Shoulder Dystocia: The Oft-Litigated Medical Claims – How to Avoid Liability and Do It Right

A Federal judge in the Middle District of Georgia entered an astounding $6,000,000 verdict for a family whose child suffered a brachial plexus injury following a delivery complicated by shoulder dystocia.  Coleman v. United States, 2016 U.S. Dist. LEXIS 102915, 1:14-CV-168(WLS) (M.D. Ga. 2016).

The judge’s finding emphasizes two things that all OB/GYNs, nurses, and other medical professionals in the field of obstetrics and gynecology should note:

(1) Review the mother’s medical history as early as possible; and
(2) Do not pull on the child’s head.

In Coleman, the mother had three prior vaginal deliveries, two of which were complicated by shoulder dystocia.  The same Nurse Midwife involved with the delivery in this case was involved in those two prior deliveries and actually documented the relevant medical history herself.  She did not, however, inform the delivering physician or the mother about the prior shoulder dystocias.

During labor, the doctor used a vacuum extractor one he realized that the child’s fetal heart rate was low.  When the head delivered, he recognized the dystocia and called for the McRoberts maneuver and the application of suprapubic pressure.  The doctor and nurse then “pulled on [the child’s] head three times.”

The Court found that the Defendants had a duty to: (1) evaluate the mother’s medical background and relay the information to the appropriate parties; (2) consider the appropriate approach to her fourth pregnancy in light of her two prior instances of shoulder dystocia; and (3) use appropriate maneuvers when made aware of the shoulder dystocia.

The Court determined that they breached their duty by not reviewing the mother’s relevant medical history when it was clearly available and would have allowed them to make a timely, thoughtful, and effective professional decision of how to handle the pregnancy and labor.  The doctor and nurse also breached the duty of care by “pull[ing] on [the child’s] head three times during…labor.”

According to the Court, their failure to review the mother’s prior medical history caused the child’s injuries because they otherwise would have identified a C-section as the safest manner to deliver the child, per the Defendant-Doctor’s own admission.  Additionally, the Defendants offered no evidence to refute that they “pulled on [the child’s] head three times during…labor,” causing the child’s injuries.

In all, the judge awarded the child nearly $6,000,000 in damages and another $400,000 to the parents.  OB GYNs, nurse midwives, and other medical professionals in the field of obstetrics and gynecology take note of the message this Federal judge has made loud and clear.

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