November 28, 2019

The Supreme Court of Iowa (“Iowa Supreme Court”) in its opinion filed on October 25, 2019 upheld a defense verdict in a shoulder dystocia birth injury medical malpractice case, holding: “we conclude the district court did not commit reversible error in the specifications of negligence it submitted to the jury. We determine Dr. Widmer’s CME records were not admissible to show a breach in the standard of care. However, although it was an abuse of discretion for the district court to prohibit the use of CME records as impeachment evidence, the error was harmless. Further, defendants’ expert opinion testimony was properly disclosed and did not reflect an opinion in anticipation of litigation. We also conclude the district court did not abuse its discretion by limiting the jury’s access to the birth video.”

The Iowa birth injury medical malpractice lawsuit alleged that the defendants encountered the medical emergency of shoulder dystocia after the baby’s shoulder became stuck on his mother’s pelvis (a shoulder dystocia is a medical emergency because the infant’s delay in birth may cause severe brain damage or death if not resolved in six minutes or less). The defendants performed maneuvers to resolve the stuck shoulder that resolved the shoulder dystocia in one minute and ten seconds, but the baby was born with a permanent injury to his left arm preventing normal use and function.

The baby’s delivery was captured on a twenty-one minute birth video recorded by the child’s aunt, which had been introduced into evidence during trial. During deliberations, the jury asked to view the birth video, which was not submitted to the jury for deliberations. The district court complied with the request and played the video for the jury once in its entirety. Over the plaintiff’s objections, the birth video was not sent back to the jury room during deliberations but could be viewed an additional time upon request by the jury. Such a request was made and the video was again played in its entirety. Subsequently, the Iowa medical malpractice jury returned a defense verdict, finding that the defendants were not negligent. Consequently, the jury did not reach the question of causation or damages.

On appeal, the plaintiff argued that the district court failed to incorporate the following specifications of negligence against the defendant physician in the jury instructions: (1) directing to push after shoulder dystocia was identified, (2) failing to properly and effectively direct the delivery team as well as failing to properly and effectively use maternal and fetal maneuvers, and (3) mistakenly concluding the baby was experiencing bradycardia. With respect to the nurses, the plaintiff argued that the district court failed to incorporate two specifications of negligence: (1) directing to push after shoulder dystocia was identified, and (2) failing to properly and effectively perform maternal maneuvers.

The Iowa Supreme Court held: “We think the specific act or omission of repeatedly directing to push was adequately encompassed in the district court’s instructions. The district court’s specifications stated [the defendant physician] was negligent by “failing to direct or coordinate proper maneuvers” and “applying excessive or improper traction . . . after the recognition of shoulder dystocia.” These instructions are directly related to the concept of “directing to push” … The same is also true for the … nurses. Failing to meet the standard of care “in the performance of the McRobert[s] maneuver” encompassed “directing to push” after the recognition of shoulder dystocia … the district court’s jury instructions adequately encompassed [the plaintiff’s] specifications of negligence … [v]iewed as a whole, the district court’s instructions ensured the jury would give consideration to each alleged act or omission.”

With regard to the video issue, the Iowa Supreme Court stated, “Whether exhibits are submitted to the jury during deliberations is a matter within the district court’s discretion … It is clear the district court was concerned with the context of the jury’s reason for viewing the video. To avoid giving a disproportionate importance to specific sections of the video, the district court’s judgment call was to play the entire video once. This exercise of discretion was not clearly unreasonable.”

Source Eisenhauer v. The Henry County Health Center, No. 17–1971.

If you or  your baby suffered a birth injury during labor and/or delivery in Iowa or elsewhere in the United States, you should promptly find a birth injury lawyer in Iowa or in your state who may investigate your birth injury claim for you and represent you and your child in a birth injury case, if appropriate.

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