Pitocin Induced Birth Injury Malpractice Questions & Answers

Contractions Lawsuits stemming from the negligent use of Pitocin almost always involve children who have suffered a brain injury or the death of the mother. The economic costs of caring for brain damages children are excluded from any damage cap in most states, including Maryland. This means this type of birth injury case often involves claims that claim at least several million dollars of damages and sometimes the damage claims can run north of $50 million. These are big cases where there is a lot at stake for everyone involved. This page is intended to help explain the medical-legal issues that arise with Pitocin.

What is Pitocin?

Pitocin is used to start or increase already present labor contractions during the delivery process. Pitocin is the synthetic version of oxytocin. A delivering mom already produces oxytocin. This drug just gives you more of that hormone. So Pitocin allows the mother to precisely stimulate a uterine contraction which in frequency, duration and intensity resemble a normal contraction.

How is Pitocin administered?

Pitocin in administered by IV.

What is the typical goal using Pitocin?

Pitocin is usually given to cause the uterus to get into an adequate contraction pattern. Usually, the goal is for the mother to have contractions every two to five minutes or so of regular frequency and adequate strength.

How can hyperstimulation with Pitocin cause a uterine rupture?

Yes, because there is either excessive force on the myometrium which is the smooth muscle tissue on the uterus. If the mother has contractions that are too frequent, this increases pressure on the uterus. This pressure makes the uterus thinner and increases the possibility of a rupture of the walls of the uterus.

The single most common symptom of uterine rupture is maternal tachycardia. Other symptoms include vaginal bleeding, stomach pain, and fetal bradycardia.

What is uteroplacental perfusion and does Pitocin increase the risk of it?

Uteroplacental perfusion is a decreased flow of fluid to and from the placenta. Like placental abruption, which is addressed in this next question, any compromise in the integrity of the placenta's connection to the child can cause a risk of harm.

Increasing the strength, frequency, and duration of the mother contractions with Pitocin can impede uterine blood flow.  This complication certainly does not necessarily mean that Pitocin should never have been given in the first place. But when you see tachycardia, bradycardia, decelerations or other nonreassuring fetal heart rate changes, you have to reconsider whether Pitocin is doing more harm to the child than good.

Placenta profusion can also cause arterial hardening. The result can be hypertension that causes pre-eclampsia which can cause serious injury or death to the baby and the mother.

What is placental abruption can misuse of Pitocin cause it?

Placental abruption is when the placenta separates from the wall of the uterus before childbirth. This can deprive the baby of food and oxygen. Pitocin can cause uterine overstimulation of the uterus, causing, or contributing to, placental abruption.

You know you have uterine hyperstimulation where there are strong tetanic contractions. These contractors can cause problems with decreased uteroplacental perfusion and can also cause uterine and placental rupture, cervical lacerations, and amniotic fluid embolus.

Uterine overstimulation can usually be managed quite effectively. But you have to identify the problem and remove Pitocin if you believe it may be causing the problem.

How long does it take Pitocin to work?

Pitocin can start working in just a few minutes or it might take longer depending largely on the dose and the patient's sensitivity to the the drug.

How quickly can the doctors "turn off" the effects of Pitocin?

Child During Delivery The half-life of Pitocin is about 3.5 minutes. This means Pitocin will cease to have an effect within 10 to 15 minutes and likely even sooner. So if Pitocin is pushing things too far the wrong way, withdrawing the Pitocin can bring it back. But the key is turning off the Pitocin when the circumstances demand it. Continuing to administer Pitocin despite a persistent, nonreassuring fetal heart pattern in the origin of many birth injury medical malpractice claims.

If the baby is in distress, it is good enough just to decrease the dosage of Pitocin the mother is receiving?

If the baby has just a mild or intermittent variable deceleration pattern, just reducing Pitocin might be completely appropriate. If the baby is in serious distress, it is hard to argue that just reducing the Pitocin is appropriate and will solve the problem.

What is the best way to monitor whether Pitocin is doing more harm than good?

Ultimately, doctors and nurses need to watch both the baby and the mother. If a doctor is going to prescribe Pitocin, it is incumbent upon them to have constant external or internal monitoring of the fetal heart rate and observation of any non-reassuring fetal heart rate patterns, particularly late decelerations. Too often, you have a situation where the fetal monitor is showing late decelerations or other signs of distress, or contractions are 5 or more in 10 minutes, firm, or last longer than 90 seconds. This is the baby telling the health care providers to stop the Pitocin and take steps to quiet the uterus. Sometimes, the breakdown is that the nurses are asleep at the switch. But, often in these cases, nurses sound the appropriate alarms and the doctor is rolling his eyes because he thinks the nurse if overreacting.

Are there rules the doctors and nurses should follow in prescribing Pitocin?

Most hospitals have Pitocin protocols to be followed by OB/GYNs and labor and delivery nurses. What is maddening is how blithely these doctors will contend during that litigation process that it is okay to ignore these protocols.

What is the nurse's role in handling the Pitocin?

The nurse has a bigger role than you would think. The nurse has to be able to read the strips and understand the pharmacokinetics of this drug. But what surprises people is the nurse's independent obligation to do the right thing. The nurse has a duty to follow written protocols and exercise independent judgment by questioning the doctor's orders. If the doctor will not do what the nurse believes is proper, the nurse has to be a patient advocate and follow the hospital's change of command. This usually requires her to start with her direct supervisor and take it all the way up the chain to the physician head of the department, if necessary. If the nurse does not act as the patient's advocate in this way, the nurse can also be liable in a medical malpractice lawsuit brought by the child or mother.

Getting a Lawyer for Your Malpractice Claim

If your child has suffered a birth injury and you believe the failure to discontinue Pitocin could have been a contributing cause to the harm done to your child, call Ron Miller or Laura Zois today and let's talk about your options. 

Our law firm has a track record of success in wrongful death and catastrophic injury cases. We can help you and your child get the compensation you need and deserve. Call Miller & Zois today and speak to our birth injury medical malpractice attorneys at 800-553-8082 or get an online case evaluation.

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