Defense Verdict in Bronx County Supreme Court
Elizabeth Cornacchio recently obtained a defense verdict in a birth injury case tried in Bronx County Supreme Court against a hospital.
Plaintiff claimed that the labor and delivery of a 23-year-old, first-time pregnant woman, was mismanaged. The plaintiff-mother presented to the defendant institution with complaints of abdominal pain and bleeding at 25 weeks 6 days gestation. The patient was assessed and determined to be in labor; antibiotics, steroids to enhance fetal lung development, and magnesium sulfate were started in an effort to forestall delivery. There was a question of preterm premature rupture of membranes, but an amniotic fluid index, while low, was within the range of normal and the bleeding made testing of vaginal fluids ambiguous. Plaintiff claimed that an elevated white blood count of 23.6 drawn one hour after admission was diagnostic of infection in the presence of a mother with tachycardia. The defense described the white blood count as normal for a mother in labor and the tachycardia was a non–specific finding, brought on at least in part, by an anxiety attack documented in the records and worked up as a possible cardiac event.
The defense further emphasized that the absence of fever, uterine tenderness and fetal tachycardia supported the judgment that there was no intrauterine infection in the form of chorioamnionitis. Plaintiff argued that the administration of antibiotics made all subsequent cultures and testing unreliable.
A repeat blood test some six hours later was further elevated to 30.6, but this was accounted for by the administration of the steroids to enhance fetal lung development. Plaintiff claimed that a cesarean section should have been performed by the third hour after admission at the latest. The defense contended that the timing of the section, which was done at nine hours after continued dilatation and effacement, despite high doses of magnesium sulfate, was appropriate, and that the Apgar scores of 3 and 8 and the cord blood gas disproved the presence of hypoxia. While chorioamnionitis was found on pathology, defense experts described this as consistent with inflammation, and the negative placental cultures and cultures of the baby throughout her admission supported the “no infection” position. The infant-plaintiff suffers from cerebral palsy, manifesting primarily in spastic quadriparesis with some disputed cognitive impairment.
After 3 days of deliberations, the jury returned a defense verdict.