Hypoxic Ischemic Encephalopathy at Sinai Hospital Lawsuit

Stapleton v. Sinai Hospital

(Filed January 28, 2016)

Jurisdiction
  • Baltimore City
Defendants
  • Sinai Hospital of Baltimore
  • A Sinai/Wellbridge pediatrician
  • A Sinai/Wellbridge respiratory therapist
Hospitals Involved
  • Sinai Hospital
  • Greater Baltimore Medical Center
  • Children's Hospital of Pennsylvania
Summary of Plaintiff's Allegations

A 15-month-old girl becomes ill with a fever, tremors, and signs of a disconjugate gaze, which means her eyes are not turning the same way. Her parents take her to the emergency department at Greater Baltimore Medical Center. It is determined that the girl needs hospitalization in a Pediatric Intensive Care Unit ("PICU"), so she is transferred to Sinai Hospital.

During the first 8 days of her admission to the PICU of Sinai Hospital the girl develops seizures, the cause of which goes undiagnosed. As a result of those seizures, her respiratory status is affected. She is intubated on occasion and is given respiratory therapy to adjust and control her ventilator. After the girl goes more than 24 hours without a seizure, the doctors want to see if she can breathe without her tube, so they make a plan to remove it.

The Defendant doctor is the pediatric intensive care specialist assigned to the PICU. She evaluates the girl in the early evening, at shift change, and does not follow the plan her predecessors developed to remove the tube. She tells the girl's parents that she is going to dinner but assures them that she would be able to return promptly if paged.

While the Defendant doctor is at dinner, the girl dislodges her breathing tube. The Defendant doctor is paged and returns promptly to the hospital as she said she would. The Defendant doctor determines that the breathing tube should remain out. The Defendant Doctor once again leaves the hospital to get dinner, assuring the parents that she would be available if paged urgently.

Several hours later, the girl begins having difficulty breathing. The Defendant respiratory therapist is called for, who determines that there is no reason to change the plan for a trial extubation.

Shortly thereafter, the girl's pulse oxygen monitor begins dropping below normal. There are multiple readings of 0 (normal being above 93%). An alarm goes off when the girl's oxygen saturation levels and heart rate begin falling dramatically. No attempt is made to intubate her. The Defendant doctor is paged urgently, but does not return to the hospital for at least 50 minutes. When the Defendant doctor finally does return, she performs emergency intubation.

The doctors at Sinai PICU recommend that the girl be transferred to a hospital better able to care for her condition. The girl is transferred by helicopter to Children's Hospital of Pennsylvania (CHOP). At CHOP, an MRI reveals that the girl has suffered irreparable injury. To this day, she is unable to care for herself and likely never will.

The girl's parents filed a lawsuit in Baltimore City against Sinai Hospital, the doctor, and the respiratory therapist. They allege that the standard of care was violated when the defendants (1) failed to properly monitor the girl's condition, (2) failed to timely intubate the girl, (3) failed to call a health care provider to intubate the girl when the doctor did not respond promptly to the urgent page, (4) failed to provide oxygen to the girl in a timely manner. As a result of the Defendants' negligence, the girl has sustained serious and permanent injuries to her body and her parents have been and will be forced to incur significant medical expenses.

Negligence
  • Negligence in Child's SurgeryFailed to properly monitor the girl's condition
  • Failed to timely intubate the girl
  • Failed to call a health care provider to intubate the girl when the doctor did not respond promptly to the urgent page
  • Failed to provide oxygen to the girl in a timely manner.
Specific Counts Pled
  1. Injury to child
  2. Injury to parents
Plaintiff's Experts and Areas of Specialty
  • Steven D. Baisch - board certified in pediatrics and pediatric critical care medicine. A Clinical Professor of Pediatrics at the University of Minnesota at the time the suit was filed. Donates less than 10% of his time testifying in medical malpractice cases.
Additional Comments
  • It sounds like there are some holes in the medical records that the plaintiffs' expert had a hard time filling. Apparently, the original game plan was to keep an endotracheal tube for the night but then the child was extubated.
  • Many endotracheal tube malpractice cases involve the size of the tube - as we have here although the expert does not elaborate on why a 3.5 tube was inappropriate. Other commonly litigated issues are the positioning and placement of the tube, and the monitoring to see that the tube remains in place. There is no doubt that endotracheal intubation is a difficult procedure, and even the most skilled physicians often require multiple attempts to place an endotracheal tube.
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