Example Cerebral Palsy Complaint in Pennsylvania Part 1 of 8

IN THE COURT OF COMMON PLEAS
STONELEIGH COUNTY, PENNSYLVANIA

MOTHER PLAINTIFF and
FATHER PLAINTIFF, Individually
and as Parents and Natural Guardians
of BABY PLAINTIFF, a Minor
Plaintiffs,

v.

STONELEIGH HOSPITAL,
GOODLIFE HEALTH,
GOODLIFE MEDICAL GROUP, t/d/b/a
GOODLIFE MATERNAL-FETAL
MEDICINE,
A, D.O.,
DOC S, D.O.,
DOC F, M.D.,
DOC C, D.O.,
DOC N, M.D.,
NURSE H, R.N.,
NURSE P, R.N.,
NURSE G, R.N.,
NURSE R, R.N., and
NURSE M, R.N.

Defendants.

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No.:
CIVIL ACTION—
MEDICAL PROFESSIONAL
LIABILITY ACTION

JURY TRIAL DEMANDED

COMPLAINT

AND NOW, TO WIT, this ________ day of June, 2019, comes the Plaintiffs, Mother Plaintiff, individually, and as the mother and natural guardian of Baby Plaintiff, a minor, and Father Plaintiff, individually, and as the father and natural guardian of Baby Plaintiff, a minor, by and through their attorneys and files the following Complaint upon a cause of action whereof the following is a statement:

PARTIES

1. Mother Plaintiff (hereinafter “Ms. Plaintiff”), as parent and natural guardian of Baby Plaintiff, a minor, is an adult individual who resides in Stoneleigh, Pennsylvania.
2. Father Plaintiff (hereinafter “Mr. Plaintiff”), as parent and natural guardian of Baby Plaintiff, a minor, is an adult individual who resides in Stoneleigh, Pennsylvania.
3. Baby Plaintiff (hereinafter “Baby Plaintiff”), is a minor individual residing with her mother Mother Plaintiff in Stoneleigh, Pennsylvania.
4. Defendant Stoneleigh Hospital is a Pennsylvania non-profit corporation and a licensed medical facility with offices in Stoneleigh County, Pennsylvania and specifically has a business located in Stoneleigh, Pennsylvania. Plaintiff is asserting a professional liability claim against this Defendant.
5. Defendant GoodLife Health is a Pennsylvania non-profit corporation and a licensed medical facility with offices in Stoneleigh County, Pennsylvania and specifically has a business located in Stoneleigh, Pennsylvania. Plaintiff is asserting a professional liability claim against this Defendant.
6. Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine is a Pennsylvania non-profit corporation and a licensed medical facility with offices in Stoneleigh County, Pennsylvania and specifically has a business located in Stoneleigh, Pennsylvania. Plaintiff is asserting a professional liability claim against this Defendant.
7. Doc A, D.O., at all times relevant hereto was a doctor of osteopathic medicine, licensed in the Commonwealth of Pennsylvania, and holding himself out as having special training and qualifications in obstetrics, gynecology, and maternal-fetal medicine. At all times relevant hereto, this Defendant was an agent, ostensible agent, employee, officer, and servant of Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, Defendant GoodLife Health, and/or Defendant Stoneleigh Hospital. Plaintiff is asserting a professional liability claim against this Defendant.
8. Doc S, D.O., at all times relevant hereto was a doctor of osteopathic medicine, licensed in the Commonwealth of Pennsylvania, and holding himself out as having special training and qualifications in obstetrics, gynecology, and maternal-fetal medicine. At all times relevant hereto, this Defendant was an agent, ostensible agent, employee, officer, and servant of Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, GoodLife Health, and/or Defendant Stoneleigh Hospital. Plaintiff is asserting a professional liability claim against this Defendant.
9. Doc F, M.D., at all times relevant hereto was a doctor of medicine, licensed in the Commonwealth of Pennsylvania, and holding herself out as having special training and qualifications in obstetrics and gynecology. At all times relevant hereto, this Defendant was an agent, ostensible agent, employee, officer, and servant of Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, Defendant GoodLife Health, and/or Defendant Stoneleigh Hospital. Plaintiff is asserting a professional liability claim against this Defendant.
10. Doc C, D.O., at all times relevant hereto was a doctor of osteopathic medicine, licensed in the Commonwealth of Pennsylvania, and holding herself out as having special training and qualifications in obstetrics and gynecology. At all times relevant hereto, this Defendant was an agent, ostensible agent, employee, officer, and servant of Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, Defendant GoodLife Health, and/or Defendant Stoneleigh Hospital. Plaintiff is asserting a professional liability claim against this Defendant.
11. Doc N, M.D., at all times relevant hereto was a doctor of medicine, licensed in the Commonwealth of Pennsylvania, and holding himself out as having special training and qualifications in obstetrics and gynecology. At all times relevant hereto, this Defendant was an agent, ostensible agent, employee, officer, and servant of Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, Defendant GoodLife Health, and/or Defendant Stoneleigh Hospital. Plaintiff is asserting a professional liability claim against this Defendant.
12. Nurse H, R.N., at all times relevant hereto was a registered nurse, licensed in the Commonwealth of Pennsylvania, and holding herself out as having special training and qualifications in obstetrical and gynecological nursing. At all times relevant hereto, this Defendant was an agent, ostensible agent, employee, officer, and servant of Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, Defendant Stoneleigh Hospital, and/or Defendant GoodLife Health. Plaintiff is asserting a professional liability claim against this Defendant.
13. Nurse P, R.N., at all times relevant hereto was a registered nurse, licensed in the Commonwealth of Pennsylvania, and holding herself out as having special training and qualifications in obstetrical and gynecological nursing. At all times relevant hereto, this Defendant was an agent, ost
    ensible agent, employee, officer, and servant of Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, Defendant Stoneleigh Hospital, and/or Defendant GoodLife Health. Plaintiff is asserting a professional liability claim against this Defendant.
14. Nurse G, R.N., at all times relevant hereto was a registered nurse, licensed in the Commonwealth of Pennsylvania, and holding herself out as having special training and qualifications in obstetrical and gynecological nursing. At all times relevant hereto, this Defendant was an agent, ostensible agent, employee, officer, and servant of Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, Defendant Stoneleigh Hospital, and/or Defendant GoodLife Health. Plaintiff is asserting a professional liability claim against this Defendant.
15. Nurse M, R.N., at all times relevant hereto was a registered nurse, licensed in the Commonwealth of Pennsylvania, and holding herself out as having special training and qualifications in obstetrical and gynecological nursing. At all times relevant hereto, this Defendant was an agent, ostensible agent, employee, officer, and servant of Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, Defendant Stoneleigh Hospital, and/or Defendant GoodLife Health. Plaintiff is asserting a professional liability claim against this Defendant.
16. Nurse R, R.N., at all times relevant hereto was a registered nurse, licensed in the Commonwealth of Pennsylvania, and holding herself out as having special training and qualifications in obstetrical and gynecological nursing. At all times relevant hereto, this Defendant was an agent, ostensible agent, employee, officer, and servant of Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, Defendant Stoneleigh Hospital, and/or Defendant GoodLife Health. Plaintiff is asserting a professional liability claim against this Defendant.
17. At all times relevant hereto, the employees, agents, servants, including physicians, physician assistants, nurse practitioners, residents, fellows, nurses, nurse midwives, and technicians who provided care to Mother Plaintiff and her unborn twins (including Baby Plaintiff) between February 11, 2017 and February 18, 2017, including, but not limited to, Dr. A, Dr. S, Dr. F, Dr. C, Dr. N, Nurse Hon, Nurse P, Nurse G, Nurse M, and Nurse R were under the control and were acting within the course and scope of their employment and/or ostensible agency and/or professional relationship with Defendant Stoneleigh Hospital.
18. At all times relevant hereto, the employees, agents, servants, including physicians, physician assistants, nurse practitioners, residents, fellows, nurses, nurse midwives, and technicians who provided care to Mother Plaintiff and her unborn twins (including Baby Plaintiff) between June 16, 2017 and June 20, 2017, including, but not limited to, Dr. A, Dr. S, Dr. F, Dr. C, Dr. N, Nurse Hon, Nurse P, Nurse G, Nurse M, and Nurse R were under the control and were acting within the course and scope of their employment and/or ostensible agency and/or professional relationship with Defendant GoodLife Health.
19. At all times relevant hereto, the employees, agents, servants, including physicians, physician assistants, residents, fellows, nurses, nurse midwives, and technicians who provided care to Mother Plaintiff and her unborn twins (including Baby Plaintiff) between June 16, 2017 and June 20, 2017, including, but not limited to, Dr. A, Dr. S, Dr. F, Dr. C, Dr. N, Nurse Hon, Nurse P, Nurse G, Nurse M, and Nurse R were under the control and were acting within the course and scope of their employment and/or ostensible agency and/or professional relationship with Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine.
20. At all times relevant hereto, Defendants, and each of them, individually or by and through their agents and employees, or as a joint venture, assumed the responsibility for the diagnosis, care, and treatment of Mother Plaintiff and her unborn twins (including Baby Plaintiff).

FACTS COMMON TO ALL COUNTS

21. Throughout the course of her pregnancy, Mother Plaintiff followed the prenatal care and advice given to her by Defendants and their employees, agents, and/or ostensible agents.
22. On December 20, 2016, Mother Plaintiff was diagnosed via ultrasound with monochorionic diamniotic twins. In layman’s terms, these are twins that have two separate umbilical cords, but share a common placenta. For purposes of this Complaint, the twins will be referred to as twin A and twin B.
23. For her twin pregnancy, Ms. Plaintiff received all of her regular (meaning “non-high risk”) obstetrical and gynecological care from Defendant Stoneleigh Hospital t/d/b/a GoodLife Stoneleigh Hospital OB/GYN.
24. On January 19, 2017, Ms. Plaintiff began seeing GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine (hereinafter referred to “Maternal-Fetal Medicine”) for management of her high-risk pregnancy. Because Ms. Plaintiff was pregnant with monochorionic diamniotic twins, she was at high risk for severe complications including fetal hypoxia, preterm delivery, fetal death, intrauterine growth restriction, hypertension, and utero-placental insufficiency, among other things.
25. Maternal-fetal medicine physicians, nurses, physician assistants, nurse practitioners, and nurse midwives specialize in the care and treatment of high-risk pregnancies. Maternal-fetal medicine physicians care for women who face unexpected problems that develop during pregnancy, such as early labor, growth restriction, and hypertension.
26. Initially, Ms. Plaintiff was seen by maternal-fetal medicine every two weeks for surveillance of twin-twin transfusion syndrome, fetal well-being, fetal development, and evaluation of utero-placental insufficiency.
27. Ms. Plaintiff kept all of her maternal-fetal medicine appointments and complied with all of her healthcare providers’ recommendations.
28. On April 6, 2017, the maternal-fetal medicine clinic employee/agents performed an ultrasound and fetal heart monitoring on Ms. Plaintiff. The ultrasound demonstrated reduced umbilical artery blood flow and fetal cardiac arrhythmia for twin B.
29. Ms. Plaintiff had another ultrasound at maternal-fetal medicine on May 18, 2017, at 29 weeks and 2 days gestation. This ultrasound diagnosed both twins with intrauterine growth restriction (hereinafter referred to as “IUGR”). IUGR is condition where a fetus is smaller than expected for their gestational age or the number of weeks of pregnancy. IUGR is caused by utero-placental insufficiency, which is the poor transfer of nutrients and oxygen between the mother’s uterus and the placenta.
30. On May 18, 2017, both twins had biometric measurements and fetal weight consistent with the 6th percentile. Twin A was 1,131 grams and twin B was 1,129 grams. This means they were smaller than 94% of all other fetuses for the same gestational age.
31. Given the number weeks she was pregnant and the presence of IUGR, Ms. Plaintiff was told to follow up twice weekly with maternal-fetal medicine for antenatal testing for the remainder of her pregnancy.
32. On May 23, 2017, maternal-fetal medicine performed a non-stress test that revealed fetal heart rate variable decelerations with twin B, with two variable decelerations lasting 1-2 minutes down to the 130s for one and down to 120s with the second. As a result, Ms. Plaintiff was sent to labor and delivery at Stoneleigh Hospital for continued monitoring. Although these decelerations were further evidence of utero-placental insufficiency, the healthcare providers at Stoneleigh Hospital performed fetal heart monitoring for a couple of hours and discharged Ms. Plaintiff
    home the same day.
33. An ultrasound on June 2, 2017, measured twin A at 1,453 grams and twin B at 1,508 grams. According to this test, twin A was in the 6th percentile for gestational age and twin B was in the 9th percentile. A follow up evaluation for fetal growth was set for 34 and 3/7 weeks gestation; however, that evaluation never took place because the twins were emergently delivered at 34 weeks gestation on June 20, 20
34. On June 9, 2017, maternal-fetal medicine performed a biophysical profile of the twins. At this point, Ms. Plaintiff was 32 weeks and 3 days pregnant and reported leakage of fluid and decreased overall fetal movements. Fetal heart monitoring indicated that twin B was non-reactive to the mother’s contractions. As a result, Ms. Plaintiff was sent to the labor and delivery unit at Stoneleigh Hospital.
35. At Stoneleigh Hospital on June 9, 2017, Ms. Plaintiff was admitted and evaluated by maternal fetal medicine fellow Dr. A. At all times relevant hereto, Dr. A was an employee/agent/ostensible agent for Defendant GoodLife Medical Group, t/d/b/a GoodLife Maternal-Fetal Medicine, Defendant GoodLife Health, and Defendant Stoneleigh Hospital. While being monitored at Stoneleigh hospital, Dr. A and the nursing staff noted one of the twins was experiencing late decelerations, which was evidence of utero-placental insufficiency. Despite this evidence, Ms. Plaintiff was discharged from the hospital several hours later.
36. On June 16, 2017, the employees at maternal-fetal medicine performed a biophysical profile of Ms. Plaintiff’s twins. The sonographer discovered Ms. Plaintiff had elevated blood pressure of 140/90 and protein +1 in her urine. Concerned about preeclampsia, the sonographer called the charge nurse at Stoneleigh Hospital and the Obstetrician on call. She told Ms. Plaintiff to go to Stoneleigh Hospital labor and delivery for follow up of her hypertension and proteinuria.
37. At the time he saw Ms. Plaintiff on June 16, 2017, Dr. A was a fellow in the GoodLife maternal-fetal medicine fellowship program. He worked at Stoneleigh Hospital and at GoodLife maternal-fetal medicine offices throughout Pennsylvania. At all times relevant hereto, Dr. A was directly supervised by Dr. S, another maternal-fetal medicine physician. Both Dr. A and Dr. S saw Ms. Plaintiff on multiple occasions from December 2016 until June 16, 20 According to the medical records, Dr. S was aware of Dr. A’s assessment and plan on June 17, 2017 and June 18, 2017, as he signed off on this in the patient’s medical chart approximately two weeks later.
38. At all times relevant hereto, Dr. A and Dr. S had direct knowledge of Ms. Plaintiff’s high-risk pregnancy and medical history. Both physicians had seen and evaluated Ms. Plaintiff at the GoodLife Maternal-Fetal medicine on several occasions prior to June 16, 20 Both physicians were aware of her current pregnancy, her medical history (including prior non-stress tests and biophysical profiles), and her risk for complications. Prior to June 16, 2017, both physicians knew or should have known that Ms. Plaintiff displayed direct evidence of IUGR and utero-placental insufficiency.
39. On June 16, 2017, Ms. Plaintiff arrived at Stoneleigh Hospital complaining of a nausea, vomiting, and headaches for the past three days. These signs and symptoms were further evidence of utero-placental insufficiency and hypertension. Significantly, Ms. Plaintiff never complained of headaches during any prior visits or evaluations. On June 16, 2017, Ms. Plaintiff also had protein in her urine and elevated blood pressure. She was immediately placed on continuous fetal heart monitoring, which showed late decelerations and periods of non-reactivity consistent with utero-placental insufficiency and hypoxia with both twins. She was admitted to Stoneleigh hospital with orders for lab work and 24 urine protein to investigate preeclampsia.
40. While at Stoneleigh Hospital from June 16, 2017 until approximately 2pm on June 17, 2017, Ms. Plaintiffs’ twins were placed on continuous fetal heart monitoring.
41. The Defendant nurse employee/agents responsible for reviewing the fetal heart strips, and communicating their findings to the physicians and other healthcare providers, during this period of time, included, but was not limited to, Nurse G, Nurse R, and Nurse H. Nurse G, Nurse R, and Nurse H and the other nurses involved in Ms. Plaintiffs’ care were at all times employee/agents/ostensible agents of Defendant GoodLife Health and Defendant Stoneleigh Hospital.
42. Despite regularly reviewing the fetal heart strips from June 16, 2017 until the approximately 2pm on June 17, 2017, Nurse G, Nurse R, Nurse H, and the hospital employee/agents/ostensible agents failed to appreciate that both twins demonstrated multiple late decelerations as well as periods of non-reactivity consistent with utero-placental insufficiency and IUGR. In addition, the nurses and hospital employee/agents failed to chart these decelerations in the medical record as well as communicate their findings to other healthcare providers, including, but not limited to the obstetricians and maternal-fetal medicine physicians at the hospital. The nurses and hospital employee/agents also failed to take any remedial action in response to the late decelerations such as changing maternal position and/or placing Ms. Plaintiff on oxygen. They also failed to perform any additional testing to identify the nature and extent of the utero-placental insufficiency.
43. From June 16, 2017 until June 17, 2017, Nurse G, Nurse R, Nurse H, and the hospital employee/agents/ostensible agents caring for Ms. Plaintiff failed to follow Stoneleigh Hospital’s policies and procedures regarding the charting, documentation, and communication of late decelerations on fetal heart strips. Moreover, Nurse G, Nurse R, Nurse H, and the hospital employee/agents/ostensible agents failed to follow Stoneleigh’s Hospital policies and procedures regarding communicating this information to other healthcare providers.
44. None of the nurses went up the chain of the command to report this information to a supervising nurse, especially since the physicians at Stoneleigh Hospital were not taking any action in response to the utero-placental insufficiency by investigating the cause of the problem. Had the nurses gone up the chain of command, additional steps such as a contraction stress test would have been taken to identify the nature and extent of Ms. Plaintiff’s utero-placental insufficiency. Moreover, had the nurses communicated the findings on the fetal heart strips to the physicians at Stoneleigh Hospital, including, but not limited to, Dr. A and Dr. S, the physicians would have had a more complete picture of the nature and extent of the utero-placental insufficiency experienced by Ms. Plaintiff’s twins and they would not have discharged her from the hospital on June 18, 20
45. On June 17, 2017, an order was placed for Ms. Plaintiff to receive two doses of Betamethasone. Betamethasone is a steroid that helps with utero-placental insufficiency and to develop a baby’s lungs if born prematurely. Only one dose of betamethasone was given on June 17, 2017, with a second dose scheduled for June 18, 20 The second dose was never administered, even though the nurses and physicians knew this would be helpful in preventing utero-placental insufficiency and to prevent respiratory distress if the baby was born prematurely.
46. Maternal-fetal medicine fellow Dr. A evaluated Ms. Plaintiff at Stoneleigh Hospital on June 17, 2017, at approximately 11:35am. Dr. A noted that Ms. Plaintiff was suffering from gestational hypertension with growth restricted twins; however, he failed to appreciate the significance of these findings and the evidence that both twins were suffering from utero-placental insufficiency. He also failed to rea
    lize that one twin (twin A) was growing discordantly from the other twin (twin B), which was further evidence of utero-placental insufficiency and that twin A was now obtaining oxygen and nutrients from a smaller section of the placenta compared to twin B. As a result of failing to appreciate the significance of her condition, Dr. A removed Ms. Plaintiff from continuous fetal heart monitoring on June 17, 20 Dr. S reviewed Dr. A’s note and approved Dr. A’s plan of medical care for Ms. Plaintiff.
47. From June 16, 2017 until her discharge on June 18, 2017, Ms. Plaintiff experienced multiple episodes of elevated blood pressure, including one reading as high as 168/ Her elevated blood pressure from June 16, 2017 until June 18, 2017 was further evidence of utero-placental insufficiency.
48. Defendant Stoneleigh Hospital nurses and physician employees, including, but not limited to Nurse H, Nurse P, Nurse G, and Nurse R, knew or should have known that these elevated blood pressures were dangerous for patients such as Ms. Plaintiff who was pregnant with twins and posed an additional risk of hypoxia and injury for Ms. Plaintiff and her unborn twins.
49. Defendant Maternal Fetal Medicine physician employees, including, but not limited to Dr. A and Dr. S, knew or should have known that these elevated blood pressures were dangerous for patients such as Ms. Plaintiff who were pregnant with twins and suffering from additional complications such as IUGR and utero-placental insufficiency.
50. On the evening of June 17, 2017, Ms. Plaintiff complained of a continuing headache despite receiving pain medication. These headaches were further evidence of utero-placental insufficiency and hypertension.
51. The morning of June 18, 2017, Ms. Plaintiff was again placed on the fetal heart monitor for approximately 50 minutes. During that time, the fetal heart strips showed the twins were having decelerations, which was evidence of utero-placental insufficiency. Both Nurse P and Nurse H were monitoring the fetal heart strips during this period of time.
52. The Defendant employees/agents/ostensible agents at Stoneleigh Hospital who were caring for Ms. Plaintiff, including, but not limited to, Nurse H and Nurse P, knew or should have known that the fetal heart strips on June 18, 2017 showed evidence of utero-placental insufficiency. This information should have been documented and communicated to the physicians and maternal-fetal medicine physicians at Stoneleigh Hospital. Had the nurses communicated the findings on the fetal heart strips to the physicians at Stoneleigh Hospital, including, but not limited to, Dr. A and Dr. S, the physicians would have had a more complete picture of the nature and extent of the utero-placental insufficiency experienced by Ms. Plaintiff’s twins and they would not have discharged her from the hospital on June 18, 20 Moreover, the nurses also failed to go up the chain of command. Had the nurses gone up the chain of command, additional steps such as a contraction stress test would have been taken to identify the nature and extent of Ms. Plaintiff’s utero-placental insufficiency and she would not have been discharged from the hospital.
53. The Defendant maternal-fetal medicine physicians, including, but not limited to, Dr. A and Dr. S, knew or should have known that the fetal heart strips on June 18, 2017, showed evidence of utero-placental insufficiency and significant IUGR.
54. At approximately 7am on June 18, 2017, Ms. Plaintiff was seen and evaluated again by Dr. A and Dr. S. Dr. A charted that Ms. Plaintiff was suffering from gestational hypertension and IUGR. Despite this, Dr. A determined Ms. Plaintiff was not suffering from preeclampsia and decided to discharge her home from the hospital. Upon discharge, Dr. A advised Ms. Plaintiff to get a blood pressure cuff to keep track of her blood pressure, which is further evidence that Dr. A was aware of the danger that existed for Ms. Plaintiff if she was discharged unmonitored from the hospital.
55. At the time she was discharged, Dr. A wrote that he was planning to deliver Ms. Plaintiff at “36 1/7 weeks.” At the time Dr. A made the decision to discharge Ms. Plaintiff from Stoneleigh Hospital, he failed to realize that one of the twins (twin A) was not growing as expected and in fact was growing discordantly from the other twin (twin B). An ultrasound was performed on June 18, 2017 at Stoneleigh Hospital prior to discharge, but failed to address growth or fetal weight. The lack of growth, in addition to the IUGR, gestational hypertension, and fetal heart strip abnormalities, were all evidence of utero-placental insufficiency. Had Dr. A understood and appreciated these findings, he would not have discharged Ms. Plaintiff from the hospital on June 18, 20
56. According to a note signed by Dr. S dated July 6, 2017, Dr. S agreed with Dr. A’s assessment and plan to discharge Ms. Plaintiff from Stoneleigh Hospital.
57. In another note in the Stoneleigh Hospital medical chart from Ms. Plaintiff’s June 20, 2017 admission, Dr. S is identified as having disagreed with his fellow Dr. A’s decision to discharge Ms. Plaintiff form the hospital on June 18, 20 Nevertheless, Ms. Plaintiff was discharged from the hospital on June 18, 20
58. Both Dr. S and Dr. A failed to appreciate the severity of Ms. Plaintiff’s medical condition when she was discharged from Stoneleigh Hospital on June 18, 2017, which included being pregnant with twins suffering from a combination of IUGR (including discordant growth), gestational hypertension, and utero-placental insufficiency. This failure constitutes a breach of the standard of care and subjected Ms. Plaintiff’s twins to severe and permanent injury.
59. Both Dr. S and Dr. A failed to appreciate that there was no benefit to continuing with Ms. Plaintiff’s pregnancy given the twins’ gestational age (approximately 34 weeks) and Ms. Plaintiff’s current pregnancy complications.
60. At all times relevant hereto, Defendants knew or should have known that Ms. Plaintiff was pregnant with monochorionic diamniotic twins and at high risk for pregnancy complications when she was sent to the hospital on June 16, 20
61. At all times relevant hereto, Defendants knew or should have known that Ms. Plaintiff was suffering from pregnancy complications such as gestation hypertension, IUGR, and utero-placental insufficiency while she was admitted to Stoneleigh Hospital from June 16, 2017 until June 18, 20
62. At all times relevant hereto, Defendants knew or should have known that Ms. Plaintiff was experiencing signs and symptoms of utero-placental insufficiency, including, but not limited to, headaches, nausea, vomiting, hypertension, and IUGR while she was admitted to Stoneleigh Hospital from June 16, 2017 until June 18, 20
63. At all times relevant hereto, Defendants knew or should have known that utero-placental insufficiency, IUGR, and gestational hypertension could be fatal to Ms. Plaintiff’s twins (including Baby Plaintiff) if not investigated and treated.
64. At all times relevant hereto, Defendants knew or should have known that utero-placental insufficiency, IUGR, and gestational hypertension could cause serious hypoxic injury, including, but not limited to, permanent organ damage and brain injury to Ms. Plaintiff’s twins (including Baby Plaintiff) if not investigated and treated.
65. At all times relevant hereto, Defendants knew or should have known that high-risk pregnancy patients such as Ms. Plaintiff who are suffering from pregnancy complications such as utero-placental insufficiency, IUGR, and gestational hypertension at 34 weeks gestation require continuous monitoring and surveillance for worsening of their condition and signs and symptoms of fetal hypoxia and injury.
66. Both Dr. S and Dr. A discharged Ms. Plaintiff from the hospital without apprec
    iating the risk of permanent injury and harm from hypoxia to Ms. Plaintiff’s twins if she was left undelivered and/or unmonitored, especially since her pregnancy would not continue for another week. They also failed to appreciate the risk of permanent injury since head and/or body cooling to treat hypoxic injury (including brain injury) was not available for a child born at less than 35 weeks gestation per Stoneleigh Hospital protocol. In addition, Ms. Plaintiff underwent an ultrasound on June 18, 2017; however, the ultrasound technician, and the physicians who reviewed the ultrasound, including, but not limited to, Dr. A, Dr. S, and Dr. F failed to appreciate that the ultrasound did not measure fetal growth. Had the ultrasound technician measured fetal growth, they would have realized that twin A and twin B were growing discordantly. Moreover, they would have realized that twin A was growing at a much slower rate, which was approximately in the fourth percentile for gestational age. This was evidence of significant utero-placental insufficiency affecting the health of twin A that subjected the twin to substantial risk of hypoxic injury if not investigated and treated.
67. Dr. S, Dr. F, Dr. A, and the other healthcare providers at Stoneleigh Hospital discharged Ms. Plaintiff from Stoneleigh Hospital when the twins could have easily been delivered by cesarean section on June 18, 20 Alternatively, on June 18, 2017, Dr. S, Dr. F, Dr. A, and the other healthcare providers at Stoneleigh Hospital, could have admitted Ms. Plaintiff and kept her at Stoneleigh Hospital for continuous monitoring until her delivery. Had Ms. Plaintiff’s twins been delivered on June 18, 2017, or if she was kept at the hospital for continuous fetal monitoring until her delivery, her twins (including Baby Plaintiff) would not have suffered hypoxic injury, including, but not limited to, a permanent brain injury.
68. Ms. Plaintiff continued to have elevated blood pressure on June 18, 20 This was a sign and symptoms of gestational hypertension and utero-placental insufficiency.
69. Prior to discharge, Ms. Plaintiff was also seen and evaluated by Dr. F, an obstetrics and gynecology resident at Stoneleigh Hospital. On June 18, 2017, she discharged the patient without appreciating the severity of her medical condition that included but was not limited to IUGR, gestational hypertension, and utero-placental insufficiency (which was a sign of hypoxia). On June 18, 2017, Dr. A co-signed Dr. F’s discharge summary, indicating that he agreed with the plan to discharge the patient.
70. Dr. F, Dr. A, Dr. S, Nurse H, Nurse P, and the other healthcare providers and employees/agents/ostensible agents at Stoneleigh Hospital, discharged Ms. Plaintiff from Stoneleigh Hospital without realizing that she did not obtain her second dose of betamethasone, which would have assisted with developing the twins’ lungs and preventing utero-placental insufficiency.