia was not predictable. Shoulder dystocia occurs during delivery involving mothers without gestational diabetes and fetal weights below ________ grams, according to the defendants’ experts. When the shoulder dystocia was encountered, the defense argued that the delivering physician acted appropriately in quickly delivering the infant. Records showed that spontaneous membrane rupture occurred at 3:30 a.m.; by 3:50 a.m. the plaintiff mother was fully dilated; the infant’s head was delivered at 3:52 a.m.; the defendant physician recognized a turtle sign indicating dystocia; an episiotomy was performed and the baby was delivered at 3:54 a.m.

The defense also argued that the minor plaintiff is doing well in school and is able to use her left arm for swimming and piano lessons. Based on the fact that the plaintiff mother is a college graduate and the plaintiff father has a Masters Degree in science, the defense argued that in all likelihood the minor plaintiff will graduate from college and be able to obtain a non- physical type of employment. The defendants argued that the plaintiff’s claim for loss of future wages was speculative.

The jury found that the defendants were not negligent.

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