In the spring of 1998, 31-year-old plaintiff presented to the
Ob/Gyn practice of Dr. Stuart Miro and Dr. Judith Stavis, Miro
& Stavis, M.D., P.C. in Pomona, N.Y. She was interested in becoming
pregnant and the doctors gave her advice. In autumn 1998, she
became pregnant and continued seeking the services of Miro and
Stavis for the management of her pregnancy. Miro and Stavis followed
the pregnancy throughout its course.
The
plaintiff mother claimed that the pregnancy was notable in that
she had early first trimester bleeding; in that she consulted
with Miro and Stavis because she did not feel that she was gaining
enough weight or looked right; and that in her third trimester,
she experienced heavy bleeding. The plaintiff mother had two early
ultrasounds which were reported by Miro and Stavis as "normal"
and a third ultrasound at approximately 20 weeks which she testified
was also reported to her as normal. The plaintiff mother was last
seen by Stavvis at a routine office visit on April 22, 1999. She
claimed that she was informed at that time that everything was
normal.
In
May 1999, in her third trimester, the plaintiff mother and her
husband, were on the Jersey shore when she began to bleed profusely.
She called Miro and Stavis and was told to report to the local
emergency room. After doing so, the plaintiff mother was transferred
to a larger facility, Jersey Shore Medical Center, where she received
her first indication that her child had Intra-Uterine Growth Retardation
(IUGR), meaning that the child was abnormally small and could
be severely chromosomally defective.
The
plaintiff mother was transferred to the Westchester County Medical
Center in Valhalla, N.Y., where she was admitted on May 21. At
that institution, an amniocentesis was performed--the first one
of the plaintiff mother's pregnancy--which revealed that the baby
was chromosomally damaged. However, it was not until a second
amniocentesis result was obtained a few days before she gave birth
that she learned the baby would suffer from Wolf-Hirschhorn Syndrome,
manifested by mental retardation, physical disfigurement, hearing
loss, inability to speak, respiratory difficulties and feeding
difficulties, among other problems. The plaintiff mother remained
hospitalized and under strict bed rest and medication until she
delivered on June 11, 1999. Her child, thereafter spent about
two months in the medical center himself; an additional two months
at Blythedale Children's Hospital in Valhalla, N.Y.; and has since
been institutionalized at St. Margaret's Center in Albany, N.Y.
The
parents sued Dr. Miro, Dr. Stavis and their practice. They made
a claim of wrongful birth, arguing that the plaintiff mother did
not receive the standard of care necessary to properly monitor
her pregnancy; that has she received the standard of care, under
the circumstances, she would have been alerted to the fact that
she was carrying a badly chromosomally damaged child; and that
had she received that information in time to effect a termination,
she would have. The parents specifically claimed that they should
have been told that the bleeding for several weeks during the
first trimester meant that there was a small possibility of chromosome
damage. In addition, at some 12 to 14 weeks into her pregnancy,
the plaintiff mother claimed that she was given inappropriate
advice about Alpha Fetal Protein Testing, which she was told was
not necessary because she was young and healthy.
The
plaintiff mother also claimed that at her 20th week, she had an
ultrasound which indicated that there was a two-week discrepancy
in what the doctors had assumed was her due date based upon her
last menstrual period and the development of the child. The parents
alleged, and the defense expert obstetrician conceded, that if
there were a two-week discrepancy in "dating" that this would
be a "red flag" and a very important finding which should be followed
up.
The
ultrasonographer's report showed a two-week developmental delay,
but the plaintiff mother claimed that she was never told, nor
was she informed of the need for a two-week follow-up ultrasound
at approximately 22 weeks. If she had had the follow-up ultrasound,
the defendants conceded that it would likely have shown "an additional
fall-off in size and weight" and that this, too, could have led
to the diagnosis of IUGR in a timely fashion. Stavis claimed that
the plaintiff mother was told to return for a 22-week ultrasound
and that she failed to appear for the test.
Another
of the ways in which "dating" is monitored by obstetricians is
by the measurements of fundal heights, which are taken routinely
by the doctor during pregnancy. The defendants' records had no
indication that fundal heights measurements were taken during
the plaintiff mother's pregnancy. The defendants claimed that
they did not take the fundal heights by measurement, which the
parents claimed is the convention, but by finger widths, and that
in any event they only chart fundal heights if they are abnormal.
They also claimed that in their case they were always "normal"
and there was no need to chart them.
Neither
of the defendants had any recollection of the plaintiff mother
as a patient at the time of trial, and thus they testified only
to what their general practice was at the time of her treatment
and based on their office records.
The doctors
claimed that they believed that the plaintiff mother would have
never terminated the pregnancy under any circumstances, anyway.
The child
suffered from profound mental retardation, , physical disfigurement,
hearing loss, inability to speak, respiratory difficulties and
feeding difficulties, among other problems.
The child
has been confined at St. Margaret's Center in Albany, N.Y., since
he was approximately four months old and all sides conceded that
he will stay there for the remainder of his life. Under New York
Law, in a wrongful birth case, the only damages that are permissible
are for the maintenance of the child from birth to 21 years of
age. The defense did not contest the child's life expectancy up
to 21 years.
A Rockland
County, New York jury found that both defendants departed from
good medical practice in their management of the pregnancy.
The parties
had previously stipulated that in the case of a plaintiff's verdict,
the damages awarded would be $3.84 million.