Decatur, GA—An Atlanta-area obstetrician was cleared of responsibility last week for the childbirth-related shoulder injury that has left a girl without the use of her right arm. Cantrell v. Moore, 13A49232.
A DeKalb County State Court jury found Dr. Brad Moore did not cause the brachial plexus injury Emma Cantrell suffered during her birth in November 2006. Cantrell suffered the injury, which damaged nerves leading from her shoulder to her spine, leaving her right arm functionless, after her shoulder became stuck during delivery, called shoulder dystocia.
Cantrell’s parents, Elaine and Charles Cantrell, claim Moore caused their child’s injury by inappropriately using a vacuum device in delivery and failing to properly resolve the baby’s shoulder dystocia.
During closing arguments August 22, a day before the verdict, the Cantrells’ attorney, Pamela Pantages of Nurenberg Paris, requested more than $3.3 million for the child’s injuries.
The seven-day trial focused on Moore’s decisions in delivering the child and whether they caused her shoulder injury. During her closing argument, Pantages contended evidence showed Moore breached the general standard of care in vacuum-assisted deliveries by continuing to use the vacuum device despite the fact that the device had disengaged, commonly called “popping off,” multiple times.
“There are rules. If the mom can’t push the baby out, and there’s been two pop-offs and four pulls the vacuum has failed,” Pantages said, arguing Moore’s use of the vacuum exceeded even what a defense expert testified as a general maximum number of attempts with the vacuum device.
“Going beyond four is a deviation from standards of care, and we know that happened because that’s what’s in the record,” Pantages said. “[Moore] continued after the four, that is below the standard of care by definition.”
Pantages argued Moore compounded his error with the vacuum device by using traction, or pulling the baby, ultimately causing the injury, which permanently damaged nerves from her shoulder to her spine. “Emma was a perfectly healthy baby before Dr. Moore put the vacuum on her head and before Dr. Moore used traction,” Pantages said. “This could all have been prevented and avoided if he did the safe thing and did not expose Emma to an unnecessary risk of harm.”
However, the defense argued Emma Cantrell’s shoulder dystocia was not caused by Moore’s vacuum-assisted delivery method, and he acted appropriately in freeing her shoulder.
During his closing argument, Peters & Monyak’s Robert Monyak argued evidence showed there was no established rule requiring a physician to stop using a vacuum device after two pop-offs, and, attempting a caesarean delivery at that point in Emma's delivery would have posed more risk to the baby. “Dr. Moore’s judgment was just to go ahead and finish with one more vacuum pull,” Monyak said. “That was reasonable. That made sense. There were reasons to do that.”
Monyak added the use of the vacuum did not cause the baby’s shoulder dystocia. And, he contended Moore properly attempted a number of maneuvers to free the baby’s shoulder, which was considered a medical emergency, given the fact that associated compression of the umbilical cord could have led to the baby’s brain damage or death if not resolved within 5 minutes.
Monyak argued Moore’s use of traction was not a maneuver in and of itself, but merely used to determine the effectiveness of delivery maneuvers on the shoulder dystocia. He said evidence showed it is a common technique under the circumstances. “It just makes sense that doctors would, in fact, test to see, ‘Do we still have a tight shoulder?’ And, also see if they can deliver the baby in a normal way with some gentle traction,” Monyak said. “It is indeed routine.”
Email Arlin Crisco at [email protected].
Plaintiffs are represented by Pamela Pantages of Nurenberg Paris and Wilson Law’s James O. Wilson.
The defense is represented by Jeffrey Peters and Robert Monyak, of Peters & Monyak.
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