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Northern Trust Co. v. University of Chicago Hospitals and Clinics12/23/2004
jury's verdict.
In this voluminous record, testimony and evidence about the placement of the fetal monitor is remarkably scant. The obstetrical nurse who placed the monitor was never named nor did she testify at trial. The parties agree, and it remains undisputed, that Scates arrived at the hospital at 3:20 p.m. and the monitor was attached and began reading the fetal heart rate at 3:50 p.m. There is some general testimony about what the monitor showed at this time from the doctors on duty, though it appears to be conflicting; Dr. Ryan testified that the monitor, once attached, showed a normal fetal heart rate, while Dr. Rosner testified that the monitor, once attached, showed signs of fetal distress. There is also some general testimony alluding to the effect of the delay in attaching the monitor: UCH's expert Dr. Donn testified that there was "absolutely no way" that the injury occurred at or about the time of delivery but rather days before, so the time at which the monitor was placed was irrelevant to the injury; plaintiffs' expert Dr. Abern testified that had Marshawn been delivered earlier, there would have been little or no brain damage.
Providing more specific testimony about the placement of the monitor was UCH's expert Dr. Roberts and plaintiffs' expert Dr. Fields. Dr. Roberts testified that, based on the symptoms that Scates presented with when she arrived at the hospital, she was "appropriately triaged" by the obstetrical nurse. He went on to explain that, in his opinion, the placement of the monitor at 3:50 p.m. was entirely reasonable, since the nurse would have needed time to take Scates to a labor room, obtain a urine sample and history, have her disrobe and prepare her for examination. However, Dr. Fields' testimony was in direct contradiction. It is true that Dr. Fields testified that even without earlier placement of the monitor, Marshawn should have been delivered earlier. Yet, he also specifically testified that the placement of the monitor at 3:50 p.m. was a deviation from the standard of care. In his opinion, which he explicitly stated was to a reasonable degree of medical certainty, it was the nurse's duty, based on what Scates was presenting with at the moment she arrived (i.e., meconium-stained amniotic fluid), to attach the monitor no later than 3:30 p.m. Dr. Fields further testified, again to a reasonable degree of medical certainty, that had the monitor been attached at 3:30 p.m., it more likely than not would have shown that Marshawn's heart rate was abnormal, prompting the decision to perform a cesarian section at 4 p.m. and obtaining Marshawn's delivery no later than 4:30 p.m. when, in his expert opinion, permanent brain damage had not yet occurred. He based his opinions on his review of Marshawn's prenatal and medical records, the fetal monitor strips produced during delivery and the depositions of doctors and other experts in this cause.
Ultimately, what is presented here is a conflict between Dr. Roberts and Dr. Fields as to whether the placement of the monitor at 3:50 p.m. rather than 3:30 p.m. was a proximate cause of Marshawn's injury. In simple terms, this boiled down to credibility--a battle of the experts. The disagreement between these medical authorities as to cause-and-effect does not preclude a verdict for plaintiffs. See Ziekert, 182 Ill. App. 3d at 930. Rather, as we noted above, an expert opinion, held to a reasonable degree of medical certainty--as Dr. Fields' was here--provides an adequate basis for a jury finding that causation was proved. See Witherell, 118 Ill. 2d at 337; Ziekert, 182 Ill. App. 3d at 930. The jury was free to believe Dr. Fields' testimony about the time-placement of the fetal monitor and its effect in this cause over
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