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We represented the family of a 31-year-old mother of five who died eight days after giving birth to twin sons. Late in her prenatal care, her OB–GYN became concerned over her increasing blood pressure and the appearance of protein in her urine, which together with edema, were signs of pre-eclampsia. In order to monitor the pre-eclampsia, the patient was regularly asked at intervals whether she was experiencing any of the classic signs of worsening pre-eclampsia: i.e., headache, visual disturbance, and/or epigastric pain.
Near the end of her pregnancy, her pre-eclampsia had worsened and her doctor decided to admit her for a C-section delivery of her twins. The twins were delivered on February 2. Although the conventional medical view is that delivery of the babies is the cure for pre-eclampsia, there is much medical literature indicating that pre-eclampsia can worsen even during the post-partum period. During her admission at the hospital for the delivery of her twins, our client did not voice any complaints of headaches, epigastric pain, or visual disturbances. As such, she was discharged on February 5 with the understanding that she should follow-up with her OB-GYN in six weeks at his office.
The hospital at which she delivered provides a routine post-partum visit by a maternal/infant home health nurse, whose purpose is to teach and educate moms in the care of their babies, and to look for new signs and symptoms affecting the health of the mother and children. The home health visit was scheduled for February 7. On the evening of February 5, our client began to experience a severe headache and neck stiffness. The headache and neck stiffness continued and was unrelieved by Tylenol or the pain medication she had been prescribed for her incision. She decided to wait for the home health nurse to arrive before seeking further medical attention in regards to these new symptoms. On February 7 at 12:45 p.m., the home health nurse arrived from the hospital and spent 90 minutes with our client, checking her status and the status of the babies. Our client complained of, and the nurse charted a complaint of a headache. However, the nurse characterized it as a minor headache which was more consistent with the type of headache one occasionally gets from an epidural anesthesia. She made this nursing diagnosis and charted same, telling our client to call her doctor if the headache got worse. There was no mention in her chart regarding the neck stiffness, although another family member testified that he came into the room to make sure that the nurse also understood there was neck stiffness in addition to the headache. Believing that these symptoms were the result of the anesthesia, our client and her family did not seek any further medical attention. By February 10, other family members had returned to work, leaving our client alone with the newborns. She was preparing to take the twins to their first pediatrician visit when she suddenly died from a bleed in her brain, diagnosed as a subarachnoid hemorrhage by the County Coroner’s Office.
NPHM retained several expert witnesses. A home health registered nurse opined that the home health nurse breached the accepted standard of care because she failed to appreciate the signs and symptoms of headache and neck stiffness as being significant; failed to contact the OB-GYN to seek his advice; and made a medical diagnosis that the headache was due to the epidural anesthesia.
NPHM also retained an OB-GYN who rendered the identical opinions. In addition, Plaintiff retained a neurologist who opined that the nurse breached the accepted standard of care for the identical reasons, and in addition, had the OB-GYN been made aware of these new symptoms on February 7, our client would have been admitted to the hospital where her medical condition (which he characterized as a leak from a brain aneurysm) would have been promptly diagnosed and treated, resulting in her survival. Lastly, we retained a forensic pathologist who opined that our client’s subarachnoid hemorrhage was a result of a treatable condition (a brain aneurysm) which, if attended to on February 7, February 8, or February 9 would have resulted in her survival.
The Defendants retained the services of a registered nurse, an OB-GYN, a world-renowned OB-GYN with a subspecialty in maternal fetal medicine, and a neurosurgeon. The gist of the defense experts’ opinions were that the nurse did not make a medical diagnosis and acted reasonably in telling our client that her headaches might be due to her epidural anesthesia. In addition, the experts opined that her subarachnoid hemorrhage was a condition that could not have been predicted and/or prevented by any of the facts presented to the nurse or her OB-GYN at any time from February 7 through February 10.
The matter was scheduled for a jury trial on July 16, 2007. The matter proceeded to mediation on July 3, 2007. On July 13, 2007, the case was settled for $1.7 Million.
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