Infant Dies After Obstructed Labor And Delivery Complications

ByVictoria Negron

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Updated onJuly 12, 2018

This case involves a 34-year-old overweight female with gestational diabetes. The patient was screened 10 weeks prior to delivery and it was discovered she had gestational diabetes. She was referred to a nutritionist and given a printout of a diet. The patient did not receive any additional follow-up to monitor her blood sugar levels following that visit. The patient went into labor at 34 weeks gestation. Prior to the delivery, the patient requested delivery by Cesarean section. She communicated this request to the nurse, but the nurse never communicated the request to the doctor because he felt it was not a necessary precaution. During delivery, the baby developed shoulder dystocia. The baby was delivered with a subgaleal hemorrhage and passed away a week later.

Question(s) For Expert Witness

1. Do you have experience treating patients with gestational diabetes?

2. Given this patient's risk profile, is it fair to assume that additional protocol should have been followed to ensure safe delivery of the baby?

3. What are the obligations of the nurse when a patient requests delivery by Cesarean section?

Expert Witness Response

inline imageI routinely treat patients with gestational diabetes as it is a fairly common pregnancy complication. When a patient has risk factors such as this Plaintiff, the nurse would need to have a heightened suspicion for the potential for a big baby (due to poorly controlled blood sugars) in this mom who was overweight. This could increase the risk for shoulder dystocia, even at 34 weeks gestation. It would be important to determine if appropriate nursing interventions were implemented once the shoulder dystocia was identified. It is the duty of the nurse to inform the physician of the patient's desire. ACOG advises against routine C-section delivery for fetal macrosomia unless the fetus is estimated to weigh over 4500 grams in a diabetic patient. I have provided deposition testimony in several cases as a nursing expert witness involving shoulder dystocia. The babies in the cases I've been involved have had brachial plexus injuries and/or neurological injuries.

About the author

Victoria Negron

Victoria Negron

Victoria Negron has extensive experience in journalism and thought leadership in the legal space, with a background crafting content, whitepapers, webinars, and current event articles pertaining to the role of expert witnesses in complex litigation matters. She is a skilled professional specializing in B2B product marketing and content marketing. Currently, she serves as an Enterprise Product Marketing Manager at Postman, and previously held the position of Technical Product Marketing Manager at Palantir Technologies, where she developed her skills in launch strategies, go-to-market strategy, and competitive analysis.

Her expertise in content marketing was further refined during her tenure at the Expert Institute, where she progressed from a Marketing Writer to Senior Content Marketing Manager, and eventually to Associate Director of Content & Product Marketing. In these roles, she honed her abilities in digital marketing, SEO, content strategy, and thought leadership.

Educationally, Victoria holds a Master of Business Administration from the University of Florida - Warrington College of Business and a Bachelor of Arts in Literature, Art, and Hispanic Studies from Hamilton College. Her diverse educational background and professional experience have equipped her with a robust skill set in product marketing, content development, and strategic marketing initiatives.

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