Hypoglycemia is the culprit
In 2014, Ms. Walker contacted us about her son Matthew. Matthew, who was 10 years old at the time, was a twin who was born prematurely at approximately 29 weeks gestation. Although Matthew and his twin brother, Scott, were both born prematurely at 29 weeks gestation, only Matthew had cerebral palsy and developmental delay.
A slow start to the investigation
When Matthew was approximately 2 years old, Ms. Walker contacted an attorney to investigate why Matthew was disabled while Scott was completely healthy. She retained Law Firm A and an investigation began. For over 2 years Law Firm A collected records and spoke to various expert witnesses. However, Law Firm A was unsuccessful in solving the case. They informed Ms. Walker of their efforts and supplied her with the medical records they had obtained. Distraught by the news, Ms. Walker gave up for the time being.
In 2010, Ms. Walker contacted Law Firm B. As with Law Firm A, Law Firm B opened a file and started their own investigation. Within 6 months, Ms. Walker was again told that no expert witnesses were willing to support the case. As such, Law Firm B closed their file and sent Ms. Walker a letter indicating that they could not help with Matthew’s case.
A beacon of light
Shortly after Matthew’s 10th birthday, Ms. Walker contacted Wais, Vogelstein, Forman & Offutt, LLC. WVFO immediately conducted a statute of limitations analysis and determined that there was still plenty of time left to pursue Matthew’s claim. Next, WVFO obtained the rejection letters from Law Firm A and Law Firm B. The rejection letter from Law Firm A was very short and did not provide any insight into what avenues or theories were being pursued in order to bring a claim. However, the rejection letter from Law Firm B made it clear that Law Firm B had only investigated the claim by looking at potential medical errors arising from the labor and delivery care.
Over the next several months, WVFO collected and examined the medical records. Unlike Law Firm A and Law Firm B, WVFO also requested and obtained the neuroimaging – i.e., the actual pictures of Matthew’s brain. Those pictures and images were sent to a renowned pediatric neuroradiologist in California, Dr. Peterson, who discovered something startling.
Dr. Peterson informed WVFO that the pictures of Matthew’s brain showed brain damage from hypoglycemia – i.e., low blood sugar levels. Armed with the truth about the mechanism of Matthew’s brain damage, the search was on to find out if Matthew had periods of hypoglycemia that were mismanaged by the health care providers.
Back to Matthew’s newborn records
It is well-established that prolonged and intense periods of low blood sugar in a neonate can result in brain damage. According to a recently published article [link to https://www.medicinenet.com/script/main/art.asp?articlekey=205907], neonatal hypoglycemia is “the most common preventable cause of brain damage in infancy.” This was also true in 2004 when Matthew was born. Thus, after speaking to Dr. Peterson, the lawyers at WVFO turned their attention back to Matthew’s newborn records. What they uncovered next was stunning.
Shortly after delivery, Matthew’s plasma blood glucose levels were checked. In a newborn who is less than 24 hours old, an abnormal plasma blood glucose level is one that is less than 30 mg/dl. After that, the threshold is 45 mg/dl [link to https://emedicine.medscape.com/article/802334-overview]. Matthew’s first plasma blood glucose level, taken at 11 hours of life, was 22 mg/dl. No treatment was given. His second plasma blood glucose level, at 21 hours of life, was 5 mg/dl. Again, no treatment was given. In fact, Matthew’s plasma blood glucose levels remained dangerously low for almost 24 hours without adequate treatment.
A fresh look
Equipped with a new theory that was likely not considered by Law Firm A or Law Firm B, WVFO reached out to a preeminent neonatologist in Arizona, Dr. Sawyer. Intrigued by what WVFO had uncovered thus far, Dr. Sawyer agreed to review the case. Within a few weeks, WVFO was on the phone with Dr. Sawyer to discuss his opinions.
Although Dr. Sawyer was not a pediatric neuroradiologist, he too looked at the pictures of Matthew’s brain. He also reviewed Matthew’s newborn records and other treatment records. Based on his review of the pictures, films and records, Dr. Sawyer was of the opinion that the neonatologists caring for Matthew on the first day of life had breached the standard of care by not recognizing and appropriately treating Matthew’s hypoglycemia on the first day of life. Dr. Sawyer was also of the opinion that these breaches in the standard of care had caused Matthew’s brain damage, cerebral palsy and developmental delay.
But the case wasn’t completely solved yet.
Dr. Sawyer wanted to see Matthew’s twin brother’s records before completely signing off on the case.
Same kids, much different treatment
Like Matthew, Scott also had hypoglycemia in the immediate newborn period. Scott’s initial plasma blood glucose was higher than Matthew’s, as it was recorded as 26 mg/dl. But in stark contrast to the care given to Matthew, the neonatologists caring for Scott immediately and aggressively started treating Scott with glucose infusions. As expected, Scott’s blood glucose levels rebounded to an acceptable range and they continued to treat him accordingly. WVFO had now uncovered why Matthew was disabled and why Scott was a normal 10 year old boy.
After reviewing Scott’s medical records, Dr. Sawyer signed off on the case and a lawsuit was promptly filed.
A genetic disorder?
Given the profound difference in the level of treatment between Matthew and Scott, the Defendants in Walker v. Hospital A did not have much of a defense. The Defendants claimed that Matthew suffered from a genetic thyroid disorder. The thrust of the argument was that given this disorder Matthew would not have responded to the same type of treatment Scott received, and thus still would have suffered brain damage and cerebral palsy anyway.
Matthew’s case was in litigation for a little over one year before the case was settled for millions of dollars.
CASE CLOSED.
