This blog was written by Gloria Seidule, not AI. 

Premature babies are defined as babies born before the 40 weeks normal time of pregnancy (gestation). The earlier the baby is born before 40-week gestation, the less likely the baby will survive outside of the womb.

Before 2021, if the mother went into labor at 25 weeks or more gestation, “standard of care” for health care providers was to try to save the baby with resuscitation, medication and any necessary medical intervention. If the mother went into labor before 25 weeks gestation, “standard of care” was to allow the baby to be born and die in the parents’ arms with no attempt at resuscitation.

In law, “standard of care” is that level of care which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by similar and reasonably careful health care providers.

After 2021, the American College of Obstetricians and Gynecologists (ACOG) changed their recommendations to state for babies born as early as 22 weeks gestation (extremely premature babies) medication may “be considered” if resuscitation “is planned” and after “appropriate counselling”.

This case illustrates the legal issues that surround real life cases in which parents face a 22-week gestation premature delivery of their baby.

THE CASE

PLAINTIFFS ARGUMENT

In 2022, Plaintiffs, parents, called their doctor because the mother was experiencing labor pains at 22 weeks. The doctor instructed them to go to the local hospital where the doctor had privileges (allowed by the hospital) to deliver babies. The doctor and hospital representatives met the parents at the hospital and after an examination told the parents that the labor could not be stopped, and they should prepare to let the baby be born and die in their arms. They were not informed that 20 minutes away there was another hospital with a neonatal intensive care unit (NICU) that could treat 22-week gestation babies. The parents state they would have immediately transferred to that better hospital if they had been informed of this choice. They claim they were not informed of any of the risks or benefits of at least trying to save their 22-week premature baby.

DEFENDANT’S ARGUMENT

Defendants, doctor and hospital, state the mother presented in the emergency room in advanced labor that could not be safely stopped. The doctor stated that it was impossible to determine her condition with a telephone call and it was reasonable to inform them to go to the nearest hospital where the doctor had privileges.

The defendants state they followed the ACOG recommendations because medication was “considered” by the doctors, but resuscitation was not “planned” upon arrival at the hospital because they did not reasonably know her condition until their arrival to the ER, and by that time it was too late.

The defendants did not inform the parents of the survival rates and morbidity rates (percentage of children with moderate to severe medical conditions even if they survived 22-week prematurity) because the health care providers “considered” these and determined counselling was not appropriate because it wasn’t an option for the parents.

FACTS

Babies born at 22 weeks have a greater than 50% survival rate if born in a hospital with a NICU.

There are around 1424 NICU’s in the United States. 50% have the capability to treat 22-week premature babies.

There was a NICU with the capability to treat the plaintiff’s baby within 30 miles of their home.

It would have taken 20 minutes by ambulance to transfer the mother to the NICU hospital.

There is a dispute between medical experts if transfer would have been in time to save the baby.

The morbidity rate for 22-week premature babies, even when standard of care met, is 50%. This means that half of the babies who survived would have lifelong developmental problems.

The parents were not provided with this information because the doctor and hospital determined it was too late when they arrived at the local hospital.

The cost of treating 22- week premature babies can be well over $100,000.00.

The jury is not told if the parents had medical insurance because it was considered “irrelevant” by the Judge on the case.

ISSUE

LEGAL CAUSE (TREATMENT WITHOUT INFORMED CONSENT)

The negligent failure to obtain informed consent to a medical treatment is a legal cause of injury resulting from the treatment if, as a result of such negligence, the patient was induced to undergo a medical treatment to which the patient would not reasonably have consented had they been adequately informed.

YOU DECIDE

You have been placed on the jury for this case. SUBMIT YOUR ANONYMOUS VOTE BELOW:

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Did the doctor fall below standard of care in advising the parents to go to the local hospital instead of the NICU hospital when the parents called reporting labor pains?
When the parents arrived at the local hospital, did the doctors and hospital fall below standard of care in failing to inform the parents of the risks of survival and morbidity and of their option to transfer to the hospital 20 minutes away?
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