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I.G., a minor v Anonymous Physician/Medical Center

Dr. Fagel obtained a settlement of $4,250,000 on behalf of a child who now has brain damage as a result of injuries that occurred during the birth process. The mother, who had a history of asthma, was admitted to the defendant hospital with high blood pressure and placed in the care of a midwife- no obstetrician was present throughout the entire labor and delivery process. She was given Albuterol for her asthma and then Pitocin to facilitate her labor. At about 7 p.m., a nurse noted fetal tachycardia (accelerated heart rate) so the nurse ordered an amnioinfusion. At 8 p.m., the patient had decreased breath sounds and the Fetal Monitor Strip continued to show an elevated heart rate. The Pitocin was stopped and the mother was given more Albuterol before she started pushing at 8:15 p.m. The mother’s blood pressure continued to rise and the fetal heart rate continued to accelerate until it sharply dropped at 9:30 p.m. At 10 p.m. the midwife decided to perform a vacuum delivery and successfully delivered the baby after three minutes. The obstetrician then arrived at 10:10 p.m., well after the baby had been delivered. The plaintiff was born with dangerously low vital signs and was subsequently diagnosed with hypoxic brain injuries.

Dr. Fagel argued that the defendants negligently failed to diagnose the mother’s pre-eclampsia and hypertension, which led to decreased blood (and oxygen) flow to the fetus prior to delivery. Furthermore, the use of Albuterol for asthma dramatically worsened the already-dangerous situation. Finally, the defendant obstetrician should have come to the hospital to manage the patient’s labor; it was below the standard of care to allow a midwife to manage a high-risk patient.