Our Claims and Legal team secured a defense verdict in Kings County Supreme Court on behalf of an obstetrician in a case involving an allegation of failing to properly investigate and manage vasa previa in a 23-year old pregnant female resulting in an emergency Caesarean section (C-section), perinatal asphyxia, and neonatal death.
The plaintiff was a then 23-year old female who presented to the insured obstetrician reporting that her last menstrual period was 5 weeks prior. An ultrasound was performed which confirmed pregnancy and the patient was started on routine prenatal care. At 20 weeks gestation, a sonogram indicated a low-lying placenta. A subsequent ultrasound was performed at 24 weeks which demonstrated a posterior placenta. At 30 weeks gestation, the patient presented to the hospital complaining of decreased fetal movement. A biophysical profile (BPP) was performed and was interpreted as normal by the perinatologist. Ten days later, the patient presented to the hospital reporting vaginal bleeding for one hour. The patient was transferred from the emergency department (ED) to the labor and delivery ward. Fetal heart tracings showed late decelerations. The hospital obstetrician performed a bedside sonogram which revealed a fetal heart rate of 60-70 beats per minute. The obstetrician called an obstetrical emergency code and the plaintiff underwent an emergency C-section. The male infant was delivered with Apgar scores of 1 at 5 minutes, 1 at 10 minutes, and 1 at 15 minutes. The infant was resuscitated and transferred to the neonatal intensive care unit (NICU) in critical condition where he subsequently died 3 ½ hours post-partum. The delivering obstetrician noted possible vasa previa on inspection of the placenta. The mother subsequently sued our insured and the hospital.
At trial, the plaintiff’s counsel tried to show that our defendant-obstetrician did not properly investigate and follow the plaintiff’s low-lying placenta. The attorney argued that our obstetrician should have ordered transvaginal ultrasounds with color doppler imaging to better assess the possibility of vasa previa and should have made preparations such as planning an elective C-section and the administration of steroids to hasten lung maturity. Plaintiff’s counsel also tried to show that our obstetrician should have reviewed the sonograms herself rather than rely on the maternal fetal medicine physicians’ interpretations. The plaintiff’s expert witness opined that the plaintiff should have been admitted to the hospital during her entire third trimester.
During the trial, our legal team was able to show that our insured-obstetrician appropriately followed the plaintiff’s low-lying placenta and that both the 24-week and 30-week ultrasounds showed resolution of the low-lying placenta. It was also shown that relying on the perinatologists’ expertise in fetal ultrasound interpretation is customary and accepted practice in obstetrical care. Through examination of our experts and cross-examination of the expert witnesses for the plaintiff, our defense counsel demonstrated that the low-lying placenta had sonographically resolved, no other maternal risk factors were present which would indicate that this was a high-risk pregnancy, and the 24- and 30-week biophysical profiles were normal, therefore admitting the plaintiff to the hospital during the third trimester was not indicated in this case. Finally, the defense was able to show that pathological examination of the placenta revealed that this was not a case of vasa previa but rather a case of a velamentous cord insertion, the finding of which was not evident on the prenatal ultrasounds performed. After reviewing the evidence presented by both plaintiff and defense counsel, the jury determined that our insured obstetrician did not depart from the standard of care in this case.