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Morrell v. Finke11/3/2005
e station Madeline had progressed to documents Madeline at the zero station. The fetal heart monitor strip shows another severe decel occurred at 7:10 p.m., but Dr. Finke explained it was not a decel that was of concern to her because it occurred when the linen on Donna's bed was changed. At 7:20 p.m., Donna became fully dilated and completely effaced, and the nurse began having her push.
After Dr. Finke examined Donna and rotated the baby at approximately 7:00 p.m., she was called across the hall to deliver another baby. That baby, delivered by forceps, was born healthy at 7:10 p.m. The medical professionals, both doctors and nurses, agreed that the "7:10 p.m. baby's plan of delivery" should not dictate or have any effect on Madeline's plan of delivery. Nurse Rose Fenton explained that if two babies needed Dr. Finke's attention at the same time, the nursing standard of care does not permit the nurses to simply wait for Dr. Finke to become available. The standard of care requires the nurses to proceed with finding another doctor: the nurses would have called the house supervisor and said, ">We have a situation, I need two doctors, there's only one here,' the emergency room doctor could have come up." At 7:15 p.m., while Dr. Finke was still out of Donna's room, the fetal heart monitor strip recorded another severe prolonged variable decel down to 60 beats per minute for forty seconds, followed by tachycardia, with a spike in the heart rate to 180. Dr. Finke testified that this decel would have caught her attention, but explained that Donna was pushing by this time and said that she did not give the same credence to decelerations occurring in the pushing phase of labor as she did to those occurring during the active phase of labor. Each time Donna pushed, a severe prolonged decel occurred: Madeline's heart rate dropped to 50 beats per minute for over a minute with each decel. At 7:25 p.m., Madeline was still at zero station, according to a nurse's note.
F. Delivery
Dr. Finke returned to Donna's room at 7:35 p.m., in time to see another severe prolonged variable decel at 7:40 p.m. Donna's mother, Sally Ellis, was in the labor and delivery room and testified that Dr. Finke said: "Oh boy, she's got my attention. Let's get her out now." Dr. Finke performed a pelvic examination and determined that she needed to take action. She testified that at 7:50 p.m., she decided to proceed with a vaginal forceps delivery because of the severe prolonged decels.
Dr. Finke testified that, having determined that the baby had by then progressed to the plus one station and was low enough in the birth canal, she felt comfortable that the baby was about to progress to plus two station, and she could not predict whether further prolonged decels would occur. Dr. Finke described the 7:40 p.m. decel as the "end point" of her decision for action and agreed that there was "urgency" because of the large decels.
Preparation for delivery included making warm towels and oxygen available for the baby, getting the delivery table ready, removing the catheter and monitor, scrubbing, removing the end of the bed and putting stirrups in place, and placing the mother's legs in the stirrups. Dr. Finke described how she would have first evaluated the station, felt the baby's head, "ghost " placement of the forceps outside the mother's body, and then placed each blade with one hand while guiding it into place beside the head with the other. Dr. Finke applied the forceps at approximately 8:00 p.m. She testified that she would have held the forceps with two fingers of one hand on the handles, placed her other hand on top for a downward pressure to move the head under the pubic bone, and followed with
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