GA - Couple sues Hospital, Dr. Tracey St. Julian, and hospital staff for gross negligence after baby decapitated during delivery, July 2023

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Did the medical staff take appropriate action/measures if the baby had died in utero and they were trying to save the life of the mother at that point (and the baby's head was tragically severed from its body post mortem)? From what I am reading here from our verified medical experts, it sounds like that may be the case.
 
Sundog said:
Did the medical staff take appropriate action/measures if the baby had died in utero and they were trying to save the life of the mother at that point (and the baby's head was tragically severed from its body post mortem)? From what I am reading here from our verified medical experts, it sounds like that may be the case.
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Possibly, but the big issue is that the doctors all tried to cover things up.
 
airportwoman said:
Possibly, but the big issue is that the doctors all tried to cover things up.
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It's not black and white. The question is: did they not volunteer the information about decapitation to cover up an error or deviation from standard of care, or did they not volunteer the information about decapitation to spare the family the gory details of how the baby died? The former is definitely a problem. However, the latter is done often in medicine. When a person gets hit by a car, doctors usually just say they died from their injuries. They may say the person was run over or the person had numerous broken bones. They don't get into the the gory details (and believe me, the details are often very gory) unless the family asks/is eager to know. That's because the emotional trauma of the loss can be compounded by knowing what happened to your loved one's body as they died. That's especially true after a physically traumatic event, such as a car accident, a homicide, or in this case, childbirth.

So I think it's too soon to assume it's a cover-up. JMO.
 
bombardier said:
Another poster was talking about how hospitals in the US try to reduce their number of C-sections. It's sounding like the hospital was trying to do all they could to encourage a vaginal delivery, and realized the need for a C-section too late to save the baby.
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Sounds like a reversion to 16th and 17th century medicine, to me.

JMO.
 
www.11alive.com

Parents of baby decapitated during birth: Doctor hired to perform independent autopsy shared exam on social media

In a new lawsuit, the parents allege that a pathologist hired to perform an independent autopsy on their baby shared videos of the exam on social media.
www.11alive.com www.11alive.com
This poor couple! Apparently the pathologist they paid out of pocket to autopsy the baby took videos and posted it online, something he has a history of doing. He said it was 'educational' and the baby wasn't identified in the video. Um....what other headless babies are there in this area?? Features like this are just as identifiable as a name and IMO if true this violates HIPAA...
 
BeginnerSleuther said:
I'll offer this with the disclaimer that my specialty is not OB-Gyn. C-sections should always be a last (or close to last) resort, IMO. Has nothing to do with hubris.
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Well, in this case, the C-Section should have probably been considered immediately.

MOO, is that a C-Section is better than risking the life of the baby or the mother.

The outcome here was horrible.

As for the provider that showed pictures of the decapitated baby, horrible, but doctors are strange. I worked with one guy who had an exchange with his med school buddies, "Can you top this" of grotesque and unusual presentations in ophthalmology. Always under the thinly veiled guise of "educational images".
 
BeginnerSleuther said:
Vaginal deliveries that result in complications are switched to a C-section. Having a C-section with one birth increases risk for future vaginal births. It is possible, especially as medical technology has advanced, but it's higher risk. So vaginal delivery is favored and only switched if (a) woman has had prior C-section and/or (b) there's a complication.
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Hospitals definitely attempt to do a vaginal delivery first before considering a major surgery. I had severe preeclampsia at 38 weeks of pregnancy (12 weeks early) and my team STILL wanted to try for an induction of labor to see if I could deliver vaginally, even though I was at risk and my daughter a micro-preemie. I labored 48 hours with no progress (delivery was not actually occurring) and then was switched to a cesarean.
 
Wallendo said:
Although not really related to this case, my father still has possession of his great-grandfather's decapitation hook. My great-great-grandfather was a physician in the period before and after the Late Unpleasantness (Civil War), and this instrument was used to remove the dead baby's body in two or more pieces to save the mother's life.

The decapitation hook is probably not a part of a modern obstetrician's armamentarium due to modern technology.

There is a reasonable question about whether or not a cesarean section was required prior to this incident. It sounds like dismemberment was later required (the mother is still alive).

We have only the plaintiff's lawyer's opinions in this case. It would be interesting to hear what was actually told to the family (at least the physician's and hospital's point of view. We will likely never know since a case of a decapitated baby will raise great sympathy among probable jurors and the case will likely settle (without regard to the facts of the case).
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What I understand from the article, the childbirth was complicated by shoulder dystocia (when the head is out, but the shoulders get stuck in the pubic area). This article lists a number of maneuvers that are used to deliver if the complication occurred.


(Please pay attention to "heroic maneuvers". You can Google "images" of each of them. There may be complications.)

However, the situation is unclear as untrauterine fetal death is associated with a higher rate of shoulder dystocia, so if they said that the baby died inside, and then shoulder dystocia happened when delivering a dead fetus, it might be also true.


So, I can't say for sure what happened here. It is plausible that the fetus died before labor, there were no heartbeats, so the hospital proceeded with vaginal delivery, but due to shouIder dystocia the baby had to be extracted via both c-section (body) and vaginally (head). JMO - I suspect this is what had happened. I assume, though, that the doctor should have said to the mother that there was no heartbeat heard before the delivery. In fact, they monitor heartbeats, so she should have heard/seen that there were none.

Less possible, but not totally excluded is shoulder dystocia in the process of initially normal childbirth, then some maneuvers attempted that didn't work, and eventually, fetal death. It is less likely, IMO, but statistically, fetal death as the result of shoulder dystocia is 0.4%. While very rare, it might happen. Fetal anoxic brain injury in cases of shoulder dystocia is 0.5-23% (I think the wide range is explained by how long it takes to deliver after dystocia happened.) Please pay attention that shoulder dystocia is a subjective diagnosis, as they write. What it means to me is when one doctor might think he still can deliver the baby safely, another will view it as an emergency and act faster.

Either way, lack of communication with the family clearly took place. I hope the family, and the public, too, can receive the explanation. Wishing the family closure.
 
IDK said:
From the article you posted, here is the last ditch effort when all else fails:

“Symphysiotomy is only recommended when all other techniques have failed7,27,35,37. In fact, Menticoclou18 states that it should be applied only after 5 minutes if the dystocia has not been solved yet and the other maneuvers, even the Zavanelli, have failed. It has been used as a last resort. It involves the surgical division of the fibrous tissue and cartilage7 of the pubic symphysis7,35,37 in order to increase the pelvic diameters7,35. However, it should be avoided because the separation of the pubic symphysis is not restored and has been related to complications such as bladder, urethral and vaginal injury. These injuries could lead later to urinary incontinence, chronic pelvic pain, and unstable pelvis7,35,37.”

I wonder which maneuvers were attempted— this last one sounds horrible, what a choice to have to make between the baby’s life or those profound injuries to the mother.
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If you look up images for Zavanelli maneuver, I think it is the one when trauma to the baby's neck can happen, although I do not think this is exactly what happened here.
 
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There is another very sad side to it.

I can't post links to most of 2023 articles because the country is so divided that even articles with good statistics are impossible to cite. So i had to cut it from one article "As the first class of post-Dobbs medical students prepares to be matched to OB-GYN residency programs on Friday, preliminary 2023 data from the American Association of Medical Colleges shows that the average number of applications per obstetrics and gynecology residency program fell from 663 in 2022 to 650 in 2023."

Another article from 2018 - the situation got only worse post-Covid but at least this one I can link.

www.aamc.org

Labor pains: The OB-GYN shortage

Half of U.S. counties lack a single OB-GYN, and some women’s lives are endangered by long treks for needed care. What leaders in academic medicine are doing.
www.aamc.org www.aamc.org
 
Charlot123 said:
Either way, lack of communication with the family clearly took place. I hope the family, and the public, too, can receive the explanation. Wishing the family closure.
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RSBM

We don’t have the doctor’s statement or notes from the patient’s chart. We don’t know what type of communication took place at the hospital. It could have been that everything was explained and communicated with the mother and/or her husband, we simply don’t have all the facts in this case. We only have the side of the mother and father as they remember it.

During high stress, emotional, and traumatic situations, patients often don’t recall things that were explained or stated to them. I’ve been in rooms with patients, typing every word the doctor said to them into their electronic record. Then days later the patient claims that “the doctor never explained “ or “Why didn’t the doctor tell me?” and I can see in the visit documentation exactly what the doctor discussed with the patient. Even when family members are with a patient they often don’t recall or remember incorrectly what was stated.

Even in less traumatic situations, patients have said, “The doctor never said I shouldn’t drink alcohol while taking this medication” or “No one ever said I had to see an endocrinologist” when an entire conversation is recorded in the documentation.

This couple is young, and I have wondered if their parents or other family member was with them at the hospital? Because at this point all I have see is their claims about what happened and what was said. And it is quite possible that they don’t recall everything that was explained to them in this tragic situation.

JMO
 
vls12345 said:
www.wsbtv.com

Death of baby decapitated in metro Atlanta hospital ruled homicide, ME confirms

According to a lawsuit filed by the parents, the baby became stuck during labor and the doctor began pulling.
www.wsbtv.com www.wsbtv.com

"The Clayton County Medical Examiner’s Office has confirmed that the death of a baby decapitated in a hospital has been ruled a homicide."
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Alright, color me confused; in the complaint (linked in post #93 of this thread), fetal monitoring showed bradycardia (slow hr) followed by no heart rate around 10:46pm, and the lower half of the baby was delivered at 12:11. So, if the fetal monitoring is to be believed (and if this info is coming from the actual report and not second hand info), the baby was deceased more than an hour prior to delivery.
So, did the decapitation happen while the Dr was attempting to vaginally deliver the baby?? This whole time, I was under the impression that it happened during the C section, but I guess that was never explicitly stated.
I'd love to see the MEO's report and see how they came to that conclusion. To differentiate stillborn vs died after birth, there are lung changes that can show us if the baby ever took a breath. I'm guessing this baby never took a breath because he died while in the birth canal, it looks like? How is the pathologist able to differentiate death due to decapitation vs suffocation, heart rate analomies during delivery? I'm very interested in how this plays out!
 
the Dr.'s response to the baby's extreme distress was not to move mother into McRoberts position but to continue trying to force vaginal delivery with application of traction. this is what I believe allegedly caused the decapitation. I don't get why the Dr. didn't follow protocols. I don't get why she didn't call for a C-section right away at 9:26pm when the category III strips became apparent. The baby could have made it IMO if she had.

per the American Journal of Obstetrics and Gynecology:

561: Category III fetal heart rate tracings: a rare occurrence strongly associated with adverse neonatal outcome
https://www.ajog.org/article/S0002-9378(09)01538-5/fulltext
 
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