Feds off the Hook for Newborn's Illness
(CN) - The federal government is not to blame for a Public Health Service clinic's alleged failure to tell a pregnant woman of an infection that gave her baby water on the brain, a federal judge ruled.
In early 2010, Parkview Health Center, a Public Health Service clinic in Philadelphia, estimated Briana Winfield's due date as Aug. 18, according to the undisputed facts.
Though Winfield's results on a test for Group B Streptococcus (GBS), a leading infectious cause of neonatal morbidity and mortality in the United States, were abnormal in late July, the clinic did not plan to inform her until her follow-up visit scheduled for Aug. 5.
Dr. Henry Su, a Parkview physician, says he wrote an order on the results slip to treat Winfield with an antibiotic IV during labor to lower the risk of giving GBS to her child.
Winfield's results, however, were not attached to her chart, but were placed in a folder where Parkview keeps abnormal test results until patients return for a follow-up.
When Winfield was taken by ambulance to Hahnemann University Hospital a little before 7 a.m. on Aug. 5, a doctor noted in Winfield's chart that her GBS status was unknown.
The chart shows a records request was sent half an hour later, but does not say to whom.
While Parkview's phone records show Hahnemann called the clinic 20 minutes later - more than an hour before Parkview opened for the day - no record indicates who made the call, whether it was in regard to Winfield, or whether a message was left or forwarded to the hospital.
By the time Winfield's membranes were artificially ruptured at 10:50 a.m., Hahnemann's chart shows that none of her records had been received, "[d]espite multiple calls to Temple [University Hospital]," the planned delivery spot and records holder for Parkview patients.
Hahnemann again called Parkview about an hour later, but no record indicates why.
Nearly two hours after Winfield gave birth to her daughter Zaya at 12:19 p.m., Parkview finally faxed her chart to Hahnemann, though it is unclear why.
Winfield's abnormal GBS test result was not included, however, as the clinic employee responding to records requests was unaware of the separate folder containing abnormal results.
Four days after Winfield and Zaya went home, the baby was admitted to a children's hospital with GBS meningitis, obstructive hydrocephalus (water on the brain), and GBS sepsis.
Winfield and Rasheed Carter sued the federal government on their daughter's behalf, alleging that Parkview's failure to notify the mother or Hahnemann of her GBS results caused Zaya to suffer hypoxic brain injury, seizures, poor feeding and other damages.
Uncle Sam moved for summary judgment on the couple's one-count medical malpractice suit under the Federal Tort Claims Act.
U.S. District Judge Harvey Bartle III partially denied the motion on Feb. 7, declining to find whether Parkview negligently failed to inform Winfield of her results before she gave birth.
Though Winfield's expert is "competent to testify," Parkview did not clearly fail to respond to Hahnemann's unexplained phone calls or inform the hospital of Winfield's abnormal results on the day of Zaya's birth, the ruling states.
"Even assuming that the 11:48 a.m. phone call to Parkview put Hahnemann on immediate notice of Winfield's GBS status, and the antibiotics had been administered immediately, Winfield delivered her baby at 12:19 p.m., only 31 minutes later," Bartle wrote. "There is nothing before us to suggest that intravenous antibiotics at such a short interval prior to the time of birth would reduce the risk of GBS transmission."
The judge added: "In sum, there is insufficient evidence in the record from which reasonable inferences can be drawn that Parkview had timely notice to send to Hahnemann Winfield's positive GBS test results so that the appropriate antibiotics could have been administered to her to prevent serious injury to her baby."