ISMAEL ROMAN AS ADMINISTRATOR OF THE ESTATE OF NAYELIS RUIZ ROMAN, a/k/a NAYELIS RUIZ, DECEASED, et al., Plaintiffs,
UNITED STATES OF AMERICA, Defendant.
LAWRENCE F. STENGEL, District Judge.
This is a medical malpractice action filed against the United States under the Federal Tort Claims Act. Yadira Roman, the plaintiff, contends that two physicians employed by Southeast Lancaster Health Services were negligent in managing her labor and delivery on February 16, 2008. Southeast Lancaster Health Services is a federally funded community health clinic and its employees are considered to be federal employees. Evidence was presented during a bench trial beginning on November 4, 2013. The following findings of fact and conclusions of law are based upon the evidence presented and the arguments advanced by counsel.
FINDINGS OF FACT
1. Southeast Lancaster Health Services provides medical and dental care to economically disadvantaged members of the Lancaster, Pennsylvania community. Southeast Lancaster Health Services operates a clinic at 625 South Duke Street, Lancaster, Pennsylvania.
2. Southeast Lancaster Health Services receives federal funding for its work in the Lancaster community. The medical staff, as well as the support staff, are federal employees for purposes of this case.
3. Yadira Roman was a patient of Southeast Lancaster Health Services and received medical care in 2007 and 2008 for her pregnancy from Rachel Eash-Scott, M.D., a member of the Southeast Lancaster Health Services medical staff.
4. On January 4, 2008, Yadira Roman was seen at Southeast Lancaster Health Services by a nurse practitioner for her thirty-three week pre-natal visit. Ms. Roman complained of headaches and occasional blurred vision.
5. On February 15, 2008, Yadira Roman was seen and referred by Dr. Eash-Scott to the triage unit at Lancaster General Women and Babies Hospital for PIH evaluation for increased swelling, blood pressure of 148 over 80, and proteinuria.
6. Ms. Roman was admitted to the hospital that evening for induction of labor. Dr. Eash-Scott prescribed Cervicil, a medication used to soften the cervix and encourage labor.
7. After her evaluation of Yadira Roman on February 15, 2008, Dr. Eash-Scott noted certain symptoms of preeclampsia, but did not diagnose preeclampsia.
8. Upon admission to the hospital on February 15, 2008, Yadira Roman denied any signs or symptoms of preeclampsia, specifically no headaches, visual changes, or right upper quadrant abdominal pain.
9. At or about 6:50 a.m. on February 16, 2008, Dr. Eash-Scott examined Yadira Roman and determined that she was two centimeters dilated, 100% effaced, with the fetal head at -1 station.
10. On the morning of February 16, 2008, Dr. Eash-Scott transferred care of Yadira Roman to Kirsten Johnsen-Martin, D.O., a board certified family practice physician at Southeast Lancaster Health Services. Dr. Johnsen-Martin had privileges at Lancaster General Women and Babies Hospital to manage labor and delivery. Dr. Johnsen-Martin did not have hospital staff privileges to perform a vacuum assisted delivery or a caesarean section.
11. At or about 8:25 a.m. on February 16, 2008, Dr. Johnsen-Martin examined Yadira Roman and determined that she was two to three centimeters dilated, 100% effaced and at 0 to station.
12. Dr. Johnsen-Martin then ordered that Nubain be administered to Yadira Roman for pain relief.
13. At 10:33 a.m. on February 16, 2008, Yadira Roman's membranes spontaneously ruptured.
14. At or about 11:42 a.m. on February 16, 2008, Dr. Johnsen-Martin performed a cervical exam and noted that Yadira Roman's cervix was four centimeters dilated and 100% effaced.
15. Dr. Johnsen-Martin then ordered the administration of Pitocin to induce labor.
16. On February 16, 2008, Dr. Johnsen-Martin was aware that Yadira Roman's blood pressure fluctuated from mid-140's or below (systolic), over 80 or below (diastolic) throughout the day.
17. Dr. Johnsen-Martin never diagnosed Yadira Roman with preeclampsia. In fact, Ms. Roman ...