Electronic Fetal Monitoring and Obstetrical Malpractice

Schifrin B. , The Case Against the Fatal Monitor, Southern Medical Journal 71(9): 1058 (September 1978); Cordero L Anderson C. Zuspan F. , Scalp Abscess: A Benign and Infrequent Complication of Fetal Monitoring, American Journal of Obstetrics and Gynecology 146(2): 126, 126 (May 15, 1983) [hereinafter referred to as Cordero] (“electronic monitoring of the fetal heart rate during labor has become a common obstetric practice over the past decade”); Miller F. Pearse K. Paul R. , Fetal Heart Rate Pattern Recognition by the Method of Auscultation, Obstetrics and Gynecology 64(3); 332, 332 (September 1984) [hereinafter referred to as Miller] (“continuous electronic monitoring of the fetal heart rate is widely accepted for fetal assessment during labor”).

American College of Obstetrics and Gynecology, Intrapartum Fetal Monitoring, Technical Bulletin #44 (January 1977) [hereinafter referred to as ACOG Bulletin).

See Zuspan F.P. , Predictors of Intrapartum Fetal Distress: The Role of Electronic Fetal Monitoring Report of The National Institute of Child Health and Human Development Consensus Development Task Force, Obstetrics and Gynecology 135(3): 287 (October 1, 1979) (hereinafter referred to as NICHD Report].

Hobel C. , Prenatal and Intrapartum High-Risk Screening, American Journal of Obstetrics and Gynecology 117(1): I (September 1, 1973) [hereinafter referred to as Hobel].

Ingemarsson E. Ingemarsson I. Svenningsen N. , Impact of Routine Fetal Monitoring During Labor on Fetal Outcome with Long-Term Follow-Up, American Journal of Obstetrics and Gynecology 141 (1): 29 (September 1, 1981); see also Erkkola R. , Analysis of Intrapartum Fetal Deaths: Their Decline With Increasing Electronic Fetal Monitoring, Acta Obstetrica Gynecologia Scandanavia 63(5): 459 (1984) [hereinafter referred to as Erkkola].

Havercamp A. , The Evaluation of Continuous Fetal Heart Rate Monitoring in High-Risk Pregnancy, American Journal of Obstetrics and Gynecology 125(3): 310, 310–12 (June 1. 1976) [hereinafter referred to as Havercamp]; see also NICHD Report, supra note 3, at 288; Erkkola, supra note 5, at 461–62; Miller , supra note 1, at 332; Adamsons K. Myers R.E. , Late Decelerations and Brain Tolerance of the Fetal Monkey to Intrapartum Asphyxia, American Journal of Obstetrics and Gynecology 128(8): 893–900 (August 15, 1977).

Erkkola, supra note 5.

Amato J. , Fetal Monitoring in a Community Hospital, Obstetrics and Gynecology 50(3): 269–74 (September 1977) [hereinafter referred to as Amato].

Amato, supra note 8; see also Ingemarsson E. , A One-Year Study of Routine Fetal Heart Rate Monitoring During the First Stage of Labor, Acta Obstetrica Gynecologia Scandanavia 59(4); 297, 300 (1980) [hereinafter referred to as Ingemarsson].

Hobbins J.C. Freeman R. Queenan J.T. , Editorial: The Fetal Monitoring Debate, Obstetrics and Gynecology 54(1): 103–08 (July 1979).

Parer J.T. , Fetal Heart Rate Monitoring: Answering the Critics, Contemporary Obstetrics and Gynecology 17: 163 (1981).

A sample of recent studies demonstrating the effectiveness of EFM in reducing intrapartum stillbirths and perinatal mortality includes Neutra R.R. Greenland S. Friedman E.A. , The Relationship Between Electronic Fetal Monitoring and Apgar Score, American Journal of Obstetrics and Gynecology 140(4): 440–45 (June 15, 1981); Westgren M. , Intrapartum Electronic Fetal Monitoring in Low-Risk Pregnancies, Obstetrics and Gynecology 56(3); 301–04 (September 1980): Ingemarsson, supra note 9; Johnstone J.R. Campbell D. M. Hughes G.J. , Has Continuous Intrapartum Monitoring Made Any Impact on Fetal Outcome? Lancet 1978(8077): 1298 (June 17, 1978); Gabert H.A. Stencherver M.A. , The Results of a Five-Year Study of Continuous Fetal Monitoring on an Obstetric Service, Obstetrics and Gynecology 50(3): 275–79 (September 1977).

Havercamp , supra note 6; see also Kelso I.M. , An Assessment of Continuous Fetal Heart Rate Monitoring in Labor, American Journal of Obstetrics and Gynecology 131(5): 526–31 (1978) (hereinafter referred to as Kelso].

Schifrin B. , The Fetal Monitoring Polemic, Clinical Perinatology 9:399 (1982) (hereinafter referred to as Schifrin].

See NICHD Report, supra note 3, at 289; see also ACOG Bulletin, supra note 2.

NICHD Report, supra note 3, at 289.

Helling v. Carer, 519 P.2d 981 (Wash. 1974).

Id.

Schifrin , supra note 14.

Hobel , supra note 4.

Id.

See Ingemarsson , supra note 9.

See Erkkola , supra note 5.

Id.

NICHD Report, supra note 3, at 288.

Benson R.C. , Fetal Heart Rate as a Predictor of Fetal Distress: A Report From the Collaborative Project, Obstetrscs and Gynecology 32: 259–66 (1968); see also Bowe E.T. , Reliability of Fetal Blood Sampling in Maternal-Fetal Relationships, American Journal of Obstetrics and Gynecology 107(2): 279–87 (May 15, 1970); Havercamp , supra note 6; Kelso , supra note 13.

See Miller , supra note 1.

See King J. , In Search of a Standard of Care for the Medical Profession: The “Accepted Practice” Formula, Vanderbilt Law Review 28(6): 1213, 1244–57 (November 1975) (arguing for a standard of care defined by the medical profession, not imposed upon it). The prime example to the contrary, where a court determines the standard of care is Helling v. Carey, 519 P.2d 981 (Wash. 1974), which held an ophthamologist liable for failing to test a 32 year old patient for glaucoma, even though the standard of the profession was not to test patients routinely under 40 for glaucoma. Helling has been received with disfavor by several state courts. See, e.g., Barton v. Owen, 138 Cal. Rptr. 494 (Cal. App. 1977). Helling has also met with disfavor in several state legislatures. See e.g., Wash. Rev. Code § 4.24.290 (1974).

See, e.g., Walker v. United States, 600 F. Supp. 195 (D.D.C. 1985) (accepting experts' opinion that failure to activate interval fetal monitor was below standard of care, but finding no proof that such failure was the proximate cause of injury); First National Bank of Chicago v. Porter, 448 N.E.2d 256, 263-65 (Ill. App. 1983) (accepting experts’ opinion that failure to use EFM was below standard of care, but finding no evidence of causation); Jones v. Karraker, 440 N.E.2d 420, 425 (Ill. App. 1982) (upholding jury's finding that failure to use fetal monitoring was a breach of standard of care).

Baldor v. Rogers, 81 So.2d 658, 660 (Fla. 1954) (cancer treatment). See also Leech v. Bralliar, 275 F. Supp. 897, 902 (D. Ariz. 1967) (prolotherapy); Hamilton v. Hardy, 549 P.2d 1099.1104 (Colo. Ct. App. 1976) (oral contraceptives); Couch v. Hutchison, 135 So.2d 18, 21–22 (Fla. Dist. Ct. App. 1961) (spinal fusion); Smith v. Beard, 110 P.2d 260, 272 (Wyo. 1941) (skin grafting); Gruginski v. Lane, 30 P.2d 970,971 (Wash. 1934) (bandaging). But see Henderson v. Heyer Schulte Corp. of Santa Barbara, 600 S.W.2d 844, 849 (Tex. Civ. App. 1980) (rejecting “respectable minority” in case involving breast implants); Hubbard v. Calvin, 147 Cal. Rptr. 905 (Cal. App. 1978) (cerebral angiogram).

Duckworth v. Bennet, 181 A. 558, 559 (Pa. 1935) (use of x-ray in orthopoedic diagnosis). See also Truan v. Smith, 578 S.W.2d 73, 75–76 (Tenn. 1979) (treatment of breast cancer); Brannan v. Lankenau Hospital, 385 A.2d 1376, 1383 (Pa. Super Ct. 1978) (antibiotics with esophagoscopy); Fritz v. Parke Davis and Co., 152 N.W.2d 129, 131 (Minn. 1967) (use of dilantin to control epilepsy); Schueler v. Strelinger, 204 A.2d 577, 585 (N.J., 1964) (failure to take second blood test where kidney disease present); Gresham v. Ford, 241 S.W.2d 408, 411 (Tenn. 1951) (use of x-ray to locate broken needle); McPeak v. Vanderbilt Univ. Hosp, 229 S.W.2d 150, 151–152 (Tenn. 1950) (leg operation).

Haase v. Garfinkel, 418 S.W.2d 108, 114 (Mo. 1967) (failure to use anticoagulants in heart disease). See also Watkins v. United States, 482 F. Supp. 1006, 1012 (M.D. Tenn. 1980) (use of antimalaria drug); Brown v. United States, 293 F. Supp. 13, 16 (E.D. Mo. 1968) (diagnosis of chronic illness); Kinser v. Elkadi, 674 S.W.2d 226, 230 (Mo. Ct. App. 1984) (necessity of bilateral aorta-femoral bypass); Rickett v. Hayes, 511 S.W.2d 187, 194–95 (Ark. 1974) (arch bars in mouth reconstruction).

Loudon v. Scott, 194 P. 488, 492 (Mont. 1920) (anesthesia); Dunman v. Raney, 176 S.W. 339, 342 (Ark. 1915) (orthopedic treatment); Pike v. Honsinger, 49 N.E. 760, 762 (N.Y. 1898) (orthopedic treatment).

Hood v. Phillips, 554 S.W.2d 160, 165–66 (Tex. 1977) (emphysema treatment). See also Snow v. Bond, 438 S.W. 2d 549,550–51 (Tex. 1969) (post-operative infection).

61 Am. Jur. 2d Physicians & Surgeons 216 (1981). See also, Joy v. Chau, 377 N.E.2d 670, 677 (Ind 1978) (approved and accepted practice in orthopedics); Woods v. Pommerening, 271 P.2d 705, 706–07 (Wash. 1954) (gold injections).

Casenburg v. Lewis, 40 S.W.2d 1038, 1040 (Tenn. 1931) (x-ray burns). See also, Truan v. Smith, 578 S.W.2d 73, 75–76 (Tenn. 1979).

But see Cordero , supra note 1, at 126 (risk of complications far outweighed by benefits); Kruse , Long-term Reaction of Women to Electronic Fetal Monitoring During Labor, Journal of Family Practice 18:543 (1984) (no adverse psychological impact); Paul R. Gauthier R. Quilligan E. J. , Clinical Fetal Monitoring: The Usage and Relationship to Trends in Cesarean Delivery and Perinatal Mortality, Acta Obstetrica Gynecologia Scandanavia 69:289 (1980) (no relationship between use of EFM and rate of Cesarean sections).

Even before 1975, a doctor may be held liable for failing to monitor on indication.

See Canterbury v. Spence. 464 F.2d 772 (D.C. Cir. 1972).

For an example of a plan of action. see, e.g., Zoller D. , Principles of Managing the High-risk Pregnant Patient, American Family Physician 27(1) 216 (January 1983).

See NICHD Report, supra note 3. at 289–90.

See Powell O. Melville A. MacKenna J. , Fetal Heart Rate Acceleration in Labor: Excellent Prognostic Indicator, American Journal of Obstetrics and Gymcology 134(1): 36, 37 (May 1. 1979).