Brain-damaged girl's parents can sue hospital and doctor, Florida court rules

The parents of a brain-damaged girl can sue the hospital and doctor who treated her instead of pursing a remedy through a state fund for birth-related injuries, the Supreme Court of Florida has ruled.

The decision could have significant liability consequences for physicians, say attorneys in the case.

Tristan Bennett was delivered by cesarean section on Sept. 26, 2001, at St. Vincent's Medical Center in Jacksonville, Fla., after her mother was involved in a car accident. The baby required resuscitation after birth but responded to oxygen efforts and was transferred to the newborn nursery, according to court records.

The newborn was later sent to the special care nursery because of moderate respiratory distress, and her respiration improved, court documents say. During the next week, she experienced several health ailments, including kidney and liver problems.

On Oct. 3, 2001, the newborn experienced a pulmonary hemorrhage and stopped breathing. Tests showed she had permanent and substantial neurological damage, court records show.

Robert and Tammy Bennett accused the hospital and obstetrician-gynecologist William H. Long, MD, of negligence. The parents said staff administered too much intravenous fluid to baby and failed to test for serum electrolyte derangements until too late.

Attorneys for the hospital and Dr. Long said the case was under the jurisdiction of the state's no-fault compensation program, the Birth-Related Neurological Injury Compensation Plan. The fund covers "birth-related neurological injury caused by oxygen deprivation occurring in the course of labor, delivery or resuscitation in the immediate post-delivery period in a hospital."

The hospital said the newborn experienced oxygen deprivation and brain injury before delivery, and that the oxygen loss contributed to other health problems and ultimate brain damage.

The parents argued that their daughter's brain damage resulted from care provided "long after the post-delivery period had ended," and that they should be allowed to pursue court damages.

An administrative law judge agreed, ruling that the injury did not occur at delivery, and that the parents could sue in civil court. But the Florida First District Court of Appeal reversed the order. The appellate court interpreted "immediate post-delivery period" to mean "an extended period of days when a baby is delivered with a life-threatening condition and requires close supervision." NICA should resolve the case, the court said.

The dispute ultimately was answered July 7, when the state Supreme Court overturned the appellate court's decision. Justices said the ruling was too broad.

"We hold that a narrow construction of the [Florida] statute is the more reasonable interpretation," the high court said. "First, it restricts the impact of the statute to those situations involving obstetricians, who are the group of physicians that the NICA plan was designed to benefit. Otherwise ... under the [appellate court's] interpretation, the statute would be expanded to cover situations where an infant is transferred from the delivery room and the obstetrician relinquishes responsibility of the infant to other health providers."

More or less protection?

The ruling protects the state's compensation fund and reinforces respect for the decisions made by administrative law judges in such cases, said Wilbur Brewton, attorney for NICA.

He said NICA was created in 1988 to alleviate a Florida medical liability crisis and has since worked to make the medical climate more stable.

"Malpractice [insurance] rates had soared," and medical centers specializing in obstetrics "were at risk of closing because they couldn't afford medical malpractice insurance," Brewton said. The fund "protects everyone. It protects health care providers, and it protects claimants. It's a good system."

NICA officials were concerned that if the appeals ruling stood, more cases would come to the compensation fund instead of the courts, potentially draining the fund's resources. The fund is sourced through assessments of doctors and hospitals and payments by participating obstetricians.

St. Vincent's was disappointed with the ruling, said Scott A. Tacktill, attorney for the hospital. He said the court's interpretation of Florida law limits NICA's ability to provide compensation for the injuries the Legislature intended to compensate. The decision also puts physicians at greater risk of being sued, he said.

Rebecca Bowen Creed, attorney for the Bennetts, said the court ruling probably will make it easier for parents to seek medical negligence remedies through the courts rather than NICA. Parents are subject to limited compensation through NICA, while they can seek full damages in court.

Tacktill filed a motion on July 22 asking the high court to reconsider its decision. At this article's deadline, the court had not said whether it would re-examine the case.