Obstetrics (from the Latin obstare, “to stand by”) is the surgical specialty dealing with the care of women and their children during pregnancy (prenatal period), childbirth and the postnatal period. Midwifery is the non-surgical equivalent. Veterinary obstetrics is the same concept for veterinary medicine.
One of AME’s obstetrics expert witnesses has written an exclusive medical malpractice article that we have provided, for your interest, below. Experts Recommended for Maximizing Recovery In Obstetrical Cases
Obstetrician: Whether or not the defendant is a general practitioner or an obstetrician, the standard of care is that of an obstetrician. That expert will testify to the proper standards of care, which were in effect at the time at that size hospital. He will discuss departures from the proper standard of care, if any, on the part of the doctor, nurses, and the hospital. In addition, many obstetricians would be comfortable in testifying to proximate causation. However, the proximate causation question is best handled by a pediatrician and/or pediatric neurologist.
Pediatrician and/or Pediatric Neurologist: When there is brain damage to the baby, it is important to ascertain the cause. Pre-delivery factors such as infections, hemorrhage within the brain and genetic and other congenital causes unrelated to negligence must be ruled out. The strongest obstetrical malpractice cases are sometime lost because of the “so what” defense.
These experts could also testify to the negligent delivery, with the low Apgar score as the proximate causation of the brain damage (cerebral palsy and/or mental retardation), and could rule out post-delivery causes such as a very low blood sugar, or pediatric or pediatric nursing negligence in failing to adequately suction the baby’s throat and maintain adequate oxygenization. When there are potential multiple insults to the child, they can testify with regard to which ones were substantial contributing factors to the brain damage.
Obstetrical Nurse: The obstetrical nurses are independent personnel who have their own duty to their patient, your client. They are in a position to determine whether or not proper care is being given, and to obtain professional assistance in a timely manner via the chain of command which must be established by every hospital. These nurses are also seeing the patient on an on-going basis and are reviewing the fetal monitor. If there is any evidence of fetal distress or lack of progression of labor, the obstetrician must be notified promptly. The nurses can place the patient on her side to minimize the negative effects of the uterine pressure and contractions on uterine blood flow in the presence of fetal distress, but they also must obtain prompt obstetrical medical assistance.
The nurses will perform sterile vaginal examinations periodically, check the fetal heart rate themselves, and, when an external fetal monitor is being used, position the transducer on the mother’s abdomen to get the best recording of the fetal heart beat. They have a duty to record, in their nurses’ Labor Room notes, what is happening to the patient and to act promptly upon any “red flags” which may arise.
Radiologist: When there is a question of cephalopelvic disproportion and pelvimetry x-rays were taken, a radiologist can comment upon what the proper interpretation should have been and how that information should be communicated to the attending obstetrician.
Hospital Administrator: He can best express the failures of the hospital to establish protocols and procedures required by the Joint Commission on Accreditation of Hospitals (JCAH) and how those failures caused or increased the risk of injury to the plaintiff. He can also discuss physician credentialing failures, nurse training failures and equipment inspection failures.
Psycho-Neurologist: This expert is a Ph.D. who specializes in sophisticated testing of all parts of the brain to detect and quantify all damages. Such damages include motor skills; intellectual functioning such as basic mathematical, reading, understanding, communicating and reasoning skills; sensory skills of vision, hearing, smell, taste and feel; memory; thought processes; and the patient’s response to any defects. Based on the dysfunction found, causation, permanency and special education needs can also be discussed.
Forensic Psychologist: This expert can administer the objective psychological tests to determine the full extent of emotional damage and emotional dysfunction of the child. They can testify as to what such a damaged child would perceive their injury to be as they age, and how that would affect them further. The psychologist can examine and test the family as well.
Forensic Psychiatrist: This expert will continue the psychiatric evaluation as a physician, and both he and the clinical psychologist will then “cry to the jury”, for the anguish of the child and family.
Occupational/Disability Expert: This expert will discuss the physical and mental limitations of the patient from a physician’s aspect, and explain how those disabilities would substantially interfere in job performance in the future (and, therefore, limit income) and how they will interfere in normal daily living, thereby increasing the psychological damages. These experts can also discuss the need for remedial and corrective operations, if indicated. The related costs and pain and suffering from such corrective surgery and care can best be expressed to the jury by this type of expert.
Employability Expert: This is a Ph.D. (not a physician) who can discuss what such a patient, if mentally intact, would have been able to earn, based upon a high school education, and normal physical condition in his city and job market versus what limitations are now imposed and based upon the disability as documented by the previously mentioned physician and Ph.D. experts.
Economist: This expert will place the dollars and cents before the jury, based upon loss of income from diminished earning capability, as testified to by the employability expert and disability experts. This, in conjunction with the cost of future medical care as testified to by the pediatrician and occupational medicine/disability experts and other physicians can clarify the economic issues (as established by your state statutes and case law) to the jury.