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J. S., a minor v Kaiser

Dr. Fagel and his associates negotiated a settlement of $3,500,000 on behalf of a child who now suffers brain damage and developmental delays after hospital staff negligently responded to fetal distress and did not perform a c-section in a timely manner. Although the fetal tracing was normal, the mother experienced several hours of severe pain and eventually requested a c-section at 11:30 a.m. However, the nurse told her that the hospital does “not do c-sections for first time pregnancies” and did not tell the obstetrician about the patient’s request. After her pain continued, the patient’s husband requested another c-section at 8 p.m., but was denied once again. At 7 a.m. the next day, during a shift change, the mother was noted to have a high temperature and a nurse noted decelerations of the fetal heart rate at 11:09 a.m. Prior to this time, the fetal monitor strip had been reassuring. The obstetrician was then called in and ordered for a stat c-section. The infant plaintiff was delivered 20 minutes later, with dangerously low vital signs and significant brain damage.

The defense contended that all care was within standard because there was no medical indication for a c-section prior to 11:10 am, since the fetal monitor strip was always reassuring. The defense continued by arguing that any injuries were caused by an infection in the mother’s placenta. However, Dr. Fagel demonstrated that the mother had several risk factors, including elevated blood pressure, extreme pain and a fever, which required earlier delivery. Had an OB performed a c-section when complication initially began, the tragic outcome could have been averted.