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Gel, Pit, & VBAC tragedyFrom: Gloria Lemay (gloria_lemay@ultranet.ca)Tue Feb 27 23:26:25 2001
Last Updated: Tuesday 27 February 2001 TOP STORIES ------------------------------------------------------------------------Mother of brain-damaged child awarded $2.8 million Judge finds 'overwhelming evidence of negligence' by RCH nurses ------------------------------------------------------------------------Mother of brain-damaged child awarded $2.8 million Neal Hall Vancouver Sun ------------------------------------------------------------------------Mother of brain-damaged child awarded $2.8 million Royal Columbian Hospital has been ordered to pay $2.8 million in damages for the negligence of four nurses who handled a fetus in distress, resulting in a boy being born with catastrophic brain damage. B.C. Supreme Court Justice Mary Ellen Boyd, in a judgment released Monday, found there was "overwhelming evidence of negligence on the defendant nurses' part." The birth mother, Lydie Guerineau, sued the hospital on behalf of her son Jesse, who is almost three. While waiting to give birth, the mother's uterus ruptured, pushing the fetus into the mother's abdominal cavity on March 16, 1998. The problem wasn't detected for almost an hour, the judge found, because of inexperience and failure to call the on-call obstetrician at the New Westminster hospital. The child was born clinically dead but was resuscitated. He has no bladder or bowel control, has to be fed by a tube and cannot communicate, although he smiles and laughs when tickled. He is expected to live until age 20. "It's going to make a huge difference to the quality of life of the parents," lawyer Nathan Smith said of the award to his client. "The parents are having to work different shifts so someone could be there to look after Jesse." Lydie Guerineau works as an accounting clerk and her husband is a forklift operator. The couple also have an eight-year-old daughter. They declined to be interviewed. The incident began with the mother complaining loudly about vaginal pain beginning at 1:10 a.m. but the on-call obstetrician, Dr. Sara Pedersen, wasn't called until 2:54 a.m. Pedersen arrived at 3 a.m., immediately checked the patient and ordered a caesarean section. The baby was delivered 23 minutes later. Both the obstetrician and the family physician, Dr. Mark Seger, testified they would have attended if they had been called sooner or alerted to any concerns about the fetal heart rate. The expert nursing evidence was also highly critical of the nurses' actions. The judge found that Jean Skidmore, the nurse assigned to the birth, was a neophyte in terms of her clinical experience with delivering babies -- she had only worked 12 shifts in that area, although she had been a nurse since 1978. Another nurse, Heather McKay, who relieved Skidmore during a 30-minute break at 2 a.m., was even more junior, having worked only four shifts in delivery nursing. The other nurses found to be negligent were the charge nurse, Miranda Ha, who assigned Skidmore as the primary care nurse, and Betty Luk, who eventually called a doctor for help. In a 58-page judgment, the judge found Luk compounded the problem by first calling the on-call general practitioner, rather than Pedersen, at 2:30 a.m. The judge noted that the mother was already at risk for problems because she had previously had a C-section birth and wanted to have a vaginal birth. When the mother attended at hospital about 11 a.m. March 15, she was about 10 days overdue, so labour was induced. Induced labour also increases the risk involved in a VBAC delivery (vaginal birth after caesarean), the judge noted. The nurses were found negligent in discontinuing a fetal heart monitoring strip, which had been improperly interpreted -- a nurse felt the drop in the baby's heart rate was simply caused by the mother shifting in bed while in pain, causing umbilical cord compression. Skidmore had consulted with the charge nurse, Ha, and both felt the mother's vaginal pain was caused by the earlier insertion of gel to induce labour. Ha also made an erroneous assumption that the patient had a full bladder, so the patient was instructed to void. The patient spent from 1:25 to 2 a.m. in the bathroom, returning to bed at 2:10. The baby was in an emergency situation by 2:10 and valuable time was lost by failing to call the on-call obstetrician, the judge noted. "In this case, each minute counts," the judge noted. "Even if Dr. Pedersen was not called until 2:30, when nurse Luk instead called Dr. Seger, the injury could still have been prevented or at least minimized." Helen Carknier of the Simon Fraser Health Region, which operates Royal Columbian Hospital, said insurance coverage by the B.C. Health Risk Society covers such awards.
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