Lopez v. Northwestern Memorial Hospital

873 N.E.2d 420, 375 Ill. App. 3d 637
CourtAppellate Court of Illinois
DecidedJuly 26, 2007
Docket1-06-1297
StatusPublished
Cited by32 cases

This text of 873 N.E.2d 420 (Lopez v. Northwestern Memorial Hospital) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lopez v. Northwestern Memorial Hospital, 873 N.E.2d 420, 375 Ill. App. 3d 637 (Ill. Ct. App. 2007).

Opinion

JUSTICE CAMPBELL

delivered the opinion of the court:

This medical malpractice action was brought against defendants Northwestern Memorial Hospital, Dr. Michael Socol and Dr. Jennifer Chan regarding the labor of plaintiff Hilaria Lopez and the delivery of her infant, the late Giselle Lopez. Hilaria and the deceased infant’s father, Roberto De Leon, also filed claims under the Wrongful Death and Survival Acts. Following a trial, the jury rendered a verdict in favor of the defendants. Plaintiffs now appeal.

The record on appeal discloses the following facts. 1 Hilaria and Roberto arrived at Northwestern at approximately 7 a.m. on December 25, 1999. Hilaria was in labor with her fourth child. Dr. Socol was the attending physician; Dr. Chan was an assisting physician. After the fetus exhibited concerning fetal heart rate decelerations, the infant Giselle was delivered by caesarian section at 7:08 p.m. At that time it was discovered that Hilaria’s uterus had ruptured; Giselle was found floating partially outside the uterus. Giselle died on February 19, 2000.

At trial, Hilaria testified that her three other children were born without incident. Hilaria was not sure when she first saw Dr. Chan, but she first saw Dr. Socol at 6 p.m. on December 25. Hilaria testified that Dr. Socol and others pushed on her stomach at approximately 6:30 p.m., for approximately 15 to 20 minutes, in what Hilaria believed was effort to deliver the baby. DeLeon testified by evidence deposition that Dr. Socol and “another lady” pushed on Hilaria’s stomach for either 5 to 10 minutes or 15 to 20 minutes.

Laura Mahlmeier testified for plaintiffs as an expert in nursing care. Mahlmeier testified that the nurses who cared for Hilaria starting at approximately 4:45 p.m. deviated from the nursing standard of care in: (1) failing to appropriately monitor the fetal heart rate pattern; (2) failing to quickly summon a doctor when problematic fetal heart rate tracings persisted; (3) failing to properly document and relieve problems with umbilical cord compression; (4) failing to discontinue the drug Pitocin under the circumstances and to summon doctors at that time; (5) failing to recognize the worsening decelerations between 5:20 to 5:45 p.m.; (6) failing to ask for the placement of an internal fetal heart rate monitor; (7) failing to push the emergency button at 6:10 p.m., failing to summon the charge nurse, attending physician and an anesthesiologist, and failing to prepare for a caesarian delivery; (8) failing to advocate for immediately moving Hilaria to the operating room when Dr. Socol and the charge nurse arrived between 6:12 and 6:27 p.m.; (9) failing to put an oxygen mask on Hilaria to hyperoxygenate her to oxygenate the baby; (10) failing to obtain additional medical consultation; and (11) failing to object to the application of fundal pressure (pressure to the abdomen), if it occurred.

On cross-examination, Mahlmeier testified that well-qualified doctors and nurses may disagree over the portions of a fetal monitor strip, but that there should not be disagreement as to its overall characteristics. Mahlmeier stated that benign or mild variable fetal heart rate deceleration is very common in labor. Mahlmeier testified that she could not say with absolute certainty that fundal pressure was applied in this case. Mahlmeier testified that cases of uterine rupture are rare and unpredictable and that the cause of the uterine rupture in this case was not clear. Mahlmeier testified that there was no evidence in this case of persistent uterine hyperstimulation. Mahlmeier stated that she would defer to the opinion of a pediatric neurologist as to the cause of death in this case.

Dr. Paul Gatewood, an obstetrician, also testified for plaintiffs. After initially overruling a defense objection, the trial court halted a line of questions based on Mahlmeier’s opinions based on Sullivan v. Edward Hospital, 209 Ill. 2d 100 (2004), which upheld a trial court’s decision to bar the testimony of a physician regarding alleged nursing negligence as undisclosed under Supreme Court Rule 213. Following a sidebar conference, Dr. Gatewood was permitted to testify that, hypothetically, if Mahlmeier had testified that certain deviations from the nursing standard of care had occurred, they would have caused harm to Hilaria and Giselle.

Dr. Gatewood later testified that there would have been neurological damage before the uterine rupture, but that the primary wrong in this case was that fundal pressure ruptured the uterus and created profound hypoxia in the baby. Dr. Gatewood testified that the beginning of the uterine rupture may have occurred as early as 6:07 p.m.; it was his opinion that the uterine rupture occurred at approximately 6:48 to 6:51 p.m. Dr. Gatewood testified that he did not have an opinion as to the cause of death in this case. Dr. Gatewood also testified that he would defer to the opinion of a pediatric neurologist and neonatalist as to the cause of injury. Dr. Gatewood testified that he could not say for sure whether Giselle suffered brain damage from hypoxia before the rupture.

Dr. Steven Albern, the plaintiffs’ expert pediatric neurologist, testified that the baby was injured by hypoxic-ischemic encephalopathy (HIE), which is a caused by a lack of oxygen, blood pressure and blood flow to the brain. Dr. Albern testified that the infant suffered HIE at least an hour before the caesarian delivery, but after an extended sidebar conference, that testimony was stricken by the trial court on Rule 213 grounds. Dr. Albern testified that HIE can be caused by compression of the umbilical cord, the placenta dislodging from the uterine wall, and uterine rupture. Dr. Albern testified that Giselle acquired HIE from the fact that her mother’s uterus burst and she was found floating in the abdomen. Dr. Albern agreed that the HIE was a direct cause of death in this case.

The defendants moved for a directed verdict at the close of the plaintiffs’ case. The trial court took the motion under advisement, pending the submission of a written motion and any response from plaintiffs.

Yarra Torres Anderson testified that she was the charge nurse on duty on December 25, 1999. Anderson testified that she monitored Hilaria’s contractions and Giselle’s fetal heart rate pattern throughout the day from the nurses’ report room and did not see anything unusual about them before entering Hilaria’s room. Anderson testified that the fetal heart rate strips were reassuring until 6:54 p.m., when Hilaria was taken to an operating room for a possible caesarian delivery. Anderson testified that she did not use fundal pressure on Hilaria and did not see anyone else do so. Anderson testified that she did touch Hilaria’s abdomen to check for contractions.

Elisa Torres testified that she was Hilaria’s primary nurse on December 25, 1999, beginning at 7:45 a.m. Torres testified that she volunteered to be assigned to Hilaria because she always volunteered to care for Spanish-speaking parents. Torres testified that she stayed with Hilaria as her only patient from 9:25 a.m. onward, except for an hour break at 3:55 p.m.

Torres testified that she did not observe anything unusual until approximately 6 p.m., when the fetal heart rate pattern showed variable decelerations requiring resuscitative measures.

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Cite This Page — Counsel Stack

Bluebook (online)
873 N.E.2d 420, 375 Ill. App. 3d 637, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lopez-v-northwestern-memorial-hospital-illappct-2007.