Child Birth Malpractice Lawsuit

[Fuzzy_Barbecue]

It’s really good to have your input and I really appreciate the time you spent for your detailed response. It’s good to have an opinion from a medical professional and to look at things from a different perspective. It’s definitely given me something to think about. I would just like to offer some clarifications on some of the points your discussed :

@lotus425

Another thing to consider is the fetal monitor reading which gauges the uterine contraction and fetal heart rate at the time of labor process. When fetal monitor demonstrates fetus is under stressful conditions (uterine contraction slows and fetal heart rate speeds up) OBGYN doctor must speed up the process to minimize complications. Hence a forcep or a head vacuum would be used (breaking the clavicle on purpose) to quickly deliver the fetus.

This is a good point and something I didn’t consider, maybe because it wasn’t communicated to me (even till now). But if they did do this on purpose to save the baby then I would absolutely not hold anything against them. The reason why I tend to believe the clavicle wasn’t broken on purpose is because neither the doctor nor the delivery nurse knew about it until days later (after the x-ray was performed). & Since the hip dislocation was only found today, I guess they don’t even know about it till now.

@lotus425

It is too late for C section once the head and neck are stuck at the pelvic rim (fetus may not make it if labor process is prolonged beyond safety measures).

I agree that time is of the essence. Honestly, I have no idea how long is safe or unsafe to be in labor. All I know is from the moment we entered the OT, it took a total of 10 to 15 minutes only. After the birth the OBYGYN doctor said to me if he hadn’t pushed on her stomach as hard as he did, it would have taken 5 or 6 hours normally, especially because this was my wife’s first pregnancy and she wasn’t experienced in pushing. He remarked that he saved a lot of time for us.

@lotus425

If you choose to pursue this in the court of law you must understand what your goals are.

1. To find out the truth at all cost? Does it really matter at this moment?
2. To prove the OBGYN doc committed gross negligence ? That he is incompetent ? He did it on purpose with ill intent?
3. To get revenge in terms of monetary compensation and causing headaches and sleepless nights for the OBGYN doc?

I am doing this mainly for #1, to find out the truth. The truth does matter because me and my family will suffer not knowing it. It didn’t help when I asked the OBYGYN doctor few days ago about why the clavicle was fractured, and he answered, “I don’t know why. I thought it went very smoothly”. He repeated this more than once, like he genuinely didn’t expect this. Which tells me he is probably innocent in all this and it really is the nurse.

As for #2, I have nothing to gain from proving the doctor is incompetent. Even though I am upset with the outcome, I am not directly blaming him. He is the top doctor in this field in the hospital and we went to him on recommendation from many other people. Even still, I hold no ill will against him. I know I may have used the term doctor/hospital/nurse interchangeably in my posts here, but I want to clarify now that I am mainly targeting the medical staff, specifically the nurse who pulled the baby. The OBYGYN doctor never even touched the baby. He was just standing over my wife the whole time pushing on her belly, so it’s fair to assume he didn’t cause the injury.

As for #3, I don’t care about money. & I don’t specifically want headache for the OBYGYN doctor but I do want the person responsible to have sleepless nights, just like we are having right now. It’s only fair. It’s not about revenge, it’s about justice.

@lotus425

The hospital and OBGYN doctor are both covered by medical malpractice insurance (NT$2 million per case) and will not settle out of court because they will not admit to any wrong doing. Insurance company will not pay for penalty or damages unless the judge and the court system rule against the OBGYN team . The court procedure will take many years with chance of appeals . You and the OBGYN doctor will spend money hiring lawyers and precious time preparing and attending court appearance over the next few years. Your chance of winning is slim (The medical charting will likely indicate such birth trauma is unavoidable and an emergency necessity due to statistics of current medical literature). But you will cause many sleepless nights and headaches for the OBGYN doctor and his spouse.

@lotus425

Lawyers will play along and encourage you to sue for monetary gains. Do you personally hate this hospital and this OGYN doctor so much that you want to pursue this further? Put yourself in the OBGYN doctor’s shoe. How would you have reacted?

I absolutely don’t hate the OBYGYN doctor. I believe the nurse was negligent, but of course, I am not 100% sure and I have no way to prove it. I don’t know who else was negligent afterwards when they missed the dislocated hips too.

If it were possible to go through with this without causing headache to the OBYGYN doctor, then I would be okay with that. But I don’t know if it’s possible to sue the nurse alone. I think the OBYGYN doctor will be pulled in either-way, unfortunately.

@lotus425

The hospital will hold an arbitration meeting with you , the social worker, the OBGYN doc, and hospital administrators. They will review all the facts and express sincere regret for what happened to your daughter but will not admit any wrong doing nor apologize for this case. (Admittance of fault means they plead guilty in the court of law)

If they even did just that, I would still drop the case. Even if they didn’t admit wrong-doing, nor apologized, but if things got to this point for them to have a meeting/review and express “regret”, then that would be enough. Because then I can expect that internally they might investigate it and if they do find some negligence on part of the nurse/hospital, then at least they will take some corrective action (even if I will never know about it), which in turn may be helpful to some future parents. That alone would be worth it for me. [Also , this would give us some closure]

Deep down I believe that most hospitals and doctors in Taiwan want to do good. They want to improve people’s health, help patients. This experience hasn’t changed my overall view of Taiwan or Taiwanese people. Having known Taiwan and Taiwanese people for the past 5 years, that’s what I have grown to expect of them; to do the right thing, whenever an issue like this is found (even if they don’t admit it).

@lotus425

Karma, spirituality, and faith will show you the way.

Thank you, that’s the best advice and it’s what I am counting on.

[jmee]

Many of us have warned fuzzy barbecue that lawsuits can be unpredictable and ultimately unsatisfying. Even so, I would not discourage him from talking with attorneys or exploring the process.

A good attorney is an adviser, and an expert, who can collect evidence, review the case, and give you another objective opinion about whether the doctors did anything wrong, and whether a lawsuit is worth pursuing.

In many such lawsuits, you and your lawyer may investigate, or proceed part way, and then realize there is nothing to be gained. This would be “pursuing the truth” even if the truth turns out to be “this is not worth spending my life’s energy on anymore.” Just keep an open mind and don’t turn the hospital/doctor into a personal/emotional enemy.

My opinion is that you should focus on your family, your daughter’s health, and your personal emotional and mental well being as priorities. Consider a lawsuit as something detached from you, that you investigate objectively with the help of your attorney.

[lotus425]

Definitely get a copy of the fetal monitor (it is obtained from a wire attached to the fetus scalp during the labor process). This is the only proof which demonstrates whether the labor and delivery process was going smoothly. I remembered from my OBGYN rotation from internship year (too long ago) that doctors would decide to do emergency C section VS purse with vaginal delivery based on the status of fetus heart rate and mother’s uterus contraction strength.

Sometimes women tire out becomes extremely fatigued and cannot push the baby out even with IV pitocin or episiotomy of vaginal perineum tissue. This is when doctors use the head vacuum. The head vacuum would give the fetus a cone head appearance temporarily but pose no harm due to lack of cranium bone fusion of fetuses. Head shape returns normal in a few days.

The truth you want is in the fetal monitor reading. There is no way to fake it. It is what it is. I hope my message is of some help and provide a form of closure for you.

Lawyers don’t sue nurses because they don’t have money. They go after doctors and hospital owner because they are the one covered by insurance and will ultimately pay the penalty. Nurses earn 40K/ month and all work under doctors order. The entire medical staff (interns/ resident physicians/ nurses) are all covered under the OBGYN doctor’s supervision.

This is the reason why I did’t become an OBGYN, General surgeon, or anesthesiologist . I matched NYU / Bellevue Hospital Anesthesiology residency program in 2002 but chose a different path of Family medicine and Dermatology fellowship due to the fear of sleepless nights and medical liability. I rather make less money and have a better quality of life while helping others and enjoy the social benefit of doctor status. Now 17 years into my career, I am so glad I chose the right path.

Doctors don’t go into medicine to make lots of money. We do it for the love of helping others. The decisions we make are always for the sake of helping patients. Patients come first. Taiwan national health insurance pays very little for what we do. Doctors practice medicine with strict guidelines from insurance agencies. Looking back at my career I make far more money from investing in stocks (mostly pharmaceutical stocks) and real estate. I tell young kids that Career in medicine really isn’t all that glamorous as seen in TV sets or movies. It is just a job. At the end of the day we all want to go home happy. Can’t save the world. We just try to help one patient at a time.

[Fuzzy_Barbecue]

Hi Everyone,

I thought I would update everyone and conclude this discussion. I appreciate everyone’s comments and suggestions, especially @lotus425 for sharing his medical experience as well.

Last week I had lodged a formal complaint with the hospital administrator. As a result I was called for a family meeting with the hospital yesterday, which included all the team involved with the delivery, as well as a social worker and case handler from KMUH.

At my end, I took with me an interpreter (work colleague) and my Taiwanese boss, who was kind enough to accompany me.

First things first, it was clarified to me that the lady who pulled the baby out wasn’t a nurse. She was in fact a doctor as well. So now we are talking about two doctors , the male one (who’s the senior one who’s also the head of Oby/Gyn) and the female doctor (who pulled the baby with vaccum extraction).

The female doctor was the main presenter there and she played some slides referencing a lot of research papers to explain why it happened. Luckily I was aware of all those research papers as I had studied them extensively before hand.

Although we had different interpretations of some of the research data but a few things they couldn’t refute (and it’s on record) :

1. It wasn’t caused by :
   excess birth weight
   or advanced gestational age,
   or advanced maternal age,
   or a narrow birth canal ,
   or a difficult birth,
   or because the baby was in distress (the APGAR score was 9).
   All above factors are agreed by both sides not to be the cause of clavicle fracture. Among these the first two are considered to be the most significant causes of clavicle fracture. In fact , (& this is on record) the senior doctor said, everything was completely normal and smooth, and if he were faced with the same decision again he still wouldn’t ever consider c-section because there was nothing wrong with the mother or the baby to consider that route.
2. This leaves only three potential causes which is
   prolonged 2nd stage of labor (over 10 hours),
   nulliparity (a first time mother)
   and use of vacuum extraction
   as the only remaining causes. From these three, the first one is a somewhat significant risk factor, but the other two are considered insignificant by a major margin (specifically according to a research paper from Egypt).

I have to point out that most other international research papers (including one from UCLA), don’t list nulliparity or prolonged labor as a cause at all. In fact most other research papers only list vacuum extraction (or used of equipment) as the final remaining cause. So, I can understand why the doctors in this case specifically used this Egyptian research paper, since it is the only major paper that lists these additional causes which favors their defense.

If they had picked others research papers, then cancellation of all known significant factors in our case would have left them with vacuum extraction as the only remaining cause in our case (which is obviously not good for them).

Despite having some reservations, I accepted their defense that “prolonged 2nd stage of labor” was the main cause of clavicle fracture in our case. Below was the table cited by them from the Egyptian research paper I mentioned, in support of their defense.

So their interpretation was that above table shows that clavicle fracture is mainly caused by the first 3 factors only, out of which the top 2 are confirmed not to apply in our case, so it’s obviously the third one (according to them).

At my end, I argued that in the confirmed absence of first two factors (i.e. birth weight and advanced gestational age), the chances should be higher for the insignificant factors to be in play.

I asked the female doctor, “How common is it in Taiwan for first time mothers to have a prolonged 2nd stage of labor, especially those who had an epidural ?” She stated that it’s extremely common.

Then I asked, “In absence of all major factors, how common was clavicle fracture to be caused just by pro-longed 2nd stage of labor?”. The female doctor went silent and didn’t have an answer. The senior doctor then jumped in and said it’s estimated to be less than 1%.

So there it is, everyone, that’s the final conclusion. Everyone here can interpret this anyway they like. For the sake of my wife and myself we have decided to agree with their interpretation that we were just the unlucky 1% or that “this just happened with no apparent cause” [which is what’s written in the official report as well, which we both had to sign].

The one good that came out of this meeting is that :

1. We finally had a discussion and were able to freely communicate with the delivery team for a good 2 hours.
2. The senior doctor was exceptionally nice to us, along with most of the team. They offered to follow up on our case regularly and monitor our daughter’s progress.
3. They also offered to personally ask the lead orthopedic doctor (the one who discovered her hips dislocation) to be pay special attention to our daughter to ensure she has a full recovery.

Just knowing that the hospital will pay special attention to our daughter from now on and ensure she gets better is the best possible outcome for us.

If my daughter grows up without any complication (of which there is a 99% chance - as the doctors said), then I will forget all of this ever happened. If for any reason we are again part of the unlucky 1% and she does have complications then I know where to go.

So the end result, we will not sue them. Having this meeting helped us a lot in getting some closure, so I have no regrets about the formal complaint.

P.S. I didn’t mention anything about the hips dislocation during this meeting because in doing my research I found that it’s congenital and unrelated to birth trauma. There wasn’t a single research paper correlating hip dysplasia with birth trauma. Also research showed that thousands of children go undiagnosed because it is really hard to detect (especially for inexperienced doctors). In fact all lawsuits globally related to hip dysplasia aren’t about birth doctors causing it but more about orthopedic doctors failing to diagnose it on time. So, I concluded that this issue had no relation with the birth delivery team and it wouldn’t be fair (or smart) to pin this on them. Again, this is just our luck that she got this too.

Thank you all, and I hope this information helps someone down the line.

[Dr_Milker]

That’s some next-level advocacy on behalf of your daughter. She’s lucky to have you as a dad!

[BiggusDickus]

It’s good that you’ve got closure.

[DrewC]

I am glad you got some closure. As a fellow parent who has been through some shit during the first month (though not as much as you), I can tell you that it’s the parents who have to shoulder the burden and trauma from these events. I believe your daughter will be okay and she’ll have no memory of this at all. As well as catering to your daughter’s needs, it’s possible you’ve been traumatized by this experience too and you also need to tend to yourself. I wish I had had a mental health professional to talk to when I went through my own trauma with my child (instead of breaking down crying in one of my classes). If you want to speak to anyone about feelings or to vent, you can DM me.

[iamspartacus]

I second this statement. I admire your actions on behalf of your family.

[Fuzzy_Barbecue]

@Dr_Milker

She’s lucky to have you as a dad!

Thank you and I am lucky to have her too. I would do anything for her.