A B.C. Supreme Court judge has found a North Vancouver doctor and hospital liable for negligence in the birth of a baby that left the child with significant injuries.
Justice Francesca Marzari said Abigail Leigh Gilmore was ultimately born by caesarean section after mother Meaghann Sitter went into labour June 13, 2014.
“Abigail was delivered with bruising along her left arm, shoulder and head, and she was admitted to the special care nursery shortly after her delivery,” Marzari said.
“Approximately a day later, seizure activity was suspected and Abigail was transferred to BC Women’s and Children’s Hospital, where imaging established that she had three fractures on the left side of her skull, and extensive brain damage.”
Marzari said Abigail is now eight years old and continues to suffer from the effects of the damage to her brain.
Sitter is Abigail’s litigation guardian, meaning she is bringing the lawsuit on behalf of her child.
Health team gets majority blame for child's lasting brain damage
The defendants are Lions Gate Hospital, the Vancouver Coastal Health Authority, three nurses who attended Sitter during the labour and Dr. Karis Love, the obstetrician primarily responsible for Sitter’s labour and Abigail’s delivery.
Liability was the sole issue before Marzari in the trial.
“I apportion 85 percent of the liability to Dr. Love and 15 percent to the hospital defendants,” Marzari said.
The judge said the infant's injuries resulted from a number of negligent acts.
“However, Dr. Love was the responsible physician, and bears the greatest responsibility for the failures of communication and monitoring during the management of Ms. Sitter’s labour, and all of the responsibility for the breaches of care during the surgery,” Marzari said.
Mother opts for caesarean
Sitter was not quite full term when she went into labour and was admitted to the hospital. During the birth, Marzari said the baby's position was not optimal to passing through her mother’s pelvis, so the doctor attempted to alter the position of infant's head.
The doctor offered Sitter the options of continuing to push for another 30 minutes while being administered oxytocin, or proceed to a caesarean section. Sitter chose a caesarean section.
“In Dr. Love’s words, Abigail’s head was ‘tightly wedged’ and ‘severely impacted’ in Ms. Sitter’s pelvis, and Dr. Love was unable to get her hand around Abigail’s head to elevate her head and deliver her, at least initially,” the judge said.
Case revolved around position of baby's head
How Abigail’s head was moved to deliver her became the key issue in the case.
Marzari found the immediate cause of Abigail’s skull fractures and the extensive brain damage she suffered was the force of Love’s hand during the caesarean section.
The doctor admitted that her hand was the cause of one of the fractures above Abigail’s ear, and likely a second one towards the back of her left parietal bone, the judge said.
Love denied responsibility for a third fracture at the top of Abigail’s left parietal bone and submitted that this fracture was more likely caused by a nurse’s hand while pushing from below. But Marzari rejected that argument.
“I find that it is far more probable that all three fractures, and the brain injuries associated with them, were caused by the same hand and the same movement: Dr. Love sliding her hand between Abigail’s head and Ms. Sitter’s pubic bone in order to dis-impact and lift the fetal head at the time of the caesarean section,” she said.
Further, Marzari said, the continuation of pushing likely further risked impacts with the pelvis. She cited a lack of communication between members of the medical team as well as a lack of informed consent about the caesarean option.
“I therefore find that breaches of the defendant medical practitioners’ standards of care during the management of Ms. Sitter’s labour were also causative of Abigail’s injuries,” Marzari said.
Monetary damages have yet to be determined.