A hospital in Georgia has agreed to pay a settlement to a family whose child suffers from disabilities resulting from exposure to Group B Streptococcus bacteria during birth. It has admitted negligence on the part of a physician who treated the mother in the emergency room and on the part of the obstetrician who saw the mother during a routine office visit shortly before the birth of the child.
The baby whose injuries prompted the lawsuit is the couple’s second child. The mother’s pregnancy and delivery of her first child were uncomplicated, and that child is healthy.
The problems with the birth that led to the lawsuit go back to Group B Streptococcus (GBS). GBS is a bacterium frequently present in the intestinal tracts of healthy people; estimates of how many people are colonized by GBS range from 8% to 30%. GBS can also be found in the genital and urinary tracts. It rarely causes illness in healthy adults, although it is among the bacteria that can cause urinary tract infections. In people with weakened immune systems, as well as in newborn babies, however, it can cause serious illness or even death.
GBS ascending from the vagina to the fetal membranes is a leading cause of stillbirth, regardless of whether the GBS reaches the fetus before or after the rupture of membranes. Thus, it is standard practice to test pregnant women for GBS around the 37th week of pregnancy, and to treat them with antibiotics during labor if they test positive. (Women who test positive for GBS are said to be “colonized” with the bacteria, rather than “infected” because they are usually asymptomatic.) Women who go into labor before they can be tested for GBS, either because of a lack of prenatal care or because they deliver prematurely, are given antibiotics prophylactically. It is not standard practice to administer antibiotics in the case of scheduled Caesarean births, because there is no rupture of membranes and therefore almost no chance for the mother’s vaginal bacteria to reach the baby.
In the case of the present lawsuit, the mother went to the emergency room of the defendant hospital in 2011, during her 35th week of pregnancy because she was experiencing preterm contractions; the hospital admitted her. The hospital did not have a labor and delivery unit at the time. The OBGYN doctor who treated the mother in the hospital ordered magnesium sulfate to halt the progress of labor. The physician also ordered intravenous antibiotics for the mother, to protect the baby from GBS in case the mother delivered. Ordering IV antibiotics in this case is within the standard of care, but the doctor breached the standard of care by failing to test the mother for GBS colonization before beginning the antibiotics.
The magnesium sulfate had the desired effect; the mother’s preterm contractions ceased, and she was released from the hospital. Several days after her discharge from the hospital, the mother went for a routine prenatal visit with another OBGYN employed by the same defendant hospital. As is standard practice for prenatal visits at this late stage of pregnancy, he tested the mother for GBS colonization, and the test results were negative. This doctor also breached the standard of care by accepting the negative test results at face value. He had access to the mother’s medical records, which indicated that she had been treated with Ampicillin, an antibiotic effective against GBS, several days earlier. The standard of care dictates that he should have retested her for GBS closer to delivery to rule out a false negative result.
On August 18, 2011, the mother gave birth at another hospital; she was 37 weeks pregnant, which is considered an early term birth. The doctors at the second hospital, which was also named as a defendant in the lawsuit, reviewed the mother’s medical records and determined that she did not need any more antibiotics to protect against GBS; this was also a breach of the standard of care. That evening, the mother gave birth to a daughter by vaginal delivery; the child appeared healthy at birth.
Within 24 hours of her birth, the child suffered a fever of 102 degrees; blood tests indicated GBS infection, and a test of her cerebrospinal fluid indicated meningitis, which is a common complication of GBS infection in neonates. Doctors determined that she contracted GBS after being exposed to the bacteria during birth. She suffered lifelong complications from the meningitis, including cerebral palsy, visual impairment, and developmental delays.
The family filed a lawsuit in 2013, when the severity of their daughter’s disabilities had been diagnosed. The lawsuit was scheduled for trial several times, but the trial was always delayed. In 2018, the defendants agreed to an undisclosed settlement amount, two weeks before a scheduled trial date. The mother, a registered nurse, did not return to work after the child’s birth and now spends her time helping her daughter manage her special needs. The child, now seven years old, is well cared for, but she requires extensive therapy and professional care. Thanks to the medical expert witnesses who worked tirelessly on her case, she can get the care she needs.
