Since some are so happy to talk about frivolous lawsuits against doctors, what do y'all think about this one?


A Missouri couple filed a lawsuit Sept. 28 against four defendants for a birth gone horribly wrong. The New York Daily News reports Friday that Arteisha Betts and Travis Ammonette of Florissant, Mo., claim their newborn son, Kaden Travis Ammonette, died while in the birth canal. The baby's head was allegedly decapitated from its neck when the doctor tried pulling the baby out of the birth canal.

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* The story gets worse. At the point, the plaintiffs say blood from the baby's neck splattered into the labor and delivery room in plain sight of the mother and father. The couple then claims the doctor did the unthinkable --Webb supposedly pushed the baby back into the uterus and ordered an emergency Caesarian section.


Newborn (http://news.yahoo.com/newborn-decapitation-birth-prompts-malpractice-lawsuit-191400728.html)

hmmm... i'm going to go out on a limb and say this one's not frivolous. -M

I would want to make sure the baby was alive immediately prior to birth. The amount of force required to do that to a living infant would be more than anyone with any experience delivering babies would ever use. Or anyone with a lick of common sense. I think as a 3rd year medical student I wouldn't have been that stupid. But let's see what the actual facts of the case are.

I read the news article. The baby was not normal, although the article doesn't tell us why his abdomen was large. Ordinarily a 28 week infant would be born easily, so the fact that the baby got stuck means that the baby's abdomen was huge. Did the infant have a problem that was compatible with life? Is there documentation that the baby was alive at the time of delivery? One could injure a 28 week infant much more easily than a term infant. It would still require a fair amount of force to cause decapitation in a viable 28 weeker and any experienced obstetrician would know better. However, if you do a crash Caesarian section, you do it quickly and sometimes anesthesia is inadequate. You hope the trade off for the pain is the chance for a viable infant. If he crashed her he must be an obstetrician as most family medicine doctors don't have privileges for that. I do wonder why they waited so long to file the lawsuit and if their story is perfectly accurate, you'd think any attorney would jump at the opportunity to take that case. Their lawyer sounds like an ambulance chaser. But, if everything is accurate and the baby was alive and viable, they've probably got a great case. No ethical physician would disagree with their right to do so under those circumstances.

... I do wonder why they waited so long to file the lawsuit ....

Just a couple of thoughts. The action comes well within the permissible time frame, and the length of time passing from incident to filing is not surprising, at least not to me.

There is in the death of any child a period of great grieving, for most folk anyway. Except perhaps with a close family friend the notion of litigation doesn't even arise in discussion. Then there is often a period of time where the parents ponder whether an action might be undertaken. A time frame which often sees no counsel even being contacted. Once a counsel is contacted and selected, there is information gathering, review and generally efforts undertaken toward a negotiated settlement. If such negotiations appear to be heading in a less than positive direction, then a suit becomes more likely to be filed.

All matters come to conclusion in their own way. I'm aware of situations which were fully resolved in only a few months time, and others where a suit was filed in the final hours before it would be time barred, with a settlement being reached a few months later, before the defendant was ever served. And of course, some matters do ultimately proceed on to trial.

...so the fact that the baby got stuck means that the baby's abdomen was huge. Did the infant have a problem that was compatible with life? ... Their lawyer sounds like an ambulance chaser.

Would it make a difference in your mind as to the fact it appears appropriate care was not given? IMO, it could have had 4 arms, a tail and a life expectancy of 2 months and it would not have excused the physician nor lessened his liability.

As for the 'ambulance chaser' comment, did I miss something in the article? I read nothing of the sort at all. Or, is this another case of all lawyers are scum until you need one?

As for the time that passed prior to filing the case - as stated before - 100% normal. Sometimes its a race to file and other times its a wait-and-see, gather evidence, mediation, whatever until the timeline dwindles.

Im sorry for this family, i cant even begin to imagine how painful the whole thing has been. Going off the age of the infant they would have fallen into the premature realm and that should of been an extremely easy delivery because of the small size. Obviously when someone is delivering a baby that early there are alot of complications that are taking place when baby's are normally born around 40 weeks.

If this was the doctors fault then i hope they stick it to these guys. I've witnessed births before and they arent pretty. Anymore doctors push inductions (for their own personal ease so they have the weekend off) and are quick to use forceps to get the baby out. First they pump the mothers body full of chemicals that force it into labor before the mothers body is ready.The muscles dont relax properly and it basically sends their body into shock. In alot of cases (and in my wife's) then they want to use forceps and they mention that they might cause damage and deformity but they wait until labor is happening to ask for consent which doesnt give the parents any time to make an educated decision. My son was extremely bruised and swollen for the first month of his life and i was almost amazed at how much force they used in getting him out.

Yes, it would have made a difference to me. If the baby had a health problem that was going to be incompatible with life, then perhaps he had poor tissue perfusion. Perhaps he had something abnormal in his skin turgor and quality of musculature/skeletal integrity that caused a normal amount of force to have an unusual result. That might be information not discernable prior to delivery to a physician. Ultrasounds are imperfect instruments as well. It may be that the information the doctor had made him think the baby didn't have a large enough abdomen that Ceasarian delivery was required. Again, no one would expect a 28 week baby to get stuck in the birth canal. They're so small that under normal circumstances if anything they're born too quickly. If the baby wasn't being delivered as quickly as necessary, there is usually a certain amount of traction applied to deliver them. In a term baby, forceps are applied and quite a bit of force is used. Perhaps an appropriate amount of force was used, and the problem could not have been anticipated. Sometimes bad things happen and yet no one is at fault. No one has a divine promise of a perfect baby, a perfect illness, a perfect outcome to surgery. Sometimes it's not the doctor's fault when things don't go well. Sometimes it is. It's always good to find out the precise circumstances. What is out there to be read is an article written by a "journalist". Journalism has been replaced by sensationalism in a lot of newspapers, and so I, for one, would like to know all the facts of the case before making a pronouncement about just how heinous the actions actually were.

And there are ambulance chasers. We are having trouble getting pharmaceutical companies to make vaccines to prevent disease. This is because of legal liability. A lot of lawsuits regarding vaccine issues are unfounded, and these lawsuits are putting everyone else at risk. I reviewed a lot of charts for a group of lawyers for awhile. What I found was that most of the people who thought the drug had caused them to have a heart attack or stroke were overweight, smoked, had high blood pressure, diabetes or all of the above. I wonder how many of these people got a settlement, blaming something/someone else for a problem that they likely caused by their own actions or that was cause by a health problem out of a doctor or pharmaceutical company's control. Every time you watch television late at night you hear ads soliciting legal action for drugs taken, babies born with a problem, etc. Most babies born with a health problem had them before delivery, but it might be worth a few bucks from the obstetrician. Maybe he or she will settle out of court. It's worth a try, right?

As I said in an earlier post, it's entirely possible the doctor in the story above committed gross malpractice. If so, there's not a doctor I know who would support that doctor. He should not be delivering babies if that story is completely true and there were not extenuating circumstances. I would just like to know all the facts before throwing him under the bus.

Im sorry for this family, i cant even begin to imagine how painful the whole thing has been. Going off the age of the infant they would have fallen into the premature realm and that should of been an extremely easy delivery because of the small size. Obviously when someone is delivering a baby that early there are alot of complications that are taking place when baby's are normally born around 40 weeks.

If this was the doctors fault then i hope they stick it to these guys. I've witnessed births before and they arent pretty. Anymore doctors push inductions (for their own personal ease so they have the weekend off) and are quick to use forceps to get the baby out. Yeah they mention that they might cause damage and deformity but in the heat of the moment its hard to say no to it. My son was extremely bruised and swollen for the first month of his life and i was almost amazed at how much force they used in getting him out.

And yet, if an obstetrician does too many Ceasarian sections, the insurance company and/or the federal government (if they're paying) is all over him or her for doing too many. Health care costs determine some of the actions taken by physicians and they're damned if they do, damned if they don't. If you're overcautious, someone thinks you're doing it to make money. If you respond to that, you risk getting sued for not doing something. Doctors live with a lot of daily anxiety, in addition to lousy hours. We make decisions all day every day. Every single decision you make has the potential to cause a problem. Any problem can result in a lawsuit. It's no wonder our health care costs are skyrocketing, and it's not doctor's fees that are doing it. ER doctors love to admit to the hospital because you can't be sued for sending someone home with an unrecognized problem if you've admitted them. Doctors love to prescribe antibiotics. You can't miss a strep throat and get sued when someone gets rheumatic fever if you give the 90 viral sore throats antibiotics, so you won't miss the ten strep throats. If you get a CT scan on everyone with a headache, you'll rarely miss a brain tumor. If you get a CT scan on everyone with belly pain, you can't get sued for missing an appendicitis. And on and on. The pharmaceutical companies, medical equipment companies and hospitals are doing very well in our lawsuit happy climate here. And I pay $25,000 a year for family health insurance.

To save money, we have to accept a certain number of missed health problems. We have to accept the fact that people who have a lethal disease can't have millions of dollars spent on end of life care, even if they're children. If we're not willing to accept that, then health care costs will continue to skyrocket, as new technologies and drugs allow us to keep more and more people alive, to scan every last part of you in case you've got something that will result in a lawsuit if missed, no matter the likelihood.

Yes, it would have made a difference to me. If the baby had a health problem that was going to be incompatible with life, then perhaps he had poor tissue perfusion. Perhaps he had something abnormal in his skin turgor and quality of musculature/skeletal integrity that caused a normal amount of force to have an unusual result. That might be information not discernable prior to delivery to a physician. Ultrasounds are imperfect instruments as well. It may be that the information the doctor had made him think the baby didn't have a large enough abdomen that Ceasarian delivery was required. Again, no one would expect a 28 week baby to get stuck in the birth canal. They're so small that under normal circumstances if anything they're born too quickly. If the baby wasn't being delivered as quickly as necessary, there is usually a certain amount of traction applied to deliver them. In a term baby, forceps are applied and quite a bit of force is used. Perhaps an appropriate amount of force was used, and the problem could not have been anticipated. Sometimes bad things happen and yet no one is at fault. No one has a divine promise of a perfect baby, a perfect illness, a perfect outcome to surgery. Sometimes it's not the doctor's fault when things don't go well. Sometimes it is. It's always good to find out the precise circumstances. What is out there to be read is an article written by a "journalist". Journalism has been replaced by sensationalism in a lot of newspapers, and so I, for one, would like to know all the facts of the case before making a pronouncement about just how heinous the actions actually were.

And there are ambulance chasers. We are having trouble getting pharmaceutical companies to make vaccines to prevent disease. This is because of legal liability. A lot of lawsuits regarding vaccine issues are unfounded, and these lawsuits are putting everyone else at risk. I reviewed a lot of charts for a group of lawyers for awhile. What I found was that most of the people who thought the drug had caused them to have a heart attack or stroke were overweight, smoked, had high blood pressure, diabetes or all of the above. I wonder how many of these people got a settlement, blaming something/someone else for a problem that they likely caused by their own actions or that was cause by a health problem out of a doctor or pharmaceutical company's control. Every time you watch television late at night you hear ads soliciting legal action for drugs taken, babies born with a problem, etc. Most babies born with a health problem had them before delivery, but it might be worth a few bucks from the obstetrician. Maybe he or she will settle out of court. It's worth a try, right?

As I said in an earlier post, it's entirely possible the doctor in the story above committed gross malpractice. If so, there's not a doctor I know who would support that doctor. He should not be delivering babies if that story is completely true and there were not extenuating circumstances. I would just like to know all the facts before throwing him under the bus.

So... you're trying to say you yourself never cast judgment (either pro or con) without 'knowing ALL the facts'? Considering that would be impossible in virtually every circumstance in life, I'm guessing you're being a bit dramatic and picking and choosing.

You didn't originally say "there are ambulance chasers" - you said, "Their lawyer sounds like an ambulance chaser" (huge difference). I'm just wondering where you got ALL YOUR FACTS to make that statement - since you "like to know all the facts before throwing him under the bus." (or are civil attorneys not fact worthy before being thrown under said bus?)

I suppose we can cast judgement on a message board where it doesn't matter. But calling someone an ambulance chaser is a wee bit less pejorative than accusing someone of such gross incompetence that it borders on manslaughter. In that setting, having all the facts would be a bit more important than examining every case taken by a lawyer to determine whether he is persuing ambulances. However, I will retract that part of my comment.

Here's a more grizzly story:

Missouri couple sues doctors for separating baby (http://www.nydailynews.com/life-style/health/couple-baby-decapitated-delivery-article-1.1181731)

It's hard to say whether there was a breach of the standard of care here because none of us ('cept maybe Betts) knows what that is in this procedure. However, we do know for a fact that the Plaintiff's own Doctor had informed the couple that the child would have to be delivered by C-section because ultrasounds were showing that the child's abdomen was too large for the child to be delivered ******lly.

Even after being informed of that, it appears from the stories I've read that the delivery doctor proceeded with a ******l delivery after pushing the Plaintiff to make that decision.

To call an attorney an ambulance chaser for filing a suit on these facts is utterly ridiculous. Unless the Defendant-doc has a pretty good explanation, what I've read here tends to sound like it's probably malpractice.

Yes, it would have made a difference to me. If the baby had a health problem that was going to be incompatible with life, then perhaps he had poor tissue perfusion. Perhaps he had something abnormal in his skin turgor and quality of musculature/skeletal integrity that caused a normal amount of force to have an unusual result. That might be information not discernable prior to delivery to a physician. Ultrasounds are imperfect instruments as well. It may be that the information the doctor had made him think the baby didn't have a large enough abdomen that Ceasarian delivery was required. Again, no one would expect a 28 week baby to get stuck in the birth canal.

Perhaps there was something wrong with the baby that made this happen. However, it's what the doctor allegedly did to try and cover up his mistake. The original doctor had already told the couple that the baby needed to be born through a C-section. Was that not noted in the chart? Did the delivering doctor ignore this? It sounds as if this couple received incredibly sub-standard care.

Regardless of if there was something wrong with the baby, this is a horrific story and if what is alleged is true, I honestly don't know how this couple will ever get past it. Trying to excuse a doctor for trying to cover up such a large mistake, even if there was something wrong with the baby, is just wrong.

... for the child to be delivered ******lly.

Even after being informed of that, it appears from the stories I've read that the delivery doctor proceeded with a ******l delivery after pushing the Plaintiff to make that decision. ...

Pardon the shoo-fly, and yeah I know it's an automatic filter that's the cause, but sheeesh, that's a fairly silly and overly sensitive filter setting when someone can't type a common medical term in a common medical procedure.

Perhaps there was something wrong with the baby that made this happen. However, it's what the doctor allegedly did to try and cover up his mistake. The original doctor had already told the couple that the baby needed to be born through a C-section. Was that not noted in the chart? Did the delivering doctor ignore this? It sounds as if this couple received incredibly sub-standard care.

Regardless of if there was something wrong with the baby, this is a horrific story and if what is alleged is true, I honestly don't know how this couple will ever get past it. Trying to excuse a doctor for trying to cover up such a large mistake, even if there was something wrong with the baby, is just wrong.

I agree that it sounds horrific. Again though, there is some information missing. Why did the baby have such a large abdomen that at 28 weeks (when it should have weighed about 1 kg, or just over 2 lbs) it got stuck in the birth canal? That's not an even remotely normal finding. A 28 week baby has an abdomen about the diameter of a man's wrist, normally. Did it have a health problem that was incompatible with life? Do we have 100% documentation that the baby was alive at the time of birth? Without going into too many details, some of which are not for the squeamish, I have participated in a delivery in which the baby clearly had been dead for days (and the doctor somehow missed that fact and never informed the family) and one in which the family had been told their baby was dead prior to delivery and the doctor was again wrong. A baby who has been dead for several days could easily have their head separated from their body during delivery, even with fairly normal traction. Now, you wouldn't expect blood to splash on the floor if the baby was not alive, but that could have been maternal blood as well. Need more data. What nationality was the doctor who delivered the baby? In some cultures, if the baby has a health problem that makes it unlikely the baby will survive, they may not see the necessity for something like a Ceasarian section, knowing the baby would not survive long after birth anyway. While our culture, or at least some of us, might see that as horrific, I'm not sure all the foreign doctors who practice here have gone to cultural correctness classes. In fact, I'm sure a lot of them have not. Need more data. Did the doctor truly know that the baby's head had been separated from the body, or was it the blood that scared him and caused him to do a crash section or some other factor the parents didn't even understand? If you can't deliver a baby ******lly, it is the common practice to push the baby back into the uterus and do a section.

The only data we have is from the parents. I see no comments from labor and delivery or operating room nurses. There's no pathology report, nor is there a comment from the original doctor who made the recommendation that the baby be delivered via C-section. Any time a baby dies during delivery it is a horrific experience, regardless of the cause. I feel terrible for the parents. I just think it's premature to say with anywhere near 100% certainty that the doctor did somethng heinous.

And I am again sorry about the ambulance chaser comment. It's kind of sore subject for me. There was a description of the lawyer in one of the stories about this that made it sound like this lawyer was one of the bad personal injury type lawyers. That was a flippant remark I should not have made. But there are some pretty reprehensible lawyers, just as there are reprehensible doctors. This doctor may be one of them, but usually you're innocent until proven guilty in this country.

Pardon the shoo-fly, and yeah I know it's an automatic filter that's the cause, but sheeesh, that's a fairly silly and overly sensitive filter setting when someone can't type a common medical term in a common medical procedure.

I know, I tried not to laugh when I saw the ***s in Mid's post, because it's such a sad story, but I couldn't help it. We can't use medical terms for body parts?

Nm

Betts, thanks for the fascinating medical perspective. My first thought was like MMM's - a decapitated early baby who ended up being taken by C-section sure didn't sound frivolous, to me.

On the other hand, after what you pointed out, it made me wonder if this was actually a previously deceased baby with a, well I'll just say it, rotten head that popped off and who was otherwise so swollen or large that the safest way to take it would be via C-section. Need more facts but how horrible for the parents anyway you look at it. And I am sure it wasn't any picnic for the medical team.

If the baby was normal, this doesn't sound like a frivolous suit. If the baby wasn't normal, I would wonder what exactly the parents are alleging - was it that he failed to properly diagnose? Again, fascinating.

Okay, going back and looking at the article, I saw this:


TruTV reveals Betts, 21, and Ammonnette, 20, conceived a child via in-vitro fertilization. Midwest Maternal & Fetal Medicine specializes in complicated pregnancies. Both doctors, Moore and Webb, work for the clinic.

Is it just me or does it seem odd that anyone this young would be attempting in-vitro fertilization? I mean, most people that age don't even know if they have a problem conceiving and think it is just taking awhile - right? No? I wonder what was going on with this high risk pregnancy and if that could have contributed to a problem with the baby. Just wondering. The article says they alleged the baby died during the birth, not before but, of course that was an allegation and not yet established.

I'm guessing that if the baby was deceased before labor began that the attorney would have even filed the lawsuit. I'm not sure what they have up in NY as far as pleading requirements, but in Oklahoma, to get a professional malpractice case to trial, you need a very specific petition (notice pleading has been done away with) as well as a certificate of merit written by a professional in the same industry. You can't just run to the courthouse and file a bare-bones petition and not expect it to make it past a motion to dismiss.

Also, a lawyer generally won't waste time on cases which have no merit. Especially medical malpractice cases. They take a lot of resources to prosecute successfully and often, even good cases go down in defense verdicts.

Are there bad cases filed? Certainly. Do defendants who had nothing to do with the case routinely get named because they were on the charts? Absolutely. Happens all the time. Trouble is, you don't always get to really understand the facts as a plaintiff's attorney until after the case is filed and after you have started to conduct discovery.

Okay, going back and looking at the article, I saw this:



Is it just me or does it seem odd that anyone this young would be attempting in-vitro fertilization? I mean, most people that age don't even know if they have a problem conceiving and think it is just taking awhile - right? No? I wonder what was going on with this high risk pregnancy and if that could have contributed to a problem with the baby. Just wondering. The article says they alleged the baby died during the birth, not before but, of course that was an allegation and not yet established.

Infertility can happen at any age. It could have been that he has some sort of issue, or she has PCOS, or a myriad of other things that could have caused them to turn to IVF. Most of the time (Octomom's doctor withstanding) doctors don't advise such invasive and expensive procedures for no reason.

The lawyer who filed the case is an ex-policeman who is a personal injury lawyer. I'm sure there are people who might take a questionable case that is this appealing to the media, even if it were unlikely to fly. Again, we're all speculating.

If the physicians involved do high risk OB, they're likely highly trained. and yes, it is very odd for someone that age to do in-vitro. The cost alone is usually prohibitive, not to mention the fact that most people have spent several years trying to get pregnant, and then several years on an infertility evaluation first. But infertility docs are usually very protective of their patients and it seems highly unlikely they wouldn't be involved in the delivery or decisions about the delivery. This story gets stranger and stranger and I would like to hear all the facts from both sides.

Infertility can happen at any age. It could have been that he has some sort of issue, or she has PCOS, or a myriad of other things that could have caused them to turn to IVF. Most of the time (Octomom's doctor withstanding) doctors don't advise such invasive and expensive procedures for no reason.

I realize that - I think what surprised me was that they'd discovered an infertility problem at such a young age and then jumped right into trying to help her get pregnant. It happened nearly two years ago and she is only about 22, now. I mean, how long had she been trying to get pregnant before she went for the in vitro? I would have thought that even if she started trying to get pregnant at 18 - seriously trying - that it would have been a year or two before she even went in to have them check for a problem. And then, to have in vitro when she isn't even married and likely was only about 20, 21? At the oldest? Seems quite odd, to me. I looked at her record and she has a number of financial problems - debtor issues. And she is doing in vitro? Who agrees to do that? Aren't there any ethical standards for doctors about providing in vitro fertilization to a single woman with debt problems who is only 19 - 21 (at the oldest)? I mean, it sounds just as shaky as what the octomom doctor did.

ETA - I was writing this before Betts responded. Didn't mean to repeat things.

Well, I'm certainly not going to judge anyone for turning to in-vitro, but it would seem strange that the doctor would approve it if there were no other problems. It will be interesting to see how this all plays out.

Well, I'm certainly not going to judge anyone for turning to in-vitro, but it would seem strange that the doctor would approve it if there were no other problems. It will be interesting to see how this all plays out.

Oh I wouldn't, either. But it just seems very odd, to me. If this was a 30 year old woman with a husband or a committed "partner" (I am not much impressed with having a "fiance" because all that says is that they believe in marriage but seem to have no idea when it might be timely) with a decent job or with steady income coming in, somehow, it would make better sense.

I did once see a single adolescent referred to a gynecologist because she wanted to get pregnant and hadn't been able to over the course of several years. I had some ethical problems with that referral, but she wasn't my patient. But, I don't believe Medicaid will pay for in vitro fertilzation. If it does, I have a problem with that. So, where did she get the money for the procedure? People spend tens of thousands of dollars on in vitro. And the bottom line remains - what was wrong with that baby, and what truly happened in the delivery room? I wonder if there's a way to follow the case besides in the press.

You can read the Missouri court docket but that doesn't tell that much. I imagine if this isn't a frivolous case, we'll hear about it since it has gotten quite a bit of attention. I didn't read the actual complaint but am wondering what exactly they are alleging and the remedies being sought. The gory details are just horrible but perhaps the actual suit just mentions them in passing and they are really attacking a missed diagnosis with the gross facts tossed in to substantiate damages for emotional/physical distress. Just as awful situation any way you look at it.