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Bryant v. Lagrange Memorial Hospital12/17/2003
ers was ruptured she noted that there was a large quantity of thick meconium in the amniotic fluid. Dr. Kim then ordered that Yvette Bryant undergo an amnioinfusion, which is a procedure whereby a catheter is placed up around the uterus and a saline solution is run through the catheter in order to irrigate or rinse out the meconium. Yvette Bryant was administered two bags of saline solution during this procedure.
Nurse Tully testified that Dr. Shanta Nath, a neonatologist, was then called to the Hospital since hospital policy required that a neonatologist be called whenever meconium is observed. At 3:30 a.m., the fetal heart rate was 145. Dr. Nath testified that she arrived at the hospital at approximately 3:40 a.m. Dr. Nath testified that she did not provide any care to Yvette Bryant in her laboring state or provide any advice to Dr. Kim or the labor and delivery nurses. Dr. Nath testified that her primary role was to provide care to Yvette Bryant's baby once the baby was delivered.
At 4 a.m. the fetal heart rate was 135. A vaginal exam conducted at about 4:15 a.m. indicated that Yvette Bryant was dilated to 4 centimeters. Nurse Tully testified that at about 4:30 a.m. she administered Yvette Bryant a pain reliever called Nubain through an IV line.
At 4:30 a.m. the electronic fetal heart monitor strip evidenced a bradycardia or abnormally low heart rate in the 60s for 4½ minutes. In response to the low fetal heart rate, the nurses performed various standard interventions including increasing Yvette Bryant's IV fluids, physically turning Yvette Bryant on her side, and administering oxygen through a face mask. After the interventions were performed, the fetal heart rate returned to the baseline for about a minute.
At about 4:35 a.m., the fetal heart rate decelerated or dropped to the 90s for about 1½ minutes. In response to this drop, the nurses repositioned Yvette Bryant, tipped the head of her bed down, and Dr. Kim manually stimulated the baby's scalp. The baby's heart rate returned to baseline for about 2½ minutes.
At approximately 4:40 a.m., the fetal monitor strip indicated that the baby's heart rate had decelerated into the 60s. For the succeeding 17 minutes the external monitor failed to give a continuous paper tracing. Nurse Horner testified that during the time the external monitor was not tracing properly she "auscultated" the audible signals being emitted from the external monitor in order to determine the baby's heart rate. Nurse Horner testified that shortly after 4:40 a.m., the baby's fetal heart rate dropped to the 60s with no sustained return to baseline for approximately 17 minutes. Dr. Kim became concerned that the monitor was not tracing properly and therefore changed the internal lead on the baby's scalp and the "toco," in order to get a better paper tracing.
Due to a continued lack of uninterrupted tracings, Dr. Kim ultimately decided to change monitor machines. The monitor was switched at approximately 4:53 a.m. While the monitor was being switched Nurse Horner stimulated the baby's scalp. Nurse Horner testified that after Dr. Kim made the decision to change monitors she consulted Nurse Linda Stauber, because she was unfamiliar with a monitor being changed in response to concerns over equipment tracings. Nurse Stauber was a senior labor and delivery nurse who was charge nurse and was Horner's supervisor. Nurse Stauber came into the delivery room shortly before 4:57 a.m.
Nurse Stauber took a radial pulse of Yvette Bryant's wrist and compared her pulse to the audible fetal heart rate on the monitor and determined that the baby's heart rate was much slower than Yvette Bryant's heart rate. A little after 4:57 a
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