Breach of duty and causation are two of the main elements to prove in personal injury lawsuits. Even if a breach occurred, it must also be the cause of the alleged injury. In Milambo vs. Catlin (15-P-687), the Appeals Court of Massachusetts reviewed a wrongful death lawsuit brought by the father of a child who was stillborn, on behalf of the child’s estate. At the trial, one of three doctors was found by the jury to be negligent but not a substantial contributor to the child’s death. The estate alleged that the doctors who participated in the child’s delivery were negligent by delaying a c-section.
At trial, the defendants argued that the child died within the womb due to an undetermined cause. The defendants pushed back against the estate’s claim that they delayed the caesarean with the assertion that the mother delayed in giving her consent to the c-section. As part of the defense, the doctors emphasized the mother’s medical history, which included several previous surgical procedures preceding the delivery of her stillborn child. On the date of the delivery, the mother went to the hospital, complaining of constipation and abdominal pain. A fetal heart monitor was placed on the mother, which showed normal results for about five hours. After six hours, the monitor results went from normal to poor, and a c-section was determined to be necessary. The defendants claimed that the father argued with them that the baby was fine and asked for his wife’s gynecologist, asserting they didn’t know what they were doing, and the pain medication was causing the problems.
Forty-five minutes passed between the time the doctors first told the mother a c-section was needed and when consent was given. Nearly two hours after she was told a c-section was needed, the surgery was performed, and the child was delivered stillborn. The cause of death was certified as “unknown intrauterine fetal demise.” The lone expert for the estate was an obstetrician/gynecologist who testified that the consent form signed four months before should have been valid, that there should have been constant fetal monitoring, and that the delay violated the standard of care governing physicians in their specialty. The defendants had two experts who testified that the three treating physicians followed the standard of care, based on their review of the care provided to the mother and the need to receive her consent on the day of the delivery. The perinatal pathologist who testified for the defense also confirmed that the cause of the stillbirth was unexplained and undetermined.
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