Respiratory Distress of the Newborn With Resultant Cerebral Palsy

Case Overview

This case involves a premature infant delivered by cesarean section. The infants APGAR score was 9-9, but after 12 hours of life the baby became apneic and tachypneic with prominent grunting noticed by the nursing staff. The baby was started on 100% O2 and transferred to the special care nursery. The initial CXR showed coarse interstitial infiltrates consistent with RDS and hyaline membrane disease. Also during this time, an ABG was performed and was categorized as respiratory acidosis. It is important to note that surfactant had not been administered at the time CXR was taken. The patient was given his first dose of surfactant 37 hours after birth and a third CXR now showed a right-sided pneumothorax. It was at this point the first recommendation to transfer to a tertiary care center was discussed. Upon transfer the infant was given 2 additional doses of Survanta and was placed on JET for high frequency ventilation. The patient was noted to have a grade 1 intraventricular hemorrhage which resolved before discharge. Approximately two years later, the patient was admitted due to right arm weakness since birth and was seen by a physician who suggested Cerebral Palsy with possible stroke at birth.

Questions to the Neonatology expert and their responses

The attorney is looking for a qualified expert in the area of Neonatology who has had similar cases in the past.

This is a clear cut case in which the Obstetricians should have noticed some fetal immaturity on ultrasound and taken the necessary precautions in aiding in lung maturity via medical management.

One who can review the medical records and can determine if any deviation from the standard of care exists.

This is a clear cut case in which the Obstetricians should have noticed some fetal immaturity on ultrasound and taken the necessary precautions in aiding in lung maturity via medical management.

About the expert

This expert has over 35 years of experience in the field of neonatal-perinatal medicine. He earned his BA in biology from Northwestern University and his MD from Loyola University Stritch School of Medicine. He went on to complete an internship and residency in pediatrics at the University of Chicago before completing a prestigious fellowship in neonatology at Loyola University Medical Center. This expert is very active in his field as a member of multiple professional societies including the American Academy of Pediatrics, the American Heart Association, and the National Perinatal Association. In addition, this expert has published nearly 30 abstracts, 14 peer-review articles, and has been invited to speak on over 50 occasions. Formerly, this expert worked as an assistant professor of pediatrics and was the medical director of the neonatal developmental follow-up clinic at Loyola University Medical Center. He was also the director of newborn services at Hinsdale Hospital. Currently, this expert is an attending neonatologist and associate professor of pediatrics at a major medical university and affiliated medical center in Ohio. He is also the medical director of the NICU and the neonatal follow-up clinic at a medical center in Ohio.

E-000480

Specialties:

Neonatology

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