A massive $10 million jury award to a plaintiff in Florida presents a dilemma to ambulance services called on to transfer patients in labor from one hospital facility to a specialty care facility. On Sept. 21, 2003, EVAC Ambulance, a respected high-performance EMS agency, was dispatched to handle this inter facility transfer of a patient in labor and the crew responded with a duty to act as they would have to the home of a patient in labor.
The paramedic in charge was advised that the patient was 25-26 weeks pregnant and had been experiencing contractions approximately four minutes apart. The transferring physician reported the patient's cervix was minimally dilated. An emergency transport was initiated and approximately fifteen minutes into the transport, the patient began experiencing contractions three minutes apart -- lasting 30 seconds in duration.
Moments later, the patient's amniotic sac ruptured and immediately following the sac rupture, the infant presented in the breech mode. The infant was successfully delivered, wrapped in a silver swaddler and ventilatory support was started. Due to the infant's mottled skin color and flaccid condition, immediate CPR was started and continued for approximately eight minutes until the infant's color improved, had slight movement and a weak cry. The mother and premature newborn were diverted to Central Florida Regional Hospital in Sanford for stabilization where they were further treated. The infant was transferred to Arnold Palmer Hospital in Orlando and treated in their Neonatal Intensive Care Unit.
This was a premature baby 25-26 weeks' gestation. A pregnancy of normal gestation is approximately 40 weeks, with a normal range of 38 to 42 weeks. Infants born before 37 weeks are considered premature.
This was an ELBWI. (extra-low birth weight infant) 780 grams (1.7 pounds); The size of the paramedic's hand. The norm for a newborn is 7-8 lbs.
In 2003, the mortality and morbidity rate for this type of birth was 50%.
According to court records, the patient s mother had a sick placenta with necrotizing deciduitis and chorangiosis and inter-villous thrombi.
The woman in labor was technically the responsibility of the first (transferring) hospital, which elected to transfer her to a specialty center. The transferring hospital did not send a nurse and/or physician along with the EVAC crew and, while in transit to the specialty center, the woman gave birth to a premature infant. In this case, the paramedic involved was honored for the care rendered to the child delivered prematurely while in transit to the specialty center. The patient was resuscitated, according to EVAC, state and national guidelines. However, the jury elected to hold EVAC negligent based on the newborn suffering a lack of oxygen to the brain and then suffering from cerebral palsy.
DeLAND A Volusia jury has awarded $10 million to a Volusia County woman, finding EVAC Ambulance service at fault for the injuries her son received during his premature birth in 2003.
After a two-week trial, the jury decided last week that the company was negligent for transporting Margarita Chess, an Edgewater woman who gave birth to her son in the ambulance while en route to Arnold Palmer Hospital for Children in Orlando.
Addison Chess, now 6, weighed 1.7 pounds at birth and suffered a lack of oxygen to the brain, leaving him with cerebral palsy.
The mother's attorney, Bob Kelley, was satisfied with the jury's decision.
"Unfortunately, there is no amount of money that can bring justice for Addison for what happened to him, but this will help his family take care of him," Kelley said.
Mark O'Keefe, EVAC spokesman, said the company's lawyers will appeal.
"EVAC paramedics have to care for the tragic consequences of illness and injury every day. We stand behind our paramedics and intend to appeal this verdict," he said.