Pregnancy Is a Wonderful Thing...Until It Isn't

Lee S. Goldsmith, M.D., LLB

Pregnancy, child birth and raising a wonderful child are most certainly a blessing. However, errors occur and when they do, they can be disastrous to mother or child. 

During my years in medical school, I spent time working on labor and delivery. The time there gave me the opportunity to experience the joy of participating in and assisting deliveries. It also alerted me to potential problems. 

One evening I was alone on the floor with the nurses and a call came from the Emergency Room that a woman was coming up and was in labor. I looked for the residents and could not find one. I turned to the nurses who were more knowledgeable than I was and waited for the mother-to-be. She arrived on the floor -- and still no back-up. She looked at me and I obviously look scared. She said:  “Sonny, this is my twelfth child. I will tell you what to do.”  She delivered a healthy boy. I just played catch. 

Our first legal experience involved the death of a mother. She was in labor and was given an epidural. An epidural is administered for the purposes of controlling pain during labor. It is to be administered as indicated into the epidural space of the spine. The anatomy finds that the spinal cord is surrounded by the dura and then the area around the dura outside of the spinal cord is called the epidural space. When the anesthetic agent is injected into the epidural space, it is appropriate. However, if the patient is in bed and the head is down, the anesthetic agent will flow upwards, numbing all of the nerves from the lower back to the head. 

As the nerves are deadened, the patient will realize what is occurring. First, the lower part of the body will be numb. Then the areas of the chest. If the anesthetic agent goes far enough, it will deaden the area that is called the Medula, which controls the breathing centers of the body. The patient will cease breathing and, unless properly resuscitated, immediately will die.

This patient was not properly resuscitated and did expire.

There are two basic principles in dealing with malpractice situations. First, some physicians are incompetent and commit a large number of mistakes. Second, the same malpractice errors occur over and over again. 

We have now had our second case of a patient being given an epidural and it numbing the breathing centers of her body, leading to a respiratory arrest. However, in this case, the husband knew CPR and was able to resuscitate his wife until help came. While her life was saved due to her husband, her pregnancy ended up in a C-section so that the life of the child could be saved. 

This was a case of a repetitive error. However, it provides additional information. A firm with a history and experience is better able to evaluate a complex medical malpractice case than a firm with limited experience. Institutional history carries a great deal of weight.