University of Maryland Medical System Corp. v. Gholston

37 A.3d 1074, 203 Md. App. 321, 2012 Md. App. LEXIS 18
CourtCourt of Special Appeals of Maryland
DecidedFebruary 10, 2012
DocketNo. 2505
StatusPublished
Cited by25 cases

This text of 37 A.3d 1074 (University of Maryland Medical System Corp. v. Gholston) is published on Counsel Stack Legal Research, covering Court of Special Appeals of Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
University of Maryland Medical System Corp. v. Gholston, 37 A.3d 1074, 203 Md. App. 321, 2012 Md. App. LEXIS 18 (Md. Ct. App. 2012).

Opinion

DEBORAH S. EYLER, J.

In the Circuit Court for Baltimore City, Darryl Gholston, Jr. (“Darryl”), the appellee and a minor, brought suit through Nicole Player, his mother, for medical malpractice against the University of Maryland Medical System Corporation (“UMMS”), the appellant. The case was tried to a jury for six days. A verdict was returned in favor of Darryl and judgment [326]*326was entered for $8,605 million dollars.1 UMMS moved for judgment notwithstanding the verdict (“JNOV”) and for a new trial. The motions were denied and this appeal followed.

UMMS presents two questions for review, which we have reworded slightly:

I. Was the evidence legally sufficient to support a finding by a preponderance of the evidence that Darryl’s injuries were caused by a breach of the standard of care by UMMS?
II. Was the evidence legally sufficient to support a finding by a preponderance of the evidence of damages for future lost wages for Darryl?

For the following reasons, we shall affirm the circuit court’s judgment.

FACTS AND PROCEEDINGS

This case concerns Darryl’s premature birth at UMMS, on September 19, 2002. Darryl’s mother, Ms. Player, became pregnant in March 2002. Her expected due date was December 24, 2002. She was 23 years old and this was her first pregnancy. Ms. Player received early routine prenatal care at Maryland General Hospital before changing to UMMS.

On August 30, 2002, Ms. Player came to a UMMS clinic for her initial appointment. After a prenatal examination and sonogram that showed cervical shortening, Ms. Player was sent to Labor and Delivery for evaluation. She was 23 weeks pregnant. At UMMS, a physical examination showed that Ms. Player’s cervix was prematurely dilated to 4 centimeters, that it was 100% effaced, meaning that it was shortened, and that her membranes, i.e., the amniotic sac in which the developing fetus was located, were bulging. A sonogram was performed, which confirmed the premature dilatation and shortening of [327]*327the cervix and showed increased fluid in the cervical canal. Based upon the measurements from the sonogram, the fetus’s estimated gestational age was 23.2 weeks; a full term pregnancy is 38 weeks and beyond. The sonogram measurements also showed an estimated fetal weight of 723 grams, which is slightly more than 1 pounds.

The examination and sonogram were consistent with possible incompetent cervix and premature labor. For those reasons, Ms. Player was admitted to the Obstetrical Service of UMMS for treatment with medication and other modalities. The objective was to extend her pregnancy for as long as possible to increase the likelihood of survival of her fetus. The care she received succeeded in extending the pregnancy for close to three weeks. On September 19, 2002, at 11:42 p.m., Darryl was born by emergency cesarean section. The medical malpractice claim in this case concerns the treatment that was rendered to Ms. Player and Darryl that day.

Between 10:00 a.m. and 11:00 a.m. that morning, a sonogram was performed upon Ms. Player by Christopher Har-man, M.D., Director and Vice-Chair of UMMS’s Division of Maternal and Fetal Medicine. His sonogram report, which was faxed immediately to obstetrician Lindsay Alger, M.D., revealed findings as stated by Dr. Harman in the comment section of the report: “The umbilical cord has prolapsed through the length of the cervix and lies within a few mm [millimeters] of the vagina. The patient is at extreme risk for PPROM and cord prolapse.” PPROM is an acronym for preterm, premature, rupture of membranes. “Cord prolapse” is a condition in which the umbilical cord has descended into the cervix, beneath the baby’s location. In the recommendation section of the report, Dr. Harman stated: “I would recommend continuous monitoring on [the Labor and Delivery floor], with readiness for stat [Cesarean section] at all times. Our experience with htis (sic) entity is that it does not presist (sic) for very long without PPROM.”

At the same time, Dr. Harman prepared a letter report to Dr. Alger, which also immediately was faxed to her. The letter states in part:

[328]*328Our 15 minute discussion [with Ms. Player and her family] included transfer to the labor floor for continuous observation there, due to the unexpected diagnosis of occult cord prolapse. Most of the length of the umbilical cord lies within the endocervical canal, and this extends down to the portion of amniotic fluid in the membranes at the external os.[2] Since the cervix is still long, the cord is essentially trapped within the endocervical canal. This is not the same as our more common finding of cord lying above the internal os[3] when there is no presenting part, and does represent an imminent danger of acute cord prolapse, probably life-threatening because the entire length of the cord is in the cervix.

Put in ordinary lay terms, the umbilical cord was within the cervix, below the lowest presenting part of the fetus, thus creating the dangerous condition that the cord could prolapse, that is, be squeezed shut by contractions, thus cutting off the blood flow to the fetus. Dr. Harman also called staff members on the Labor and Delivery Floor and relayed his findings.

As noted above, Darryl was delivered by emergency cesarean section at 11:42 p.m. (The placenta was delivered at 11:43 p.m.) His Apgar scores, which are a measure of neonatal well-being, were 1 out of 10 at one minute, 5 out of 10 at five minutes, and 6 out of ten at ten minutes. He was blue, not breathing, and flaccid with blood pressure that was low and unstable and a significantly reduced blood volume. He was intubated, resuscitated by means of chest compressions and massage, transfused twice, and given medications to elevate and stabilize his blood pressure. He remained in the Neonatal Intensive Care Unit (“NICU”) for two months before being discharged to home.

[329]*329According to Ms. Player, Darryl is developmental^ delayed. As a young child, he was in a wheelchair. He did not learn to walk until he was 3 % and then with the use of braces. He did not start speaking in full sentences until he was 4 \ At the time of trial, Darryl was nine years old but still was not able to run. He attends school and is in a regular second grade class, but he has an aide to help him.

We shall include additional facts in our discussion of the issues.

STANDARD OF REVIEW

The standard of review of a question of the sufficiency of the evidence is de novo. Polk v. State, 378 Md. 1, 7-8, 835 A.2d 575 (2003). In a civil case, the evidence is legally sufficient to support a finding in support of the prevailing party if, on the facts adduced at trial viewed most favorably to that party, any reasonable fact finder could find the existence of the elements of the cause of action by a preponderance of the evidence. Hoffman v. Stamper, 385 Md. 1, 16, 867 A.2d 276 (2005). In a jury trial, the quantum of legally sufficient evidence needed to create a jury question is slight. Id.

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Cite This Page — Counsel Stack

Bluebook (online)
37 A.3d 1074, 203 Md. App. 321, 2012 Md. App. LEXIS 18, Counsel Stack Legal Research, https://law.counselstack.com/opinion/university-of-maryland-medical-system-corp-v-gholston-mdctspecapp-2012.