$27.6 million dollar verdict against OB in Louisville, KY. Anyone have any info?

[tugbug]

This verdict came down on 4/18. I am beating my head against a couple of lawyers in a KY politics forum and was hoping to find any info on exactly what happened/ is claimed.

Anyone have a link or any info? Thanks in advance.

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[BigBopper]

This verdict came down on 4/18. I am beating my head against a couple of lawyers in a KY politics forum and was hoping to find any info on exactly what happened/ is claimed.

Anyone have a link or any info? Thanks in advance.

http://www.kentucky.com/mld/kentucky/news/local/8475026.htm

 

[juddson]

Thanks for the article. I wish there were more facts in there. I'm interested to see what was presented to the jury. I'll see what I can find out.

Judd

 

[neilc]

this is frightening...but, it looks like the hospital is who is paying, not the doctor. the doc settled earlier.

so, it looks like CP is a blank check for the parents of these unfortunate children...as far as i have learned there is no clear etiology with most CP cases. if that is the case, how on earth can you "prove" to any reasonable person that the OB caused it? it really seems as though the jury will award to a plaintif based soley on whether there was a poor outcome, regardless of cause. there has got to be a way to require more medical merit to the case, or to require some firm link of the outcome with poor medical procedure/practice...

it just seems like a terrible situation. a jury that really has no idea of what medically is going on is asked to decide whether some poor, handicapped child and his family recieve money to care for the child. the jury sees the kid, feels terrible, has no idea what is going on medically, and thinks "what if it were me"...then, they say "oh, insurance is going to pay for it anyway" and give some huge award!

there should be a way to decide whether a case is potential malpractice or simply an untoward outcome before it even gets to the point where settlements or jury selection are being discussed. maybe a board of lawyers, doctors, nurses, midwives, judges could review cases first?

 

[juddson]

this is frightening...but, it looks like the hospital is who is paying, not the doctor. the doc settled earlier.

so, it looks like CP is a blank check for the parents of these unfortunate children...as far as i have learned there is no clear etiology with most CP cases. if that is the case, how on earth can you "prove" to any reasonable person that the OB caused it? it really seems as though the jury will award to a plaintif based soley on whether there was a poor outcome, regardless of cause. there has got to be a way to require more medical merit to the case, or to require some firm link of the outcome with poor medical procedure/practice...

it just seems like a terrible situation. a jury that really has no idea of what medically is going on is asked to decide whether some poor, handicapped child and his family recieve money to care for the child. the jury sees the kid, feels terrible, has no idea what is going on medically, and thinks "what if it were me"...then, they say "oh, insurance is going to pay for it anyway" and give some huge award!

Oh, so you've found an article with all the facts? let's have it then. I'd like to read what you have read.

Judd

 

[neilc]

no article...just extrapolating from what i read on the posted link...

quotes like this are what got me thinking:

"Still, Simpson said, "There was conclusive evidence in this case that the injury to the baby was sudden, unexpected and unpreventable," he said. "The jury basically ignored overwhelming evidence and chose to give this family some money." "

"The doctor involved in the case, Maria Schweichler, settled her part of the lawsuit with the Sapps more than a year ago for an undisclosed amount and will not have to pay the 20 percent of the $27 million the jury assigned to her. The terms of that settlement are confidential."

and especially this one..."The Sapps claimed that when Judy Sapp was induced into labor at Baptist East on Aug. 28, 1998, the hospital mismanaged Spencer's birth, overdosing Judy Sapp with Pitocin, a drug used to stimulate contractions.

The jury agreed with the family's charge that prolonged use of the drug temporarily cut off Spencer's oxygen, causing brain damage and leading to cerebral palsy."

i mean, the jury agreed with the families charge??? that doesn't sound like it was based on medical fact to me...sure, it is a complication of pitocin. but, how much was given? is it really an "overdose", or did she simply have a strong reaction to a normal dose? how long was the baby hypoxic? did they monitor blood oxygen levels, or is this after the fact guessing at what happened? i would really be curious to see the medical facts presented also. but, my guess is that they had a documented high dose of pitocin and a baby that wound up with CP.

so, i don't know much, but just that article got me to thinking about this...i love ob/gyn, but i would be lying if i didn't admit that this is very worrisome

 

[juddson]

no article...just extrapolating from what i read on the posted link...

quotes like this are what got me thinking:

"Still, Simpson said, "There was conclusive evidence in this case that the injury to the baby was sudden, unexpected and unpreventable," he said. "The jury basically ignored overwhelming evidence and chose to give this family some money." "

This is a statement of the hospital's attorney. We can agree that this is not objective data, right? right?

"The doctor involved in the case, Maria Schweichler, settled her part of the lawsuit with the Sapps more than a year ago for an undisclosed amount and will not have to pay the 20 percent of the $27 million the jury assigned to her. The terms of that settlement are confidential."

Why does this suggest something untoward to you? Is this because the settlement was 'confidentia'. Settlements are almost always confidential, and are overwhelmingly so because the party who pays the settlement wants it that way. The confidentiality in this case was almost certainly designed to protect the doctor, not the patient.

and especially this one..."The Sapps claimed that when Judy Sapp was induced into labor at Baptist East on Aug. 28, 1998, the hospital mismanaged Spencer's birth, overdosing Judy Sapp with Pitocin, a drug used to stimulate contractions.

The jury agreed with the family's charge that prolonged use of the drug temporarily cut off Spencer's oxygen, causing brain damage and leading to cerebral palsy."

i mean, the jury agreed with the families charge??? that doesn't sound like it was based on medical fact to me.

What about this suggests that it is not based on medical fact? You must be under the impression that Mrs. Sapp took the stand and gave her opinion that Pitosin caused the injury - and that based on that testimony, the jury agreed. That's not how it works, and that's not what the statement set forth in the article is designed to convey. The Sapp's presented expert testimony from physicians (and the defendants presented experts refuting the plaintiff's expert testimony) and the jury is then permitted to believe one side and disbelieve the other. I'm not sure what you are getting at.

Here's the smartest bit that you have said:

..sure, it is a complication of pitocin. but, how much was given? is it really an "overdose", or did she simply have a strong reaction to a normal dose? how long was the baby hypoxic? did they monitor blood oxygen levels, or is this after the fact guessing at what happened? i would really be curious to see the medical facts presented also. but, my guess is that they had a documented high dose of pitocin and a baby that wound up with CP.

Your statements above point out precisely why nobody can make a judgment on the appropriateness of the verdict based on the article above. The jury would have been presented with evidence on all of these questions, and would have decided to believe or disbelieve this evidence. These cases do not arise out of a vacuum. You need evidence to present a case. How do you know that evidence was not presented (no doubt it was) concerning (1) the doses of pitosin given and (2) oxygen monitoring? I'm gratified that you are also interested in seeing the facts for yourself - but I'm saddened that implicit in your statements is a recognition that you simply have no facts but are still content to judge the appropriateness of the verdict. You NO basis upon which to make even the most rudamentary judgment on whether the standard of care was deviated from and whether the deviation was the cause of the injury - other than, of course, the verdict of 12 ordinary people who answered in the affirmative in both cases.

so, i don't know much,

That makes two of us (all of us on this thread). We simply don't know anything at all. We don't know, for instance, what the doctor settled the case for. Could it have been only $200,000? We don't know if a similar offer was made to the hospital and rejected by them. We don't know if there was a gross pitosin overdose. We don't know whether a fetal heart monitor was used. We don't know whether exygen levels were taken. We don't know whether the nurse was trained in Ob (as opposed to merely "covering" the OB ward for a co-worker). We don't know whether the mother should have been induced at all. We just don't know anything.

Judd

 

[tugbug]

Juddson, I'm sure this wont pass your "objectivity" test (didnt for other folks I was discussing this with - which is why I asked for a link here), but, I'm in Louisville. This doc did my son's circumcision and I work at a hospital within a tenth of a mile of Baptist East, with several docs familiar with the case. Ive discussed it with several of these docs and they are adamant that no breach of OB standards occured. I think most are amazed it went to trial... much less this verdict.

If you can find a link or any info that is more "objective" and detailed, I would appreciate it.

 

[jashanley]

After spending a month with the ob residents and attendings during my EM residency and discussing cases similar to this, the conclusion is that most likely CP does not develop from fetal hypoxia at birth but from a long standing insult (or combinations of insults) prior to birth. Certainly, pitocin (not pitosin) acts to augment uterine contractions. Uterine contractions normally decrease placental blood flow during the contractile state and blood flow resumes with relaxation of the uterine wall. Hyperstimulation (frequent contrations) can lead to diminished blood flow and fetal hypoxia.
I agree that we do not have all the facts. Did the Ob/gyn get cord gases at the time of delivery? Did they place a fetal SO2 monitor. Did he/she do a scalp pH? What do they imply when the article says she overdosed on pitocin. She she accidentally get a bolus or was she keep at a high rate despite showing signs of fetal distress on the cardiotocometer?
I think that the truth lies somewhere in between.
I do believe that many times, despite overwhelming evidence in favor of the hospital and the MD that the jury still feels guilt and ends up rewarding the supposed victim with an inordinate amount of money for so-called emotional suffering.
The problem is anyone can sue an MD for their child's disabilities, even if the only wrong doing was caused by the mom herself (i.e. smoking, ETOH, illicit drug use, poor nutrition, toxic exposures, etc....) and not the MD. At some point people need to take responsibility for their own actions and stop blaming others for their mistakes. I'm sure that the MD may have settled out of court to avoid the long, drawn out, and exhausting legal battle, despite being in the right. It happens. However, I can only surmise a reason without knowing the facts.

 

[juddson]

Juddson, I'm sure this wont pass your "objectivity" test (didnt for other folks I was discussing this with - which is why I asked for a link here), but, I'm in Louisville. This doc did my son's circumcision and I work at a hospital within a tenth of a mile of Baptist East, with several docs familiar with the case. Ive discussed it with several of these docs and they are adamant that no breach of OB standards occured. I think most are amazed it went to trial... much less this verdict.

If you can find a link or any info that is more "objective" and detailed, I would appreciate it.

All of this may very well be true. I'm not suggesting the verdict is right. I'm just saying that there is nothing in the article which suggests one way or the other. Additional facts (which you may have because you live nearby) probably shed some light on this issue. But nothing in the article is dispositive. That's all I'm saying.

Whether your doctors are "objective" or not, I have no idea, and I won't pass judgement. I'm entitled to suggest that the hospital's own attorney is NOT an objective source, right? You'd have to give me that much. But whether other doctors are objective - I'm inclined to think they are. Why? Because I think in clear cases of negligence, fellow docs are not hesitant to come out and say so. So, i don't really question doctor objectivety.

Judd

 

[tugbug]

Juddson - how quickly do case details/opinions on cases get posted to the many "pay" legal sites? Everywhere I go to look for details I must subscribe to search. Youre a lawyer, do you have access?

Here are some additional press briefing details from a local newspaper... although, again this is the hospitals attorney speaking.

"Simpson said that Schweichler had the proper credentials, and that Judy and Spencer Sapp tolerated the drug well.

"What happened in this case was that about a half-hour before the baby was born, the baby moved and there was a complete restriction of the umbilical cord," Simpson said. "It was unexpected, unforeseeable and unpreventable."

Simpson said X-ray scans showed that Spencer's injury occurred 30 minutes before birth and had nothing to do with the drug.

"The hospital did not do anything wrong," Simpson said. "

 

[juddson]

The problem is that a case like this is fact intensive and there are generally no records of what went on in the courtroom except the trail transcripts prepaired by the court reporter. I suppose thes could be purchased (and for all I know some of the pay sites do purchase them for later analysis) but I am not sure they are available except to the parties themselves. Another poster on the other thread, Kale, I think, is a defense attorney. He may know more about this.

"legal opinions" written by judges typically occur at the apellate level only, and for this case to be appealed there has to be some issue of law handled incorrectly at the trial level. Often in these opinions there are detailed accounts of the facts presented in the case, but not always depending on the legal issue in question. In any event, that would be years off it were to happen here. Suffice it to say an appeal based on a verdict manifestly contrary to the evidence would include a very detailed accounting of the facts. But that one is hard to win (the courts defer enormously to the fact fiinding function of a jury). My guess is there will be no appeal in this case.

I suppose it is possible that one of the pay services could have sat in on the case and taken notes. But recording devices are ussually prohibited. And there's no reason to think that this would have been a particularly high-profile case when the trial started. So, I would not expect any serious coverage at that level.

We may never really know what happened in the courtroom.

Judd

 

[neilc]

ok, dont have time or inclination to use the quote thingy right now..but, the quote about the doctor accepting a settlement was not an example of untoward behavior, but just to show where i got the information that the doc wasn't held liable.

i do agree that the defense attorney statement is less than objective...but, based on what i know about Ob/Gyn, it seems pretty accurate. i have a very hard time believing that there is compelling medical evidence that can implicate pitocin as the cause of CP.

anyhow, i am not a lawyer. but, i do know that the current system simply assigns responsibilty to doctors for adverse affects, poor outcomes and other realities of life. these things are unfortunate, but unless the doctor practices BAD MEDICINE, does something outside of his training or hurts the patient thru negligence, it is not malpractice!

 

[terpgirl]

The problem is anyone can sue an MD for their child's disabilities, even if the only wrong doing was caused by the mom herself (i.e. smoking, ETOH, illicit drug use, poor nutrition, toxic exposures, etc....) and not the MD. At some point people need to take responsibility for their own actions and stop blaming others for their mistakes. I'm sure that the MD may have settled out of court to avoid the long, drawn out, and exhausting legal battle, despite being in the right. It happens. However, I can only surmise a reason without knowing the facts.

Well said!

I'm an undergrad born with Spina Bifida. When they were doing neuro on the lesion on my back, they used a wonderful brand-new invention on my back called a hot knife. Ended up causing a HUGE infection, and 15 years down the road I had to have plasstic surgery correct the horrible disfigurement and damage caused by it. OK, new things in medicine need to be tried out, fine. The neurosurgeon made a big error during the surgery--DROPPED the hot knife on my back, leaving many scars just from that. My parents didn't sue, although they told me I was more than welcome to... the nerve damage was very painful for years. That ended up being fixed 16 years later. I had full intention to seek this man out when I turned 18--nice to have the parents tell me he was 70-80 at the time of surgery so he's most likely dead. The man should have had his license taken away. I can only imagine what horrors he put others through.

I think the biggest problem beyond sympathetic juries is the lawyers. Has anyone sat at home during the middle of the weekday and seen the ads on TV??? If your child was born with a low APGAR score (regardless if the second one was higher and your child is perfectly healthy), you have recourse to sue. What the hell?! Same thing if you had a difficlut labor. I haven't seen that ad on in a while, but it's sickening to think that people honestly believe they should sue in such circumstances--and have lawyers egg them on. It's a shame.

-Liz

 

[jayman]

this is stupid. an expecting mother given a drug with the intention of HELPING her then-potentially-injurious situation has an unforseeable, adverse reaction to the drug...and then sues the doctors/hospitals who were trying to help her in the first place?!?!?

correction, this is ******edly stupid. i get so pissed when i see this kind of crap happening. two problems here: 1) juries are sympathetic, witless fools. 2) lawyers need to learn to exercise a bit of discretion when taking on cases...i know there's this internal struggle of "balancing ethics with your pocketbook" raging within every medical malpractice lawyer , but i'm certain that the direction this whole medico-legal craziness is taking is not good for anyone.

Malpractice is negligence, ill-intended actions, or results of poor medical decision-making by a doc...NOT a negative medical outcome!!! someone needs to bring this to the attention of these pathetic jurors around the country who are so quick to dismiss medical evidence and rely on their sympathy to guide them. honestly, i don't think it would matter how many docs testified that nothing was done incorrectly...half of these people probably made up their mind within minutes of hearing about this little kid with CP. the fact that cases like this are regularly won by the plaintiff, and awards of millions of dollars are just handed out, makes me sick. it just makes me respect my fellow citizen even less.

Is what happened to this kid tragic? Hell yes. Is what happened medical malpractice? HELL NO. As cool as OB and other potentially high-risk specialties are, there needs to be a major change in how we as a country handle unfortunate, but unpreventable, medical outcomes.

maybe gene hackman was right: "some decisions are too important (or too complicated) to be made by a jury." i hope things change, but i doubt they will anytime soon.

whatever. in any event, i hope the money can make this kid's life a little bit happier. god knows it's a $hitty condition to have. all i know is i'd better not read about how this family purchased some yacht or a beach house.

anyone else frustrated with this kind of crap?

 

[group_theory]

The biggest problem w/ the system is that we are asking the jury to be the "trier of facts" in complicated medical cases. There is a reason why people in the healthcare field spend years in school - medicine is complicated, it involves a whole new language, and includes science that is beyond the comprehension of most people (including college educated people) who are not part of the healthcare system. Then suddenly we as society expect these people (our "peers") to determine the "facts" from this mangled mess with conflicting expert testimony, complicated legal procedures and definitions, etc.

The fact that these jurors sometimes reach a "correct" (of course, the term correct is subjective) verdict is surprising at all.

Why not ask jurors to decide constitutional matters too. Who needs a Supreme Court to decide constitutional matters when you can have 12 "peers" do its function. Have them determine the limits of the American Disability Act, or whether or not US citizens held in Guantanamo deserve due process or not.

Sorry for the rant. I think the solution is to create a specialty court, similar to Tax Court or Bankruptcy Court. It will create less uncertainly among lawyers (both defense and plantiff) and Insurance Companies will be less willing to settle "defensable" good cases if there is a uniform standard (instead of an unpredictable standard).