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

[mickey2942]

Wow. What is terribly wrong here, is that the medical professionals saved the life of the mother, by sacrificing the baby. And then, out of possible compassion, hid the gruesome result.

The road to hell is paved with good intentions.

 

[tlcya]

I knew this would eventually have a thread. When I read the news articles last week on this case I was mortified for this couple. Based off what little I know of the circumstances involved I hope they win a huge award or settlement. I cannot even imagine their pain.

 

[tlcya]

my undertanding about the sequence of events is as follows: baby is set for vaginal delivery. The head is delivered but the shoulder is stuck in the delivery canal (shoulder dystocia). In attempts to force the shoulder from the birth canal and complete vaginal delivery suction was used to the baby's head (applied traction - against protocol). This "traction/suction decapitated the baby, meaning the head was delivered vaginally, the rest of the body remained inside mother. The mother was then rushed to a C-section where the now headless body was delivered.

The cover up ensued.

 

[MadeleineMaxwell]

As a UK midwife we are trained (along with obstetricians) to respond to shoulder dystocia. There's a set protocol involving various manoeuvres. The very last option if nothing else has worked is a caesarean section. The training is very specific in terms of timings and documentation.

The main risk, as another poster has already said is hypoxia for the baby. I genuinely can't fathom what series of events caused this to happen. This doctor has been registered for nearly 20 years, an expert by most standards I can think of.

Awful. Just awful

 

[tlcya]

A previous case of infant decapitation during childbirth from a few years back.
Mother relives the day her baby was decapitated during birth

and another: Doctor 'pulls baby's head off during childbirth while father watches'

 

[IceIce9]

my undertanding about the sequence of events is as follows: baby is set for vaginal delivery. The head is delivered but the shoulder is stuck in the delivery canal (shoulder dystocia). In attempts to force the shoulder from the birth canal and complete vaginal delivery suction was used to the baby's head (applied traction - against protocol). This "traction/suction decapitated the baby, meaning the head was delivered vaginally, the rest of the body remained inside mother. The mother was then rushed to a C-section where the now headless body was delivered.

The cover up ensued.

Shoulder dystocia occurs in approximately 1% of births and fairly often results in injuries to the baby and/or the mother. It is more commonly seen in overweight mothers, diabetic mothers, or mothers who experience a large amount of weight gain during pregnancy. But it is often seen in mothers who do not have any risk factors at all.

One situation I personally saw, a mother was delivering her second baby when shoulder dystocia occurred. The baby suffered fractures to her collarbones on both sides and a dislocated shoulder.

In this case there was no reason to suspect that the mother would experience a difficult birth as this was her second pregnancy, the first delivery was uneventful, and this second baby was smaller than the first.

When shoulder dystocia occurs the baby has to be delivered very quickly because it will suffer from lack of oxygen since the umbilical cord is squeezed.

I would like very much to learn all the facts of this case, as all we know is from the plaintiff’s attorneys.

JMO

 

[IDK]

This is horrific— it sounds like there is much more to the story. I have heard of the doctor having to break a baby’s clavicle to get them out when they are stuck, similar to what IceIce noted above, but nothing like this.
You have to wonder if the mom was being monitored appropriately during labor — sure doesn’t sound like it. So many questions.


The hospital’s statement also said the doctor named in the lawsuit “is not and never has been an employee of the hospital.” However, she must have privileges there? What exactly was her role, I wonder?

Baby decapitated during birth died in utero, metro Atlanta hospital claims; investigation continues

The infant's parents are suing Southern Regional Medical Center and those involved in his delivery at the Riverdale hospital.

www.atlantanewsfirst.com

 

[DS2021]

is that the medical professionals saved the life of the mother, by sacrificing the baby

Has it been established that her life was in danger?

 

[DS2021]

Shoulder Dystocia - an overview | ScienceDirect Topics

www.sciencedirect.com

Severe cases of shoulder dystocia may result in significant maternal morbidity (especially with more advanced maneuvers), hypoxic-ischemic encephalopathy, and even death

 

[IceIce9]

Has it been established that her life was in danger?

We haven’t heard anything from the hospital’s point of view.

The OBGYN has 26 years of experience.

Wondering if the mother had regular prenatal visits?

 

[fred&edna]

Isn't fetal heart rate monitoring fairly standard during hospital deliveries or has that fallen by the wayside?

I'm curious if the mother (or father) was aware that something terribly alarming was happening.

 

[Ray_of_hope]

Name: Tracey Lynn St Julian Designation: MD

Lic #: 54127 Profession: Physician Subtype: Full Status: Active Issued: 1/9/2004 Expires: 4/30/2025 Specialties Specialty/Subspecialty Certifying Board Primary Specialty? Obstetrics and Gynecology ABOG Y

Try going in from their home page cause it’s there:

Verify a Licensee

Verify a Licensee

medicalboard.georgia.gov

She's board certified so she's taken and passed the gold standard for a physician to practice.
Shoulder dystocia is a horrific emergency and called in OB just as a code would be called in the rest of the hospital population. Every available OB doctor and midwife will come rushing in along with anesthesia, respiratory therapists, NICU nurses and OB nurses. There's an algorithm that's followed and yearly team training wherever I've been practicing. Labor and delivery sounds like fun but it can be most unpredictable and dangerous because you do not see the infant but respond to fetal heart rates and patterns. There are risks to be assessed during mother assessments, fetal growth, medical history and patterns in labor regarding fetal HR and toco monitoring to assess how the baby is tolerating labor. Emergencies can occur at any time during labor and in a split second. So I'm waiting for more facts to surface like the infant's 'strip monitoring' and whether gold practice standards were followed. I can't imagine a more horrible circumstance and loss and I was totally upset after reading the article. My heart goes out to the parents. Totally heartbreaking. Overview of techniques to manage shoulder dystocia during vaginal birth

 

[Ray_of_hope]

Shoulder dystocia occurs in approximately 1% of births and fairly often results in injuries to the baby and/or the mother. It is more commonly seen in overweight mothers, diabetic mothers, or mothers who experience a large amount of weight gain during pregnancy. But it is often seen in mothers who do not have any risk factors at all.

One situation I personally saw, a mother was delivering her second baby when shoulder dystocia occurred. The baby suffered fractures to her collarbones on both sides and a dislocated shoulder.

In this case there was no reason to suspect that the mother would experience a difficult birth as this was her second pregnancy, the first delivery was uneventful, and this second baby was smaller than the first.

When shoulder dystocia occurs the baby has to be delivered very quickly because it will suffer from lack of oxygen since the umbilical cord is squeezed.

I would like very much to learn all the facts of this case, as all we know is from the plaintiff’s attorneys.

JMO

Agreed. And we were always taught that a broken clavicle and dislocated shoulder will heal, while death is permanent. Didn't know the mom's history. Interesting. Thank you for posting.
Just like CPR, a broken rib will heal. They hurt for sure but the alternative is worse.

 

[Ray_of_hope]

This is a simple visual so people will understand the issue better maybe. Hope it helps.

Google Search

 

[BeginnerSleuther]

Shoulder dystocia occurs in approximately 1% of births and fairly often results in injuries to the baby and/or the mother. It is more commonly seen in overweight mothers, diabetic mothers, or mothers who experience a large amount of weight gain during pregnancy. But it is often seen in mothers who do not have any risk factors at all.

One situation I personally saw, a mother was delivering her second baby when shoulder dystocia occurred. The baby suffered fractures to her collarbones on both sides and a dislocated shoulder.

In this case there was no reason to suspect that the mother would experience a difficult birth as this was her second pregnancy, the first delivery was uneventful, and this second baby was smaller than the first.

When shoulder dystocia occurs the baby has to be delivered very quickly because it will suffer from lack of oxygen since the umbilical cord is squeezed.

I would like very much to learn all the facts of this case, as all we know is from the plaintiff’s attorneys.

JMO

I agree, we need more information on exactly what went down in the room. In medical school, I had a delivery that turned out to be a shoulder dystocia. It's pure mayhem when this happens. I was shoved forcefully out of the way, two nurses literally jumped on the bed, the attending took my place and they all delivered an injured (but alive) baby and by the end, 5 other people were in the room to help. The whole thing happens very, very quickly.

The cover up wasn't right and I'd be curious to learn if they consulted the ethics committee or hospital chaplain. The parents deserved to know, horrific as it was. But I'm going to assume the incident itself was a very tragic medical outcome until there's reason to believe it was negligence or wrongdoing.

 

[BeginnerSleuther]

This is horrific— it sounds like there is much more to the story. I have heard of the doctor having to break a baby’s clavicle to get them out when they are stuck, similar to what IceIce noted above, but nothing like this.
You have to wonder if the mom was being monitored appropriately during labor — sure doesn’t sound like it. So many questions.


The hospital’s statement also said the doctor named in the lawsuit “is not and never has been an employee of the hospital.” However, she must have privileges there? What exactly was her role, I wonder?

Baby decapitated during birth died in utero, metro Atlanta hospital claims; investigation continues

The infant's parents are suing Southern Regional Medical Center and those involved in his delivery at the Riverdale hospital.

www.atlantanewsfirst.com

Relatively few doctors (especially OBs) are hospital "employees." They generally belong to a group practice that contracts with the hospital. There are exceptions to this of course -- hospitalists are hospital employees and work inpatient only and those working in academics may be employed by the hospital, a clinic or physician's organization owned by the hospital, and/or the affiliated medical school.

My guess is this OB was employed by a private practice and had admitting and delivery privileges at the hospital. JMO.

 

[IDK]

She's board certified so she's taken and passed the gold standard for a physician to practice.
Shoulder dystocia is a horrific emergency and called in OB just as a code would be called in the rest of the hospital population. Every available OB doctor and midwife will come rushing in along with anesthesia, respiratory therapists, NICU nurses and OB nurses. There's an algorithm that's followed and yearly team training wherever I've been practicing. Labor and delivery sounds like fun but it can be most unpredictable and dangerous because you do not see the infant but respond to fetal heart rates and patterns. There are risks to be assessed during mother assessments, fetal growth, medical history and patterns in labor regarding fetal HR and toco monitoring to assess how the baby is tolerating labor. Emergencies can occur at any time during labor and in a split second. So I'm waiting for more facts to surface like the infant's 'strip monitoring' and whether gold practice standards were followed. I can't imagine a more horrible circumstance and loss and I was totally upset after reading the article. My heart goes out to the parents. Totally heartbreaking. Overview of techniques to manage shoulder dystocia during vaginal birth

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.

 

[Fanboi92]

Omg as a father of 7 this is hard to see RIP baby boy.

 

[IceIce9]

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.

It is possible that the baby no longer had a heartbeat at the time the decision was made. JMO

 

[IDK]

It is possible that the baby no longer had a heartbeat at the time the decision was made. JMO

That makes sense. Are you thinking the decapitation was done purposely to save the mother’s life, or do you think the doctor did not realize how much force she was exerting? (Sorry to be so graphic, just trying to understand)