What do you think of the $55 million settlement in the Johns Hopkins malpractice case?

[Anonymous]

$55 million is ridiculous no matter what the circumstances.

[Anonymous]

8:28, thank you - I was wondering if this was one of her cases. Other posters - you can see the details in the PDF linked on the Evelyn Mulhan home birth thread - someone posted the details from her license revocation.

[Anonymous]

More details from another forum:

On or about April 14, 2010, the Board received a complaint from ... Director of Labor and Delivery and ... Director of Gynecology and Obstetrics, at Hospital B. According to the complaint, between March 25th and 26th, 2010, Respondent failed to follow the standard of care in her management of an attempted home birth by:

I. Utilizing Intramuscular Oxytocin to stimulate labor in a term pregnancy;
II. Using fundal pressure in the second stage of labor to attempt to cause descent of
the fetus;
III. Using vaginal chlorhexadrine, rather than intravenous penicillin, in labor to treat a known group B beta hemolytic strep vaginal carrier to prevent early onset GBS neonatal sepsis;
IV. Misdiagnosing fetal station resulting in an unnecessary episiotomy. The physical exam on admission to Hospital B was a fetus impacted in the vagina at + 1 station which was incompatible with the report that the fetus had been crowning when the episiotomy was performed...

... Patient B delivered a male infant ("Baby B") by LSTCS (c-section - GK), with a vertex fetal presentation and occiput posterior ("OP") position at birth. The APGAR scores were 1 at 1 minute and 5 at 5 minutes and cord/Initial blood gas was ph 7.1; pC02 63; p02 10; BE -13. Baby B was limp and cyanotic on delivery with nuchal cord x 1, required PPV for 3 minutes before being transitioned to CPAP. Baby B was transported to the NICU on CPAP with diagnoses of Hypoxic Ischemic Encephalopathy and Seizure disorder.

Baby B was transferred to a pediatric rehabilitation hospital on April 21, 2010.

It should be noted the midwife had no insurance, thus the parents couldn't sue her (so they sued Hopkins).

[Anonymous]

The reason they won the suit was because ...

"Plt [Plaintiff's] motion in limine to preclude any refence [sic], testimony or argument that ceritified nurse-midwife Evelyn Muhlhan Deviated from the standard of care and to preclude Loraal Patchen, CNM and Carolyn Gegor CNM from testifying is hereby heard and granted."

"Plt motion in limine to preclude any reference, testimony and/or evidence of Maryland Board of Nursings' orer for summary suspension of Nurse-Midwife Evelyn Muhlan is hereby heard and granted."

"Plt omnibus motion in limine regarding certain irrelevant and prejudicial evidence is hereby heard and agreed upon as it relates to Group B Streptococcus, is agreed upon as it relates to genetic cause of E.M. injuries and is granted as it relates to deviation from standard of care not casually linked to array of harm (episiotomy)."

Therefore the jury never hear what happened *before* she arrived at the hospital.

[Anonymous]

"Dr. Amy" is trolling again...

[Anonymous]

Anonymous wrote:$55 million is ridiculous no matter what the circumstances.

This verdict isn't worth the paper it is written on. She will, ultimately, get nothing and it is too bad that Hopkins will not sue her for defamation. She was an idiot to have a home birth and the midwife has lost her license but she should be in prison.

[Anonymous]

Anonymous wrote:Here is a more detailed article:

http://www.wbaltv.com/news/maryland/baltimore-city/Jury-awards-family-55M-in-medical-malpractice-suit-against-Hopkins/-/10131532/15277958/-/98elrgz/-/index.html

The disability is severe brain damage (2 yo similar to a 4 mo). According to the article (the family, not Hopkins) an emergency surgery was ordered, but took 2 hours. I agree with the PP above that it was probably a combination of 1) all surgery rooms were filled with either scheduled or emergencies and 2) needing to take stats and prep the woman.

Frankly, a woman in birth **is not** the most pressing emergency. In Baltimore, plenty of near-fatal gun shot wounds come in every night. Some worse than others. Her life was not at risk and in theory she would not have been the top triage. On a bad night it may have taken 2 hours to get her into an emergency surgery room.

a woman in labor needing a c section is in a life threatening condition.
Are you sure they did not want her to wait her turn and stand in line?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Here is a more detailed article:

http://www.wbaltv.com/news/maryland/baltimore-city/Jury-awards-family-55M-in-medical-malpractice-suit-against-Hopkins/-/10131532/15277958/-/98elrgz/-/index.html

The disability is severe brain damage (2 yo similar to a 4 mo). According to the article (the family, not Hopkins) an emergency surgery was ordered, but took 2 hours. I agree with the PP above that it was probably a combination of 1) all surgery rooms were filled with either scheduled or emergencies and 2) needing to take stats and prep the woman.

Frankly, a woman in birth **is not** the most pressing emergency. In Baltimore, plenty of near-fatal gun shot wounds come in every night. Some worse than others. Her life was not at risk and in theory she would not have been the top triage. On a bad night it may have taken 2 hours to get her into an emergency surgery room.

a woman in labor needing a c section is in a life threatening condition.
Are you sure they did not want her to wait her turn and stand in line?

I'm the above poster with the surgeon DH. You are not going to cut open a women without getting the pertinent information.

From the details, it sounds like the midwife was at fault here but JHU has to pay for it. The case will be repealed.

[Anonymous]

8:28, thank you - I was wondering if this was one of her cases. Other posters - you can see the details in the PDF linked on the Evelyn Muhlhan home birth thread - someone posted the details from her license revocation proceedings.

Now that I'm not on my phone I can link more easily... here it is: http://www.mbon.org/disc/public_orders/rn_lpn/muhl...-R060032-SS.Order-20111006.pdf

And this is Johns Hopkins' fault?

[Anonymous]

Some of you'r opinions are that this case will we repealed. Would you all say this because of the fact that the jury did not hear what happened before the patient arrived at the hospital? Given the little we know it seems what happened before arrival is pertinent to make a fair ruling, no?

Not a lawyer, just curious why some of you feel so strongly about an appeal.

[Anonymous]

Anonymous wrote:

8:28, thank you - I was wondering if this was one of her cases. Other posters - you can see the details in the PDF linked on the Evelyn Muhlhan home birth thread - someone posted the details from her license revocation proceedings.

Now that I'm not on my phone I can link more easily... here it is: http://www.mbon.org/disc/public_orders/rn_lpn/muhl...-R060032-SS.Order-20111006.pdf

And this is Johns Hopkins' fault?

This webpage no longer exists.

[Anonymous]

Anonymous wrote:Yet birth defect rates are not decreasing, although c-section rates have skyrocketed. Maybe people should accept that there are no guarantees in life, and especially in childbirth.

I think this gets to the heart of the matter, and I think it's too frightening for most people to accept. I couldn't shake a chilling feeling throughout my pregnancy that something was looming; we did both survive thanks to a c section. We otherwise would have been in a very bad place.

No one wants to hear what you're saying, though all expectant mothers and fathers should.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Here is a more detailed article:

http://www.wbaltv.com/news/maryland/baltimore-city/Jury-awards-family-55M-in-medical-malpractice-suit-against-Hopkins/-/10131532/15277958/-/98elrgz/-/index.html

The disability is severe brain damage (2 yo similar to a 4 mo). According to the article (the family, not Hopkins) an emergency surgery was ordered, but took 2 hours. I agree with the PP above that it was probably a combination of 1) all surgery rooms were filled with either scheduled or emergencies and 2) needing to take stats and prep the woman.

Frankly, a woman in birth **is not** the most pressing emergency. In Baltimore, plenty of near-fatal gun shot wounds come in every night. Some worse than others. Her life was not at risk and in theory she would not have been the top triage. On a bad night it may have taken 2 hours to get her into an emergency surgery room.

a woman in labor needing a c section is in a life threatening condition.
Are you sure they did not want her to wait her turn and stand in line?

I'm the above poster with the surgeon DH. You are not going to cut open a women without getting the pertinent information.

From the details, it sounds like the midwife was at fault here but JHU has to pay for it. The case will be repealed.

A surgeon also isn't just going to ignore a laboring woman, an emergency home birth transfer, and perhaps fetal distress. Define pertinent info. What is that, dilation, time at that point, what has the fetus's heart been doing between contractions, etc. Seems that if there's an OR available that it shouldn't take all that terribly long.

[Anonymous]

What is a reasonable amount of time to walk thru the front door in an emergency C-section situation and get paperwork, a doctor, a room for the surgery, and anesthesia? Was the baby past the stage where the doctor could give her something to slow things down like when someone is going into pre-term labor? I can't see awarding $55 million unless it is gross negligence on the part of the hospital. I could see myself going with an award in a scenario where the hospital had all the info, was monitoring the baby, and chose to go with a vaginal birth instead of a c-section even though there was some medical piece of info that would make the c-section less risky for the baby.

[Anonymous]

Sorry the link doesn't work anymore. I wonder if they took it down because the jury wasn't allowed to know anything about what happened before the couple arrived at Johns Hopkins. Some of the details follow:

"Patient #2 (baby with hypoxic ischemic encephalopathy and seizure disorder):

On or about April 14, 2010, the Board received a complaint from ... Director of Labor and Delivery and ... Director of Gynecology and Obstetrics, at Hospital B. According to the complaint, between March 25th and 26th, 2010, Respondent failed to follow the standard of care in her management of an attempted home birth by:

I. Utilizing Intramuscular Oxytocin to stimulate labor in a term pregnancy;
II. Using fundal pressure in the second stage of labor to attempt to cause descent of the fetus;
III. Using vaginal chlorhexadrine, rather than intravenous penicillin, in labor to treat a known group B beta hemolytic strep vaginal carrier to prevent early onset GBS neonatal sepsis;
IV. Misdiagnosing fetal station resulting in an unnecessary episiotomy. The physical exam on admission to Hospital B was a fetus impacted in the vagina at + 1 station which was incompatible with the report that the fetus had been crowning when the episiotomy was performed...

... Patient B delivered a male infant ("Baby B") by LSTCS, with a vertex fetal presentation and occiput posterior ("OP") position at birth. The APGAR scores were 1 at 1 minute and 5 at 5 minutes and cord/Initial blood gas was ph 7.1; pC02 63; p02 10; BE -13. Baby B was limp and cyanotic on delivery with nuchal cord x 1, required PPV for 3 minutes before being transitioned to CPAP. Baby B was transported to the NICU on CPAP with diagnoses of Hypoxic Ischemic Encephalopathy and Seizure disorder.

Baby B was transferred to a pediatric rehabilitation hospital on April 21, 2010."