Fetal decapitation at 21 weeks

CERCLAGE WAS PERFORMED on a woman who had a short cervix. A week later, Dr. A, her ObGyn, found the cerclage weak, and placed her on bed rest. Three days later, she passed blood clots, and was admitted to the hospital, where Dr. B assumed her care. When membranes ruptured at 21 weeks’ gestation, the fetal feet extended out of the vagina. The baby’s head was amputated during delivery; the child weighed <1 lb. Nursing staff reattached the head with sutures and permitted the mother to hold the child.

PATIENT’S CLAIM Dr. A should have confirmed cerclage placement by ultrasonography. When he found the cerclage unstable, he should have hospitalized the patient. Dr. B used excessive force during delivery. The nurses failed to properly monitor the mother. She claimed psychological injury in having witnessed the infant’s decapitation and being allowed to hold the corpse. Unreasonable death was claimed on behalf of the child’s estate; with proper treatment, the child had a chance of survival.

DEFENDANTS’ DEFENSE Cerclage was performed properly; Dr. A’s care was appropriate. Dr. B did not use excessive force; the fetus had extremely thin skin that tore easily. The nurses’ treatment was appropriate. The hospital was required to allow the mother to hold her baby when requested. A fetus is not viable at 21 weeks.

VERDICT A $1,362,499 Kentucky verdict was returned against the ObGyns; a defense verdict was returned for the hospital. The jury refused to address the claim of wrongful death because a fetus is not viable at 21 weeks.