On January 28, 2020, a federal judge with the United States District Court for the Middle District of Tennessee Nashville Division filed her Findings of Facts and Conclusions of Law in a birth injury medical malpractice case filed against the United States, awarding the child $15,153,488 in compensatory damages.
The Underlying Facts
A.J.J.T. was born at Blanchfield Army Community Hospital (“BACH”) at Fort Campbell on January 10, 2005. He suffered a hypoxic-ischemic brain injury prior to delivery, resulting in cerebral palsy and lifelong neurologic deficits. The parties agreed that A.J.J.T.’s injury was not the result of an infection and that he will require extraordinary medical care, services, and therapies throughout his life as a consequence of his brain injury. The plaintiffs (the child’s parents, who were serving in the U.S. Army and stationed at Fort Campbell) argued that A.J.J.T.’s injuries could have been avoided if BACH personnel had appropriately counseled and evaluated the mother prior to the date of delivery and/or complied with the applicable standard of care after she arrived at the hospital presenting signs of labor.
The federal judge found, “based on its evaluation of the evidence and the credibility of the individual witnesses, that A.J.J.T. suffered a severe hypoxic-ischemic brain injury shortly before his cesarean delivery, prior to which he was healthy and normally developed. The injury more likely than not began when A.J.J.T. experienced a significant deceleration in his heart rate around 7:30 a.m. on his date of birth. In particular, A.J.J.T.’s dire status at the moment of delivery—which placed him virtually at the point of death—is strongly corroborative of a late-arising injury … the court finds that, if A.J.J.T. had been delivered prior to 7:30 a.m. on January 10, 2005, his injury would have been avoided.”
The federal judge further found, “if Wilson [the mother] had been properly counseled, she more likely than not would have had an elective c-section prior to January 10, 2015, avoiding A.J.J.T.’s injury. BACH’s deviation from the ordinary standard of care, therefore, was an actual cause of, and substantial factor in, A.J.J.T.’s injuries and resulting condition. The court further finds that the improper valuation and counseling were a proximate cause of A.J.J.T.’s injuries.”
The federal judge also found “that BACH personnel deviated from the ordinary standard of care by failing to fully assess Wilson’s individual risk factors for VBAC [vaginal birth after cesarean], particularly those related to her short interpregnancy interval and the details of her prior unsuccessful vaginal delivery, and by giving Wilson inaccurate information about her likelihood of successfully delivering vaginally … VBAC was not successful—which Wilson should have been informed it likely would not be—and A.J.J.T. was unnecessarily subjected to the dangers associated with unproductive labor, resulting in injury. A.J.J.T.’s injuries were therefore proximately caused by the failure to counsel his mother appropriately.”
The federal judge further found “that BACH personnel deviated from the ordinary standard of care by failing to intervene with intrauterine resuscitative measures and evaluation by an obstetrician for cesarean delivery in time for delivery to be initiated by 7:10 a.m., at the latest. The court further finds that, if intervention had been made by 7:10, a cesarean delivery more likely than not would have been performed in time to avoid A.J.J.T.’s injuries. The court also finds that injuries of the sort A.J.J.T. suffered were a foreseeable risk of inaction and that inaction was a substantial factor in the injuries. The failure to intervene earlier was therefore an actual and proximate cause of A.J.J.T.’s injuries.”
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