Greenleaf v. United States of America – $2.8M

Medical Malpractice & Elder Abuse

Case Summary:

$2,836,184.45 bench verdict against the United States of America for a brain damaged baby.

Plaintiff’s Medical Expert Witnesses:
John R. Marshall, M.D., Board certified in Obstetrics and Gynecology
50-B Peninsula Center Dr., # 322, Rolling Hills Estates, CA 90274, (310) 544-1533
Donna Barras, M.D., Pediatric Rehabilitationist
5365 Kenwood Avenue, Buena Park, CA 90621, (714) 521-4167
Donna Scheideberg, CNM, Certified Nurse Midwife, Ph.D. in Family & Child Ecology

Defendant’s Medical Expert Witnesses:
Philip E. Young, M.D., Board Certified in Obstetrics and Gynecology, Infertility Specialist
9339 Genesee Avenue, Suite 220, San Diego, CA 92121, (619) 455-7520
Michael Painter, M.D., Board certified in Pediatrics and Neurology, Childrens Hospital
3705 Fifth Avenue, Pittsburgh, PA 15213 PHONE NUMBER: (412) 692-5520
F. Julia Olijnyk,

Defendant Insurance: Self Insured

Date, Time and Place of Incident(s): October 15, 1996 PLACE: Balboa Naval Hospital

Facts and Background:

On the morning of October 15, 1996, Ms. Karri Greenleaf, then 40 weeks plus 6 days pregnant, believed that her water had broken. She contacted Balboa Naval hospital to report her concern. She was advised that she should report to the hospitals labor and delivery department. After her arrival at approximately 10:30 a.m., Ms. Greenleaf was examined by Nurse Midwife Laureen Deary. Upon examination, Nurse Midwife Deary determined that Ms. Greenleafs water had not broken, but that her cervix was only dilated one centimeter and that she was remote from delivery. Nurse Midwife Deary then placed an external fetal heart monitor, which indicated Ms. Greenleaf had a late deceleration without any acelerations. Concerned about the tracing on the fetal heart monitor, a bio-physical profile was performed with a non-reassuring score of four out of ten. Ms. Greenleaf was admitted to the labor and delivery unit at 1:00 p.m. for purposes of inducing labor, continued fetal monitoring and consultation with medical staff. At approximately 1:50 p.m. Dr. Debra Arsenault became directly involved with the treatment of Ms. Greenleaf while placing Cervidil, an agent to aid the cervix in readiness for delivery. After Dr. Arsenaults involvement, Ms. Greenleaf was being treated as a co-managed patient by nurse midwifery services and the medical staff. Fetal monitoring continued throughout the afternoon, with continued late decelerations and reduced variability. At approximately 3:30 p.m. Ms. Greenleafs membrane was artificially ruptured and a fetal scalp electrode was placed. At approximately 4:00 p.m., Nurse Midwife Deary and Dr. Arsenault conferred about the non-reassuring strip and whether a cesarean section was indicated. Nurse Midwife Deary testified that she and Dr. Arsenault believed a C-section was necessary at that time. At approximately 4:00 p.m., Dr. Arsenault conferred with staff physician William Simpson, M.D., who had medical responsibility for the OB-GYN deck.

Plaintiff’s Contentions, Allegations:
Plaintiff contended that Nurse midwife Deary was negligent in failing to seek the opinion of the chief of staff when Dr. Simpson did not order a c-section at 4:00 p.m. and that she fell below the standard of care in failing to inform Ms. Greenleaf of her disagreement with Dr. Simpsons order to proceed with the amnio infusion, rather than a c-section. As for the medical staff of Balboa Hospital, plaintiff contended that the medical staff fell below the standard of care in not proceeding with a c-section at approximately 4:00 pm, after hours of late decelerations and decreased variability. Plaintiff also contended that it was below the standard of care to order an amnio infusion to differentiate between late and variable decelerations. Finally, plaintiff alleged Dr. Arsenault fell below the standard of care by not conveying a recommendation for c-section to Dr. Simpson, despite the fact that she did not understand or agree with his order for an amnio infusion at 4:00 pm. Plainti

Injuries and/or Damages:
Terminal bardycardia, resulting in hypoxic ischemic encephalopathy, seizure disorder, developmental delays, hearing loss, diminution of both gross and fine motor skills. Emotional distress for both Kiana Greenleaf and her mother Karri Greenleaf.

Defendant USA contended that the Fetal Heart Monitor Strip did not demonstrate recurrent late decelerations and that it was within the standard of care to proceed with an amnio infusion at approximately 4:00 p.m., since it was unknown whether the strip showed late or variable decelerations. Defendant USA further contended that a c-section was not required, since after the amnio infusion was completed, the late decelerations subsided and the strip improved. Defendant USA also alleged that the damages plaintiff sought were excessive and not medically necessary, and that Kiana Greenleaf suffered from a genetic abnormality that accounted for her medical condition. Defendant Nurse Midwife Laureen Deary contended that at no time did her actions fall below the standard of care, in that she did not have an obligation to seek the opinion of the chief of staff, nor did she have an obligation to inform Ms. Greenleaf that she disagreed with Dr. Simpsons orders. Further, Nurse Midwife Deary contended that she did not have the ability to order a C-section be performed, as only the physicians involved would be able to do so.

The court found that Nurse Midwife Dearys care and treatment did not fall below the standard of care at any point during her treatment of Ms. Greenleaf. Defendant USA was held wholly responsible for the negligence and damages suffered by Karri and Kiana Greenleaf.

PAST MEDICAL: $34,392.71
FUTURE MEDICAL: $2,918,799.00

Demand: $2,500,000.00

$500,000.00 from defendant USA in the form of a structured settlement. Waiver of costs from defendant Deary and Gatewood, M.D., LTD

Verdict or Award:
1. Future medical care for plaintiff $2,016,000.00 Kiana Greenleaf,reduced to present value
2. Past Medical Expenses $ 28,184.45
3. Future lost wages for plaintiff Kiana Greenleaf reduced to present value $ 292,000.00
4. General damages for Kiana Greenleaf $ 250,000.00
5. General Damages for Karri Greenleaf $ 250,000.00
TOTAL: $2,836,184.45

Other Verdict Details:
DEFENDANT #1, United States of America: 100%
DEFENDANT #2, Joseph Gatewood, M.D., LTD: 0% (Plaintiff dismissed Laureen Deary as a defendant, since agency with Joseph Gatewood, M.D., LTD was stipulated)

Length of Trial: 8 Days

Post Trial Motions and Post Verdict Settlements:
Defendant USA has reported indirectly that they will appeal the decision.

Attorney for Client: Kevin F. Quinn and Leo R. Bartolotta

Attorney for Defendant:
Kathryn Jordan, Assistant U.S. Attorney (Attorney for Defendant United States of America)
Joseph Kutyla (Attorney for Laureen Deary, R.N.)

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