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Late v. United States

United States District Court, M.D. Pennsylvania

April 20, 2017

CHRISTINA LATE and NATHAN ARMOLT, as parents and natural guardians of D.A., a minor, and in their own right, Plaintiffs,
v.
UNITED STATES OF AMERICA, Defendant.

          FINDINGS OF FACT & CONCLUSIONS OF LAW

          SYLVIA H. RAMBO United States District Judge

         I. Background

         On 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.

         II. Findings of Fact

         Pregnancy and Birth of D.A

         1. D.A. was born on February 21, 2012 at Keystone Women's Health Center, a federally supported community health center.

         2. Plaintiffs Christina Late and Nathan Armolt are the parents and natural guardians of D.A.

         3. Ms. 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.

         4. Mr. Armolt is a high school graduate and is employed as a distribution professional in an Amazon warehouse.

         5. Dr. Thomas Orndorf is an obstetrician employed by Keystone Women's Health Center and was an employee of the United States.

         6. Dr. Orndorf delivered D.A. on February 21, 2012.

         7. During prenatal care, Ms. Late was also under the care of Hilary Ginter, M.D., who is board-certified in obstetrics and gynecology.

         8. Throughout Ms. Late's prenatal care with Keystone Women's Health Center her pregnancy was normal.

         9. Sometime before 10 p.m. on February 20, 2012, Ms. Late presented at Chambersburg Hospital with complaints of contractions and leaking of fluid.

         10. Dr. 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.

         11. 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.

         12. Dr. 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.

         13. Dr. Ginter also testified she did not have any concerns regarding the fetal heart tracings or fetal well-being at any time.

         14. At 7 a.m., Dr. Orndorf assumed physician care of Ms. Late.

         15. 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.

         17. At 7:39 a.m., after only one push, Dr. Orndorf applied Laufe forceps.

         18. Dr. Orndorf pulled once and then removed the forceps.

         19. 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.

         20. Dr. Orndorf removed the forceps. With maternal pushing, baby D.A. was delivered.

         21. 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.

         22. Upon initial assessment, D.A.'s head showed moulding and forceps marks.

         23. Dr. Orndorf admitted that Ms. Late made normal progress during the three stages of labor.

         24. Dr. 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 descent.

         25. Dr. 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 labor.

         26. Dr. Orndorf admitted vomiting is a common occurrence for women in labor, which does not raise any concerns.

         27. Dr. 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.

         28. Dr. Orndorf admitted that, at 7:30 a.m., there was no concern for immediate fetal compromise.

         29. Dr. Orndorf also admitted that he had no concern about the adequacy of Ms. Late's pushing or her efforts in pushing.

         30. Dr. Orndorf admitted that forceps can increase the risk of injury to mom and baby.

         31. Dr. 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.

         32. Dr. Orndorf admitted he expected Ms. Late to have an easy delivery.

         33. Dr. Orndorf admitted protraction of the first stage of labor is never an appropriate indication for forceps delivery.

         34. Dr. 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 practices.

         35. Dr. 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 ...


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