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Morrell v. Finke11/3/2005
diatric neuroradiologist, interpreted MRI and CT scans on behalf of Plaintiffs.
Dr. Finke and the three defendant nurses testified in their own behalf and, in addition, relied upon the testimony of Barbara True-Driver, a high-risk maternal nurse; Dr. Peter VanDorsten, an obstetrician/gynecologist specializing in maternal-fetal medicine; and four health professionals who treated Madeline at the hospital: Robin White, Director of Respiratory Care; William Gilmer, respiratory therapist on the NICU team that assumed care of Madeline at birth; Dr. Scott Tisdell, the neonatologist in the NICU unit; and Dr. Gilbert Vezina, a pediatric neuroradiologist, who interpreted the CT and MRI scans for Defendants.
Nurse LaMont testified that Madeline's fetal heart monitor strip was "nonreassuring" from the start because under the criteria set forth in the hospital's fetal heart monitoring policy it documented no accelerations and no beat-to-beat variability. Nurse LaMont explained that the nurses failed to assess the fetal heart monitor strip accurately and failed to evaluate it in accordance with hospital standards. Nurse LaMont acknowledged that even normal labor stresses a fetus, but explained that variable and late decels indicate decreased oxygenation and have the potential of reducing the baby's reserves. Over time, she said, a chronic decrease in oxygenation can make it harder for the baby to tolerate labor. In her opinion, and based on the hospital's fetal heart monitoring policy, the strip never showed adequate accelerations or good beat-to-beat variability and reflected numerous and steadily worsening variable and late decels.
Nurse LaMont believed Madeline began developing oxygen deficit beginning at 4:40 p.m. In her opinion, the nurses deviated from the standard of care in five different respects: by failing to accurately assess the fetal heart monitor strip; by failing to accurately intervene based on the problems documented on the strip; by failing to provide timely care to Donna; by failing to access the chain of command to get timely care for Madeline and Donna; and by failing to properly resuscitate Madeline after birth.
Dr. Rice, board certified in obstetrics with a general obstetrical practice, was also a clinical instructor at the University of Washington Medical Center. Dr. Rice testified for Plaintiffs as to the standard of care for Dr. Finke. Based on the fetal heart monitor strip, charts, and other hospital records, he testified that Dr. Finke deviated from the standard of care of an obstetrician by failing to perform a timely C-section. In Dr. Rice's opinion, the fetal heart monitor strip was "reassuring" until about 5:10 p.m. In his opinion, the strip became "nonreassuring" from 5:20 p.m. until 7:15 p.m. From 7:15 p.m. on, Dr. Rice characterized the tracing as "ominous" and said, "you have to really be worried now if the baby is not getting into severe trouble." The 7:15 p.m. decel, he said, was a very "worrisome" prolonged decel that was significant. After the prolonged decel at 7:15 p.m., he said that the standard of care at least required preparation of the room to get ready for a C-section. Dr. Finke violated the standard of care by not starting to prepare for a possible C-section at that time. Dr. Rice further testified that, based on the entire course of Donna's labor and Madeline's condition, the standard of care required Dr. Finke to make the decision to perform a C-section at 7:27 p.m. He testified that Dr. Finke violated the standard of care by not deciding to perform and not performing a C-section at that point. Dr. Rice testified that the nurses' notes at 7:25 p.m. indicate that Madeline was still at a zero station, and that the standard of care would
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