Medical Verdicts

Could cesarean delivery have prevented shoulder dystocia?


Bronx County (NY) Supreme Court

Several days prior to delivery, a woman presented to her Ob/Gyn for a sonogram. The results indicated an estimated fetal weight of between 4,664 g and 4,770 g.

Despite the fetus’s size, the gravida underwent a trial of labor and delivered a 10 lb, 9 oz (4,800 g) baby with brachial plexus injury to her right arm. Presently, the infant suffers from permanent nerve damage with limitation of her right arm.

In suing, the family argued that the delivering obstetrician should have warned the mother of the potential risk of vaginally delivering a macrosomic infant. The plaintiffs also contended that, at the time of delivery, there was a compound presentation of the fetus’s face and hand that should have been diagnosed earlier. In addition, they claimed that the physician exerted excessive traction to resolve shoulder dystocia.

The Ob/Gyn maintained that a trial of labor was appropriate because the woman had twice delivered large babies. The physician also claimed that the compound presentation was present only at the time of delivery—not beforehand. The Ob/Gyn further argued that no traction was placed on the fetal head during delivery. The shoulder injury occurred during labor when the infant’s shoulder was lodged under the symphysis pubis.

  • The jury awarded the family $3.65 million.
The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts. While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.

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