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Morrell v. Finke11/3/2005
eport states that Madeline's "respirations were agonal" when the team arrived. Consequently, the NICU team resumed "bagging" Madeline. Madeline was given briefly to Donna to hold and then transported to the NICU under the one hundred percent blowby oxygen.
H. Treatment in NICU
Dr. Scott Tisdell, a board certified neonatologist and director of the hospital's NICU, was called to treat Madeline at 8:20 p.m because NICU nurses were concerned that she might have a skull fracture on the left side of her head from the forceps. Dr. Tisdell noted in his report of his examination of Madeline that " here's a moderate indentation on the left side where the forceps were placed." He noted that Madeline had bruising in her right ear, bruising on her scalp and on the right and left sides of her head. Dr. Tisdell also noted that Madeline was developing unusual, extensive bruising on her head, ears, arms, and even her genitals. Tests later also revealed hematomas (internal bleeding) in her liver and adrenal gland. Based on the indentation on the left side of Madeline's head and the bruising on her skull and in her ear, Dr. Tisdell was concerned that Madeline may have suffered a skull fracture and intracranial hemorrhage. Dr. Tisdell ordered a CT scan, which ruled out that possibility.
Dr. Tisdell evaluated Madeline's oxygen status, perfusion, and degree of respiratory distress, examining her color, appearance, and breathing, and drawing his own arterial blood gas sample. Dr. Tisdell drew his arterial blood sample from Madeline twenty-four minutes after her birth, and it established that at that time her pH was 7.219. In his opinion, the pH reading from his blood gas sample indicated Madeline was "acidotic."
Dr. Tisdell concluded that Madeline's perfusion was not good and that she was in moderate respiratory distress. Her breathing was labored enough that Dr. Tisdell thought she needed to be intubated; therefore, he intubated Madeline and administered bicarbonate to correct the acidosis. He also ordered packed red blood cells, Plasmanate, and fresh frozen plasma administered to Madeline in an amount equal to approximately one-third of her total blood volume to replace the blood she had lost during delivery from the developing hematomas and bruising.
Dr. Tisdell was also concerned with infection, based upon Madeline's temperature. Her rectal temperature was above 102 degrees, high for a newborn. He started Madeline on antibiotics, but he discontinued them after a few days when the cultures he ordered to test for various infections all came back negative. Further tests ruled out genetic metabolic abnormality, meningitis, and encephalitis. Madeline's breathing tube was removed on day three. Except for his continued opinion that Madeline had a subclinical infection and an episode of "apnea" (described as the "baby forgetting to breathe") on day nine, Dr. Tisdell testified that everything else had resolved, including the hematomas in Madeline's liver and adrenal gland. Dr. Tisdell discharged Madeline on the thirteenth day, sending her home with a monitor for apnea and CPR training for her parents.
I. Alleged Damages
At home, Madeline choked easily during feedings and had to be held to prevent her from vomiting. She slept with the monitor for fifteen months. She failed to progress as a normal child. She was unable to walk without the aid of a walker until age three. At age two and a half, Madeline was diagnosed with cerebral palsy with developmental delay.
Madeline has an IQ of forty-eight; she is mentally retarded. At the time of trial Madeline was seven years old and was not toilet trained. She still experiences difficulty walking; her
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