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Morrell v. Finke11/3/2005
usation expert, testified that in reasonable medical probability Madeline's brain injury occurred during the forceps delivery. In his opinion, the proximate cause of Madeline's brain injury was forceps birth trauma in conjunction with hypoxic ischemic insults she suffered during both labor and delivery, compounded by her significant loss of blood volume due to the bruising and hematomas she experienced.
Dr. Ater testified and demonstrated that when a person pushes on his hand or his fingernail bed, it gets white because the pressure temporarily decreases the blood flow to the area; when the pressure is released, the area becomes red again as blood flows back into it. He explained that this is what happened to Madeline's brain when Dr. Finke applied the forceps; Madeline's head is still, over six years later, indented on the left side where the forceps prong was placed. This severe pressure on the left side of Madeline's skull pushed in on the left side of her brain and exerted pressure. Dr. Ater testified that because, prior to the forceps delivery beginning at about 4:40 p.m. and continuing through delivery, Madeline suffered repeated hypoxic insults and was losing blood volume from internal bleeding, the mechanical traumatic insult of the ten to fifteen minutes of forceps pressure decreased the blood supply to that part of her brain and "was the straw that broke the camel's back." He testified that Madeline suffered hypoxia induced PVL on the left side of her brain corresponding to the location on her left temple where pressure was applied and the forceps indentation remains. Dr. Ater explained that Madeline's second, 2000 MRI "ruled out" other possible causes of Madeline's brain injury . Madeline's PVL is located in an area of the brain responsible for leg control and, because the left side of the brain controls the right side of the body, Dr. Ater said that the PVL explains Madeline's gait--she drags her right leg when she walks. Dr. Ater testified that Madeline will continue to suffer substantial permanent neurological injuries.
Dr. Tisdell, the treating neonatologist in the NICU, was of the opinion that in reasonable medical probability the cause of Madeline's symptoms was an infection, not hypoxia or asphyxia. Dr. Tisdell testified that all of the negative cultures did not rule out some subclinical infection. The bad outcome, he said, was more likely caused by a subclinical infection. He testified that babies can have serious morbidity, even death from infection, even though cultures are negative.
Dr. Tisdell further testified that the pH value of 7.32 for the blood Dr. Finke drew immediately after birth was "perfect" for oxygenation at the time of birth and precluded perinatal asphyxia.
He testified that the indented bruise near Madeline's left temple would not be unusual for a forceps delivery and, in his opinion, it did not equate to brain damage. Madeline's acid build-up, in his opinion, was metabolic and not indicative of acidosis or asphyxia at birth. It could mean a metabolic defect, congenital or chromosomal problems, or infection. Additionally, he said, he would have expected seizures from any brain damage at birth within the first twenty-four hours, which he claimed Madeline did not manifest. He also consulted with Dr. Laney, a pediatric neurologist, who did not assess Madeline as having asphyxia at birth. Dr. VanDorsten also disagreed with Dr. Ater's opinion that cumulative, increasingly severe hypoxic ischemic insults combined with trauma from the vaginal forceps delivery were the cause of Madeline's neurological deficits. In reasonable medical probability, in his opinion, Madeline's current condition is not related to Dr. Finke's care. Likewise, Dr. Fin
Page 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Texas Personal Injury Attorneys
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