OBGYN Expert Witness Opines on Infant’s Injured Kidneys During Delivery

Inna Kraner, J.D.

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— Updated on September 28, 2017

OBGYN expertThis case involves a child who suffered severe injury to her kidney when she was born. A sonogram had shown that the baby was in the breech position before the birth and the doctor planned to deliver the baby by cesarean section. An examination of the mother before the delivery indicated that the baby was in a vertex position with its head down. When the mother’s contractions increased, she was admitted to the hospital. An examination showed the baby to be in a frank breech position with its buttocks first. A fetal monitor showed that the baby’s heartbeat was decelerating. When the doctor tried to deliver the baby, he found that the buttocks were visible and determined that it was too late to perform a cesarean section. When the physician attempted to deliver the baby with a vaginal delivery, he used pressure on the baby’s abdomen to try to deliver her and found that the umbilical cord was wrapped around the baby’s neck. The nurse asked the doctor to cut the cord, but the doctor did not do this. The baby was born blue and not breathing. The baby had to be resuscitated and the doctor later admitted that he had probably erred about the vertex position of the baby. The baby was later diagnosed with bruising in her flank area and sacrum and extensive kidney damage. The baby had to have one of her kidneys removed and the diagnosis was that she would need a kidney transplant by the time she was 12 years old. The parents sued the hospital claiming that the doctor had been negligent in failing to diagnose the baby’s breech position in time to perform a cesarean section and also in applying undue pressure to the baby’s soft tissues during delivery.

Question(s) For Expert Witness

  • 1. Can the parents of a baby that suffered kidney damage during delivery sue the hospital if a doctor fails to diagnose a breech condition and injures the baby during a vaginal delivery?

Expert Witness Response

For the doctor in this case to have met the proper standard of care, he should have been able to determine whether the baby was in the breech position prior to delivery. Most hospitals require that obstetricians determine the presenting part of the baby by doing a vaginal examination of the mother. It is the responsibility of the doctor to know whether a baby is in the vertex or breech position so that the proper method of delivery can be used. Even when a woman’s water bag has not broken and the cervix is dilated less than 9 centimeters, it is usually possible for hospital staff to determine whether a baby is in the breech or vertex position prior to delivery. A baby that is found to be in the breech position can usually be delivered safely by cesarean section by being lifted out through the soft tissue of the uterine and abdominal wall and this creates much less risk of injury to the baby. For the doctor to have met the proper standard of care in this case, he would have had to determine the baby’s breech position earlier and perform a cesarean section so that the baby’s torso and kidneys would not be injured during the delivery.

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