Case Study: Preeclampsia Wrongful Death

Confidential Settlement

The plaintiffs were the decedent's mother as executrix of the decedent's estate, as well as the mother and father individually. The plaintiffs' claims included damages for the parents' loss of consortium during the child's lifetime in addition to the wrongful death claim, and the mother's own claim for personal injury.

The decedent's mother was seeing the defendant for regular prenatal visits. On Dec. 16, the mother was at 28 weeks gestation and presented for a regularly scheduled visit. Her blood pressure was recorded at 200/100.

The medical record also reflected that the mother's blood pressure was taken repeatedly, that the defendant "did not believe" the blood pressure and that the mother was "asymptomatic."

The medical record further reflected an 11-pound weight gain since the mother's visit four weeks earlier. No further tests were performed on the Dec. 16. According to the medical record, the mother was sent home on bed rest a fact that was to be disputed at trial.

The mother testified during her deposition that she was sent home and instructed to come into the emergency room over the course of the coming weekend if she had any problems, but that she was not put on bed rest. Two days later, on Dec. 18,  the mother became light-headed and nauseous while at work as a cook in a local restaurant. She finished her shift and drove to the emergency room where her blood pressure was found to be 247/162. A stat Caesarean section was performed and the child was born with Apgars of 0 and 3. Mother and child were then transferred to another facility.

The decedent survived for a period of 71 days in the NICU before succumbing to severe respiratory disease of prematurity and multi-organ failure.

The plaintiffs' expert opined that the defendant deviated from accepted standards of medical care in failing to recognize and adequately manage and treat the patient where she exhibited classic signs of severe preeclampsia. The mother's elevated blood pressure, according to the expert, was significantly abnormal in a woman at 28 weeks with a history of normal blood pressure readings. The expert was expected to testify that this situation required treatment to lower the blood pressure and a medical workup to determine the severity of other organ dysfunction, if any. Immediate attention would have allowed confirmation of the severity of the patient's condition and would have allowed the transfer of care to the appropriate perinatal center, where the patient could have been treated with steroids in order to afford the fetus the benefit of accelerated lung maturity.

In addition, this would have allowed the patient to deliver in a level III neonatal intensive care setting in order for immediate resuscitation to be done at delivery by a neonatologist. The expert explained that the survival of a 28-week infant in 1994 delivered after maternal steroid therapy is somewhere in the range of 80 percent.

Finally, the expert opined that the severe condition of the mother and child, and the child's ultimate death, were the result of the defendant's deviation from accepted standards.

The defendant was prepared to argue that the condition of the fetus had deteriorated significantly before the mother presented on Dec. 16. The defendant also argued at mediation that the mother failed to follow the defendant's instruction to return home to bed rest and instead went to a Christmas party that same evening, after which she worked through her entire shift two days later.

The plaintiffs' expert, however, opined that the fact that the mother purportedly complained of no symptoms did not relieve the defendant of the need to provide the mother with immediate attention on the Dec. 16. He explained that the disease of preeclampsia is most commonly present without patients complaining of specific symptoms.

The plaintiffs called into question the timing of entries that the defendant purportedly made on Dec. 16, including the entry documenting the defendant's instruction that the plaintiff was to rest in bed.

The parties agreed to mediation, but were unable to settle the case at that time. Following mediation, the plaintiffs filed a motion for production of the original record. The motion was accompanied by a preliminary statement from a handwriting expert expressing the need to further investigate specific entries. The defendant met the plaintiff's demand following service of the motion.

The outcome of every case is dependent upon the specific facts, circumstances and applicable law in that particular case.  Results in other cases are not a guaranty or indication that a similar result is likely in any other case.