United States District Court, M.D. Pennsylvania
CHRISTINA LATE and NATHAN ARMOLT, as parents and natural guardians of D.A., a minor, and in their own right, Plaintiffs,
UNITED STATES OF AMERICA, Defendant.
FINDINGS OF FACT & CONCLUSIONS OF LAW
H. RAMBO United States District Judge
March 22, 2013, Plaintiffs filed a complaint against the
United States pursuant to 42 U.S.C. § 1346(b)(1) of the
Federal Tort Claims Act related to injuries sustained by
minor-Plaintiff D.A. during his birth. (Doc. 1.) After
unsuccessful attempts at mediation and settlement (Docs. 9
& 46), and a subsequent two-year stay to allow more time
to accurately gauge D.A.'s development and the effects of
his brain injury (Doc. 53), a six-day bench trial commenced
on September 19, 2016. Based on the evidence submitted at
that trial, the court now sets forth its findings of fact and
conclusions of law.
Findings of Fact
and Birth of D.A
was born on February 21, 2012 at Keystone Women's Health
Center, a federally supported community health center.
Plaintiffs Christina Late and Nathan Armolt are the parents
and natural guardians of D.A.
Late graduated high school in 2003 and subsequently attended
Shippensburg University for one year. She then obtained a
diploma in medical billing, coding, and transcription from
the Computer Learning Network. Ms. Late has worked as a
service professional at Olive Garden restaurant for nine
years, and is a full-time employee.
Armolt is a high school graduate and is employed as a
distribution professional in an Amazon warehouse.
Thomas Orndorf is an obstetrician employed by Keystone
Women's Health Center and was an employee of the United
Orndorf delivered D.A. on February 21, 2012.
During prenatal care, Ms. Late was also under the care of
Hilary Ginter, M.D., who is board-certified in obstetrics and
Throughout Ms. Late's prenatal care with Keystone
Women's Health Center her pregnancy was normal.
Sometime before 10 p.m. on February 20, 2012, Ms. Late
presented at Chambersburg Hospital with complaints of
contractions and leaking of fluid.
Ginter was the attending physician on-call between 6 p.m. and
7 a.m. the following morning. Dr. Ginter stayed at the
hospital while on call.
During the initial six hours of labor after admission, Ms.
Late had regular contractions. Ms. Late also had two episodes
of vomiting during contractions, a symptom she also
experienced during the delivery of her first child.
Ginter testified she had no concerns with respect to Ms.
Late's progress at any time during the night. Ms. Late
had a normal labor curve throughout the night, with normal
progress of dilation and station.
Ginter also testified she did not have any concerns regarding
the fetal heart tracings or fetal well-being at any time.
7 a.m., Dr. Orndorf assumed physician care of Ms. Late.
Neither Dr. Orndorf nor any of the nurses expressed any
concern regarding Ms. Late's labor or progress, or about
the baby's heart rate or that the baby was
“stuck.” 16. Dr. Orndorf did not explain to Ms.
Late that any type of intervention was necessary, including
the use of forceps.
7:39 a.m., after only one push, Dr. Orndorf applied Laufe
Orndorf pulled once and then removed the forceps.
Although the baby was not yet crowning, Dr. Orndorf
re-applied the forceps and forcefully pulled three more
times. During this period, Dr. Orndorf was straining,
red-faced and sweaty.
Orndorf removed the forceps. With maternal pushing, baby D.A.
D.A. weighed 3, 909 grams at birth. At one minute, he had an
Apgar of 7; at five minutes, his Apgar score was 9.
Upon initial assessment, D.A.'s head showed moulding and
Orndorf admitted that Ms. Late made normal progress during
the three stages of labor.
Orndorf admitted that progress from a -1 station at 5:31 a.m.
to a station at 7:30 a.m. reflected a good rate of
Orndorf admitted it is common in labor to have variable
decelerations and late decelerations. He also admitted that a
return to baseline, accelerations, and good variability after
a deceleration in fetal heart rate are reassuring and normal.
He also admitted that Category 2 decelerations are common in
Orndorf admitted vomiting is a common occurrence for women in
labor, which does not raise any concerns.
Orndorf admitted that, when he began the delivery, the fetal
heart tracings were reassuring with accelerations of more
than ten beats per minute and variability.
Orndorf admitted that, at 7:30 a.m., there was no concern for
immediate fetal compromise.
Orndorf also admitted that he had no concern about the
adequacy of Ms. Late's pushing or her efforts in pushing.
Orndorf admitted that forceps can increase the risk of injury
to mom and baby.
Orndorf also admitted that the higher the baby is positioned
in the birth canal at the time forceps is applied, the risk
of injury is also higher.
Orndorf admitted he expected Ms. Late to have an easy
Orndorf admitted protraction of the first stage of labor is
never an appropriate indication for forceps delivery.
Orndorf admitted the policy at Chambersburg Hospital and at
Keystone Women's Health Center was to use the American
College of Obstetrics and Gynecology guidelines as best
Orndorf admitted that American College of Obstetrics and
Gynecology guidelines provide the only indications for a
forceps delivery is a prolonged second stage, where the
mother is pushing for two hours, concern over ...