Negligence caused little girl's cerebral palsy: judge
Published Tuesday, June 15, 2010 9:04PM PDT
A little girl suffering from cerebral palsy could have escaped that illness if she had been born mere minutes earlier, according to a B.C. Supreme Court judge, who found the attending doctor and nurse liable for negligence during the birth.
Mirella Rochelle Steinebach was born on March 31, 2005, at Surrey Memorial Hospital. Now five, she suffers from severe cerebral palsy, caused by oxygen deprivation when her placenta separated from her mother's uterus shortly before birth.
In a decision issued on Monday, Judge Ian Pitfield ruled that the Steinebachs' family physician Dr. Jodi Lock O'Brien and Charito Hermogenes, a nurse at the hospital, were both liable for negligence during Mirella's birth.
Mirella was born at 5:37 a.m. According to the judge's decision, the oxygen deprivation that caused her cerebral palsy occurred less than half an hour earlier, or sometime between 5:17 and 5:27 a.m.
"It follows that if Mirella had been delivered at any time before 0517 hours, it is more likely than not that she would not have suffered hypoxic-ischemic encephalopathy," or the destruction of brain damage caused by oxygen deprivation, Pitfield wrote in his decision.
Several warning signs should have convinced Dr. O'Brien to consult an obstetrician -- including a "gush of blood" at home before mother May Steinebach visited the hospital, her abnormally low weight gain during pregnancy, her gestational diabetes, and a Streptococcus infection, according to the judge.
"Dr. O'Brien owed a duty to Ms. Steinebach to consult with an obstetrician regarding the appropriate course for the management of the labour," Pitfield wrote.
Her decision not to speak to a specialist "resulted from a brief, incomplete and inadequate examination."
Pitfield also found that Hermogenes, the attending nurse, failed to consistently monitor the fetal heart rate and inform O'Brien of marked changes in that rate in the hour leading up to Mirella's birth.
"If Dr. O'Brien had appropriately assessed Ms. Steinebach and the fetus…and if Nurse Hermogenes had reported her observations to Dr. O'Brien…Mirella would have been delivered before 0517 hours and before the onset of harm," the judge ruled in finding that negligence was the root cause of Mirella's condition.
The exact amount of damages to be paid out in the civil suit has yet to be finalized, but initial estimates by Pitfield put the dollar value at around $730,000.
A ‘wonderful little girl'
The Steinebach family's lawyer Donald Renaud told ctvbc.ca that Mirella will soon begin attending school.
"She's a wonderful little girl," he said. "She's got a big dimple and she'll break your heart."
Her condition, he added, is a "real tragedy." In Pitfield's ruling, he wrote that Mirella is not likely to live past the age of 20.
But the family is satisfied with the judge's decision, Renaud said.
"We're very pleased."
He said that he's handled similar cases in the past, and doesn't expect that this one will be the last.
"I think it's unfortunate that there is such a high rate of cerebral palsy, and a certain proportion of that is as a result of the birth process and preventable errors that are not properly investigated."
As Hermogenes's employer, the Fraser Health Authority was found vicariously liable in the judge's decision. Spokespeople for the health authority did not respond to requests for comment by press time.
Contact information for Dr. O'Brien could not be located, and her lawyers did not respond to requests for comment by press time.
The defendants have 30 days to file an appeal.