Washington v. Barnes Hospital

897 S.W.2d 611 (Mo. 1995)

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Nature of the Case

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Facts

Washington was 27 years old and 32 weeks pregnant with twins. She suffered periodic abdominal pains and finally realized by near the end of the day that she was in

need of serious medical attention. She arrived at D at 5:10 p.m. The fetuses were gradually losing their heart rates right from first monitoring. By 6:08 the doctor observes that one of the babies becomes limp and by 6:10 orders a cesarean. Washington signs the consent form 3 minutes later, and the first baby is delivered at 6:24 and the second at 6:25. The second had experienced a complete placental abruption sometime prior to birth, depriving him of oxygen. P sued Ds. During pretrial, Ds' wanted to introduce the availability of free education for the child. P's objected based on the collateral source rule. D argued that the collateral source rule did not apply, both because P had not prepaid for such services, as with insurance, and because special education is available to the public at large without consideration of financial need. The court sustained P's motion. P's expert testified that Ds were negligent in failing to diagnose the abruption sooner and proceed earlier with the cesarean. Ds' experts claim that the symptoms did not clearly point to an abruption. Washington had previously given birth to a healthy child, did not complain of uterine contractions that were more intense than regular contractions. Washington never had a firm uterus, her contractions did not last longer than regular contractions, no vaginal bleeding was present, and no signs of fetal distress occurred. Ds contend the risk of delivering the twins prematurely outweighed other risks until 6:08 p.m., when the heartbeats dropped, indicating fetal distress. At the time of trial, when Corey was five, his mental level was that of a four-month-old. He will need complete custodial care, physical therapy to maintain some affectability of his arms and legs, occupational therapy to help his arm functioning and positions, and speech and language therapy for assistance in eating. Corey's brain damage was caused by a lack of oxygen prior to birth because Washington suffered a complete placental abruption. Ds claimed that Corey's injuries were due to a partial abruption that had been taking place all day, and that his injuries were essentially complete by the time Washington arrived at D. P's conceded that injuries such as Corey's could result from a partial abruption that lasted for hours or even days, even if the complete abruption was not until right before birth. However, he testified on redirect examination that in such a case he would not expect to see a fetal heartbeat of 120 shortly before birth, and he believed Corey's injuries were caused by the complete abruption. Alan Spector was called as P's expert to testify regarding Corey's future needs for special education and therapy. The jury returned verdicts against all defendants in favor of Washington in the amount of $500,000 and in favor of Corey Washington in the amount of $5,000,000. Ds then moved for a judgment notwithstanding the verdict. The court entered judgment in accordance with the verdicts but reduced the jury's award of non-economic damages for Washington from $480,000 to $446,000 and for Corey Washington from $1,209,000 to $446,000, pursuant to § 538.210, RSMo 1994. Ds appealed.