Geoffrey Fieger · Nick Rowley
March 30, 2022 5:30 PM||TLU n DemandRegister Now
On March 21, 2022, a Johnson County Iowa jury unanimously found in favor of minor-Plaintiff, Scotty, awarding over $97.4 million dollars in damages in a birth trauma medical malpractice case. It is the largest malpractice verdict in Iowa state history. The case was tried by Geoffrey Fieger of Southfield, Michigan and Jack Beam and Matthew Patterson of the Chicago law firm Beam Legal Team, LLC before the Honorable Kevin McKeever in Iowa City, Iowa. The Defendants were Mercy Hospital Iowa City and Obstetric and Gynecologic Associates of Iowa City and Coralville, P.C.
Scotty was the third child of Kathleen and Andy. Kathleen, after an uneventful and routine prenatal course, went to Mercy Hospital Iowa City in active labor with a perfectly healthy baby in August of 2018. She was admitted by her OB/GYN Jill Goodman, M.D., an employee of Obstetric and Gynecologic Associates of Iowa City and Coralville, P.C.
Shortly after admission, baby Scotty in utero signaled a non-reassuring fetal heart rate pattern on the fetal heart rate monitor. Despite preparing an operating room for C-section, Dr. Goodman did not perform urgent surgery. Instead, she ordered terbutaline and an epidural to slow down Kathleen’s natural labor so she could tend to two other laboring patients. Consequently, Dr. Goodman left the bedside to deliver two other patients for an hour, when Kathleen and Baby Scotty needed Caesarian delivery. During that time, Scotty’s fetal heart tracing deteriorated from non-reassuring to bradycardic and fetal distress. However, the nurse – who was unaware that Dr. Goodman was performing other deliveries (until she was told in her deposition) – did not call for Dr. Goodman to come back and did not call for a back-up obstetrician.
When Dr. Goodman finally returned to her patients’ bedside, Scotty was in terminal bradycardia. His mother was pushing with the nursing staff in a rather medieval technique described in the labor record as “tug-o-war”. Dr. Goodman then proceeded to attempt an operative vaginal delivery, first with forceps while Scotty in utero was in a malposition, and, when that failed despite two attempts with forceps, the OB then used a vacuum extractor to traumatically deliver the baby, although such use was an absolute contraindication. Scotty was delivered with every traumatic brain injury that the medical literature explicitly warns can result from vacuum and forceps.
Shortly after birth, Scotty was transferred to the world-renowned Iowa Children’s Hospital who promptly diagnosed his conditions during a six-week NICU stay. Shortly after his NICU admission, the Children’s Hospital discovered Scotty had a massive depressed/“ping-pong” skull fracture caused by the attempted forceps delivery, extensive bleeding in his brain from the vacuum delivery, and hypoxic-ischemic encephalopathy (“HIE”), brain damage from a lack of oxygen before birth.
Only after the delivery, the doctor and Hospital then claimed that Scotty’s severe skull fracture existed before the attempted forceps delivery despite no contemporaneous medical record documentation. So, the Defendants claimed at trial that Scotty’s severe (forceps shaped) skull fracture, bleeding and brain damage were caused by the natural forces of labor before the traumatic attempts at operative vaginal delivery. For the defense, counsel relied on an obstetrician who—contrary to all the findings of the University of Iowa doctors—suggested all of Scotty’s brain damage occurred during delivery through the birth canal. The doctor’s practice, Obstetric and Gynecologic Associates of Iowa City and Coralville, P.C., never made any offer to settle this case before trial.
The jury rejected this frivolous defense and found in favor of Scotty against both the Hospital and the doctor’s practice, awarding every penny of future medical care costs requested for Scotty’s extensive future attendant care needs. Today, Scotty is 3 1/2 years old and has been diagnosed with cerebral palsy, developmental delay, mixed expressive-receptive language disorder, ischemic brain injury, and HIE.
Exposing inherent biases and getting strikes for cause during voir dire.
Questioning witnesses about being fair, starting on a level playing field, etc. for Plaintiff or Defense and how that helps build credibility with the venire while striking potentially adverse jurors. (he was able to get 20+ strikes just for cause [bias, etc.]).
Taking advantage of physical evidence and/or demonstratives: the forceps and the skull fracture.
Using the physical use of the forceps and vacuum at trial, which is simple evidence, but has huge impact.
If you’re defending, you’re losing: don’t engage with the Defendants in irrelevant facts.
My philosophy not to bother with or even discuss with experts’ irrelevant facts that the Defendants try to highlight; in our case, this was the Apgar scores, blood gas results and insurance.
Prosecuting the defense in your case in chief.
You can discredit the Defendants’ theory of cause or liability in your opening statement and with your experts. For example, Geoffrey gave our experts softball questions about how stupid the defense is.
Taking a complicated obstetrical/medical-legal case and telling a story to your jury.
This one is pretty self-explanatory!
Telling your story through cross examination.
It’s not really the answer that matters while cross-examining a defense expert and/or Defendant; what matters is the story you’re telling through your questions.