United States District Court, Eastern District of Pennsylvania
ZAYA WINFIELD CARTER, et al.
UNITED STATES OF AMERICA
Harvey Bartle III Judge
Plaintiffs Briana Winfield (“Winfield”) and Rasheed Carter (“Carter”), in their own right as parents and as natural guardians of their minor daughter, Zaya Winfield Carter (“Zaya”), bring this one-count medical malpractice action against the United States of America (the “Government”) under the Federal Tort Claims Act, 28 U.S.C. §§ 1346(b), 2674, and 2675(a). When pregnant with Zaya, Winfield received prenatal care from Parkview Health Center (“Parkview”), a clinic that is part of the Public Health Service.The plaintiffs allege that Parkview’s negligent failure promptly to notify Winfield or Hahnemann University Hospital, where her child was delivered, of certain prenatal laboratory test results has caused Zaya to suffer hypoxic brain injury, seizures, poor feeding, and other damages.
Before the court is the motion of the Government for summary judgment under Rule 56 of the Federal Rules of Civil Procedure.
Summary judgment is appropriate “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a); see also Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). Rule 56(c) states:
A party asserting that a fact cannot be or is genuinely disputed must support the assertion by ... citing to particular parts of materials in the record, including depositions, documents, electronically stored information, affidavits or declarations, stipulations ..., admissions, interrogatory answers, or other materials; or ... showing that the materials cited do not establish the absence or presence of a genuine dispute, or that an adverse party cannot produce admissible evidence to support the fact.
Fed. R. Civ. P. 56(c).
A dispute is genuine if the evidence is such that a reasonable factfinder could return a verdict for the non-moving party. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 254 (1986). Summary judgment is granted where there is insufficient record evidence for a reasonable factfinder to find for the plaintiffs. Id. at 252. “The mere existence of a scintilla of evidence in support of the plaintiff’s position will be insufficient; there must be evidence on which the factfinder could reasonably find for the plaintiff.” Anderson, 477 U.S. at 252.
When ruling on a motion for summary judgment, we may only rely on admissible evidence. See, e.g., Blackburn v. United Parcel Serv., Inc., 179 F.3d 81, 95 (3d Cir. 1999). We view the facts and draw all inferences in favor of the nonmoving party. In re Flat Glass Antitrust Litig., 385 F.3d 350, 357 (3d Cir. 2004). However, “an inference based upon a speculation or conjecture does not create a material factual dispute sufficient to defeat entry of summary judgment.” Robertson v. Allied Signal, Inc., 914 F.2d 360, 382 n.12 (3d Cir. 1990).
The following facts are undisputed or viewed in the light most favorable to the plaintiffs as the nonmovants. Winfield began her prenatal treatment at Parkview on January 12, 2010. Her estimated due date was August 18, 2010, and her course of treatment went smoothly. On Tuesday, July 27, when Winfield was at 36 weeks and 6 days’ gestation, she was tested for Group B Streptococcus (“GBS”) colonization as part of her “term labs.” She was not scheduled for a follow-up visit at Parkview until Thursday, August 5.
GBS, a type of bacteria, is a leading infectious cause of neonatal morbidity and mortality in the United States. Up to 30 percent of pregnant women are colonized with GBS when they go into active labor. If the condition is untreated, there is a significant risk of transmitting GBS to the newborn child, which can cause the child to suffer from a number of serious illnesses. However, if a mother is given “intrapartum chemoprophylaxis” in the form of intravenous antibiotics at the time labor, the risk of transmitting GBS to her child is greatly reduced.
To combat neonatal GBS disease, the Centers for Disease Control and Prevention (“CDC”) promulgated guidelines for obstetricians, pediatricians, laboratories, and labor and delivery facilities. The CDC guidelines include the following recommendations:
• All pregnant women should be screened at 35-37 weeks’ gestation for vaginal and rectal GBS colonization.... At the time of labor or rupture of membranes, intrapartum chemoprophylaxis should be given to all pregnant women identified as GBS carriers....
• If the result of GBS culture is not known at the onset of labor, intrapartum chemoprophylaxis should be administered to women with any of [a series of] risk factors....
• Health-care providers should inform women of their GBS screening test result and the recommended interventions.
The American Academy of Pediatrics and the American College of Obstetrics and Gynecology adopted these guidelines in 2002. Consistent with the CDC guidelines, it was Parkview policy to conduct a GBS test at 36 weeks’ gestation and onward, with delivery anticipated at anywhere from 37 to 40 weeks’ gestation.
Parkview received Winfield’s GBS test results on Friday, July 30. The tests were abnormal, and Dr. Henry Su, a Parkview physician, made an underlined, handwritten notation on the test result slip to “Tx [treat] in labor.” According to Dr. Su, this notation meant that antibiotics were to be given to Winfield when she went into active labor in accordance with the recommendations described above. Winfield’s GBS test result, however, was not attached to her chart. Instead it was placed in a folder in which Parkview keeps abnormal test results until a patient is called or returns for an office visit. It was typical at Parkview to wait until a follow-up visit to discuss abnormal lab results.
Winfield was scheduled to deliver her baby at Temple University Hospital, the planned delivery location for all Parkview patients. On Wednesday, August 4, 2010, at approximately 9:15 a.m., Winfield arrived at Temple with complaints of contractions. Because it was determined that she was not in labor, she was discharged at 10:45 a.m. At 10:05 p.m. on the same day, Winfield, complaining of contractions, again appeared at Temple. Once again, Winfield was discharged. She was advised to keep her follow-up appointment at Parkview scheduled for the next day.
The timing of events on the next day, August 5, is of particular importance here. At 6:58 a.m., Winfield was taken by ambulance to Hahnemann University Hospital, where she was admitted by Dr. Justin Rasner, then a second-year resident physician. Hahnemann was not affiliated with Parkview in any way. At 7:20 a.m., Dr. Carlene Denis, another Hahnemann physician, noted in Winfield’s chart that her GBS status was unknown. At 7:30 a.m., Dr. Rasner wrote in the chart that Winfield had been seen at Temple the day before and had received prenatal care at Parkview. He also made ...