Untimely cesarean section

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Case in Point

April 16, 2013

Untimely cesarean section 

The plaintiff—who suffered asphyxia during birth that caused developmental delays and other problems—alleged that the United States was liable for an army hospital’s failure to properly respond to fetal distress and perform a timely cesarean section. The parties settled before trial for $10 million. Guill v. U.S.

Two days before her baby was due, Katie Guill, 27, went to an army hospital, complaining of sporadic contractions and pink vaginal discharge. Guill was placed on a fetal monitor and discharged home several hours later. Within five hours, she returned to the hospital, complaining of increased pain and contractions. Fetal monitoring was reassuring, and Guill was again discharged.

Several hours later, she returned to the hospital with a fever. Testing revealed a high white blood cell count. After a few hours, fetal monitoring showed a lack of fetal heart acceleration and significant deceleration in the fetal heart rate. An attending doctor noted possible bradycardia, and Guill was started on Pitocin. A nurse later notified obstetrician Steven Hong of the negative fetal monitor strips. Guill was repositioned several times, but the bradycardia continued. Nursing staff again notified Hong, who came to Guill’s bedside more than three hours after he was first notified of the bradycardia.

Hong later ordered a cesarean section. Guill’s son was born in a depressed condition, with Apgar scores of two at one and five minutes. Now 4, he is unable to crawl, sit, or walk, and suffers from developmental delays and visual and motor impairment.

The child sued the United States, alleging the medical staff’s failure to properly respond to fetal distress and perform a timely cesarean section led to acute asphyxia. Suit also claimed failure to properly resuscitate the infant.

The parties settled for $10 million before trial.

Citation: Guill v. U.S., No. 3:12-cv-05022 (W.D. Wash. Nov. 2, 2012).

Plaintiff counsel: AAJ member Laurie M. Higginbotham, Austin, Texas.

Plaintiff experts: Richard Sweet, obstetrics, Sacramento, Calif.; Evelyn Hickson, labor and delivery nursing, Federal Way, Wash.; William Rhine, neonatology, Palo Alto, Calif.; Jane Vaccaro, life-care planning, Gig Harbor, Wash.; and Robert Moss, economics, Seattle.

Defense experts: Jeffrey Phelan, obstetrics, City of Industry, Calif.; Christine A. Gleason, neonatology, Seattle; Robert Shavelle, life expectancy, San Francisco; Janet Toney, life-care planning, Albuquerque; and R. Wesley Tyson, pediatric pathology, Evergreen, Colo.

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