C.M. v. United States

C.M. v. United States,
2006 U.S.Dist. LEXIS 82127
E.D. Missouri; November 9, 2006

  • Alleged injury or harm: subgaleal hematoma, hypoxic ischemic encephalopathy, and related injuries
  • Theories of negligent conduct: failure of the doctor to be present earlier to monitor personally the plaintiff’s labor, and failure to order a caesarean delivery
  • Judgment: Defendant is liable.

The plaintiff, C.M., suffered a subgaleal hematoma and diffuse ischemic injury while she was being delivered, with a diagnosis of hypoxic ischemic encephalopathy with neo-natal seizures. (Decision, at *11.) She and her mother, Jasmine Lucius, alleged that her injuries were caused by the physician’s delay in arriving at the hospital to deliver her and/or by his failure to order her delivered by caesarean section.

The Court, deciding the case under the Federal Tort Claims Act and applying the substantive law of Missouri, held that:

  • ”[T]he acts and omissions of Dr. Reed in the care of [Jasmine] during her labor and in the delivery of C.M. did not meet the standard of care required.” (Decision, at *19.) Specifically, “Dr. Reed should have been present earlier to monitor personally [Jasmine’s] labor” (Decision, at *19) and “it fell below the proper standard of care when Dr. Reed failed to order a caesarean delivery after the initial vacuum extractor did not operate properly” (Decision, at *22);
  • Dr. Reed’s “negligent acts and omissions caused C.M.‘s injuries.” (Decision, at *19.) Specifically, “had Dr. Reed been at the hospital no later than 11:00 a.m., much if not all of the damage could have been avoided” (Decision, at *21) and “[g]iven the exigencies of the moment, Dr. Reed could have quite easily shifted to a caesarean procedure at that time, and avoided the subgaleal hemorrhage and possibly the ischemic injury” (Decision, at *22); and
  • The total of economic and non-economic damages awarded for C.M. is $2,715,326.64.

The reasoning of the Court exhibits the following features:

    • The Court carefully constructs a timeline of relevant events (e.g., notice to the absent doctor of maternal or fetal distress), primarily from hospital records;
    • Although the testimony is implied, there is no explicit statement of an expert opinion on the standard of care for time of arrival at a hospital for labor and delivery, adapted to the circumstances of the particular case;
    • Although the testimony is implied, there is no explicit statement of an expert opinion on whether it was negligent not to order a caesarean section under the circumstances of the particular case; and
    • The Court discussed the following elements of damages:  past medical bills; future lost earnings and medical needs (including discounting to present value); and non-economic damages.

Open an HTML copy of the reasoning.

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