Date of Verdict: April 19.

Court and Case No.: C.P. Lehigh No. 2011-C-3247.

Judge: Lawrence J. Brenner.

Type of Action: Medical malpractice.

Injuries: Shoulder dystocia, Erb’s palsy, flattened humeral head.

Plaintiffs Counsel: James J. McHugh Jr. and Nancy G. Rhoads, Lopez McHugh, Philadelphia.

Defense Counsel:Gary M. Samms, Jacqueline S. Roe and Eileen K. Keefe, Obermayer Rebmann Maxwell & Hippel, Philadelphia.

Comment: A Lehigh County judge has issued a defense verdict in a case where a young girl’s parents claimed doctors improperly managed their daughter’s vaginal delivery, leading to shoulder dystocia and long-term disability as a result.

But the jury cleared Dr. Christina Brown, Dr. Adriaan Vangaalen and Dr. Jennifer Landes and the hospital for which they work, St. Luke’s Hospital and Lehigh Valley Health Network, finding the defendants were not liable for the child’s injuries. The jury came back April 19.

The plaintiffs, Nicole and Barry Fretwell as parents of Sydney Fretwell, had claimed the health care providers failed to properly recognize the increased risk for shoulder dystocia and the eventual clavicular fracture and Erb’s palsy that the baby — now a preteen — sustained as a result of her birth in May 2000.

On May 1, 2000, according to the Fretwells’ fourth amended complaint, Nicole Fretwell presented to the hospital at more than 40 weeks into her pregnancy for a labor induction. Her pregnancy was complicated — Fretwell was Group B streptococcus positive and had one abnormal three-hour glucose tolerance test value, the complaint said. She was also obese and had mild asthma.

During the 2 p.m. hour that day, doctors placed a fetal heart rate monitor, initiated magnesium sulfate and membranes were ruptured. Throughout the rest of the afternoon and evening, doctors placed a fetal scalp electrode and intrauterine pressure catheter, initiated Pitocin and lastly an epidural analgesia.

By the midnight hour of May 2, Fretwell was put in stirrups and told to push.

When she was not able to clear the infant’s head below her pubic bone, doctors applied a vacuum.

According to the complaint, there were "three pulls and excellent maternal bearing-down efforts and two pop-offs of the suction cup," and the baby’s head was brought to crowning.

However, the baby’s anterior shoulder did not clear during delivery attempts.

At around 1 a.m., Sydney Fretwell was born.

According to the complaint, the baby’s left arm had a clavicular fracture requiring treatment.

Nicole Fretwell was noted to have a complete fourth-degree proctoepisiotomy with urethral meatus damage.

Sydney Fretwell, on the other hand, was diagnosed with and has suffered from a left Erb’s palsy and posterior subluxation and flattened humeral head as a result, the complaint alleged, causing both physical and psychological problems.

The complaint said the injuries were proximately caused by the named defendants and other health care providers listed in the complaint and exhibits attached thereto.

The plaintiffs advanced four counts of medical malpractice and sought recovery for the injuries, developmental delay, motor problems, physical and mental pain and suffering, loss of life’s pleasures, medical expenses, loss of earnings capacity, disfigurement and more.

In a pretrial memorandum of Brown, one of the doctors, the defendant noted that the vacuum was unsuccessful in fully delivering the baby. But, after its use, the baby’s head was brought to crowning and she was delivered. It was then, according to the papers, that doctors diagnosed the shoulder dystocia. According to the defense papers, to deliver the baby, doctors then employed the "McRoberts" position — in which the woman is on her back, legs bent at the knees and pulled toward her shoulders — and utilized mild downward traction, superpubic pressure and a proctoepisiotomy.

The baby was then delivered "without difficulty," according to the record, the defense papers said, and the episiotomy was repaired.

Brown’s lawyers, of Obermayer Rebmann Maxwell & Hippel, did not return calls requesting comment.

The plaintiffs’ attorneys did not return calls.

— Ben Present, of the Law Weekly •