The plaintiff child was born at a hospital in July 2000. The delivery was at full-term with a normal delivery and normal Apgar scores. He was discharged after two days despite facial jaundice and an above-normal bilimeter reading of sixteen. The infant did well for two days before exhibiting decreased feeding, irritability and restlessness.

His mother called the doctor’s office twice and was told to feed him with a syringe and bring him into the office the next morning. After the parents noticed the infant had turned yellow, they brought him to an emergency room. The infant’s bilirubin level was found to be 38.2 (hyperbilirubinemia) and a transfer was arranged in order for a double volume exchange transfusion.

The transport team of the receiving hospital picked up the baby and arrived back at the receiving hospital about four hours after the baby was brought to the first hospital. An umbilical venous catheter was inserted for the exchange transfusion and an order was placed to reconstitute whole blood to be used for the transfusion. When the blood was ready and the exchange transfusion was started it was discovered that the umbilical catheter was no longer withdrawing blood.

Alternative arterial access was attempted, but the fellow attempting this was unable to obtain an arterial line after multiple attempts and the pediatric surgery service was called for assistance. After four attempts by pediatric surgeons were unsuccessful, an arterial line was finally able to be placed into the brachial artery. The first unit of blood was successfully administered within an hour after the exchange transfusion was started and the bilirubin level was reduced to 18.8.

The infant, however, suffered bilirubin encephalopathy due to excess bilirubin crossing the blood brain barrier, causing severe cerebral palsy, spastic quadriplegia, profound hearing loss and upward gaze palsy. The child requires twenty-four hour care and can only communicate by advanced computerized devices.

The plaintiff alleged delay in performing the exchange transfusion and the brain damage could have been prevented if the transfusion had been done at least one hour earlier. The plaintiff alleged a delay in leaving with the infant from the first hospital and a delay due to the blood not being ready at the time the infant arrived at the receiving hospital. The plaintiff also claimed negligence in the placement of the umbilical catheter.

The defendant claimed that the infant’s bilirubin level had been at critical levels in excess of twenty-four hours before the receiving hospital was contacted and that it was not standard to pre-order blood and that the transport was within the standard of care.

According to a Jury Verdict Reporter, a defense verdict was returned. The hospital had settled for $5,750,000 and the doctor and pediatric group settled for $2 million prior to trial. N.N.P. named.

With permission from Medical Malpractice Verdicts, Settlements & Experts; Lewis Laska, Editor, 901 Church St., Nashville, TN 37203-3411, 1-800-298-6288.