As a Texas medical malpractice attorney, I’ve seen firsthand the devastating consequences when doctors, physician assistances, nurse practitioners, and registered nurses providers fail to follow established standards of care. One critical area where such failures can have tragic outcomes is in the management of Group B Streptococcus (GBS) during pregnancy and delivery.
The truth be told, GBS is a common type of bacteria that’s generally harmless in healthy adults. Like all bacteria, though, when GBS colonizes and grows in the wrong place, it can cause serious problems.
When medical professionals ignore GBS guidelines, such as those outlined by the American College of Obstetricians and Gynecologists (ACOG), the results can be catastrophic, leading to preventable injuries or even the loss of a newborn’s life.
In this article, we’ll explore the dangers of GBS, the standard of care for its management, and how medical malpractice can occur when these standards are not met, drawing on insights from cases like one I’m currently handling.
What is Group B Streptococcus (GBS)?
Group B Streptococcus is a type of bacteria commonly found in the intestines, rectum, or vaginal canal of healthy adults. According to the Centers for Disease Control and Prevention (CDC), approximately 25% of pregnant women carry GBS without symptoms.
While GBS typically doesn’t cause issues for the mother, it can be transmitted to a newborn during labor and delivery, potentially leading to serious infections such as sepsis, pneumonia, or meningitis. Early-onset GBS disease, which occurs within the first week of a newborn’s life, is particularly dangerous and can result in severe disability or death if not prevented or treated promptly.
The risks of GBS are well-documented, and medical guidelines, such as those from ACOG and the CDC, provide clear protocols that will prevent GBS infections in newborns. These guidelines emphasize the importance of screening pregnant women for GBS between 35 and 37 weeks of gestation and administering intrapartum antibiotic prophylaxis (IAP) during labor when indicated. Unfortunately, when doctors, nurses, and other healthcare providers fail to adhere to these standards, the consequences can be devastating.
That’s what happened in a case I’m currently handling. To preserve their privacy, we’ll call the mom Christy and her newborn son Kevin.
Kevin’s Case: A Preventable Tragedy
In a recent case, Christy, a 20-year-old pregnant mother, went to a Texas hospital to be admitted for contractions. She was a 39 weeks in her pregnancy.
This was her second pregnancy. During the prenatal care and labor and delivery of her first child, she was told she was GBS positive. That’s why Christy was sure to tell the obstetrician and labor and delivery nurses about it when she arrived at the hospital with painful contractions.
Despite her history of GBS colonization in a prior pregnancy, the doctors and nurses didn’t order antibiotics while she was in labor and delivery. Frequently, the antibiotic choice is penicillin, but may sometimes be ampicillin or cefazolin.
The doctor and nurses noted some concerns in Christy’s medical record. The most significant issue is her baby had a condition called fetal growth restriction (FGR), with an estimated fetal weight in the 1st percentile. These factors heightened the risk of GBS transmission and complications after birth, because this small term baby might not be strong enough to fight off a GBS infection.
Tragically, that’s what happened shortly after Kevin was born. He developed early-onset GBS sepsis, and died the day after he was born. The failure to order and administer penicillin to Christy during her 16-hour labor, was a direct breach of the standard of care. This preventable error led to Kevin’s death, underscoring the critical need for healthcare providers to follow established GBS protocols.
The Standard of Care for GBS Management
The standard of care for managing GBS in pregnancy is well-established. ACOG and CDC guidelines recommend universal screening for GBS colonization between 35 and 37 weeks into a pregnancy. You can learn more in this article that defines what the standard of care is in a Texas medical malpractice case.
If a woman tests positive, has a history of GBS colonization in a prior pregnancy, or presents with risk factors such as preterm labor, prolonged rupture of membranes, or fever during labor, IAP should be administered during labor. Penicillin is the preferred antibiotic, as it crosses the placenta and reduces GBS colonization in the vaginal canal, significantly lowering the risk of neonatal infection.
In cases where a woman’s GBS status is unknown, such as when a patient has had limited prenatal care, the standard of care requires healthcare providers to err on the side of caution. This may involve performing a rapid GBS test, which provides results within an hour, or presumptively administering antibiotics during labor.
That’s what should have happen in Christy’s case because of her baby’s small size and diagnosis of FGR. In her case, though, the medical and nursing team’s failure to inquire about Ms. Caldera’s GBS history, perform a rapid GBS test, or initiate antibiotics despite known risk factors constituted a clear deviation from these standards.
When Does GBS Mismanagement Constitute Medical Malpractice?
Medical malpractice occurs when a healthcare provider fails to meet the standard of care, resulting in harm to the patient. In the context of GBS, malpractice may arise from:
- Failure to Screen for GBS: Not conducting GBS screening between 35 and 37 weeks, or failing to inquire about a patient’s GBS history, especially in cases of limited prenatal care.
- Failure to Administer Antibiotics During Labor: Not providing antibiotics during labor when a patient is GBS-positive, has a history of GBS, or presents with risk factors.
- Inadequate Monitoring or Testing: Failing to perform rapid GBS testing or relying on delayed test results, as seen in Christy’s case, where the results of a stat test weren’t available until after Kevin’s birth.
- Lack of Advocacy by Nursing Staff: Nurses have a duty to advocate for patients, particularly in high-risk scenarios, by ensuring that physicians are aware of the need for IAP. In fact, hospital policy requires nurses to advocate for patient safety.
These failures can lead to severe outcomes, including neonatal sepsis, brain damage, or death. In Kevin’s case, the medical team’s inaction despite clear risk factors directly contributed to his death from GBS infection and sepsis.
The Consequences of GBS-Related Malpractice
The consequences of failing to manage GBS properly can be life-altering. Newborns who survive GBS infections may face long-term disabilities, such as developmental delays, hearing loss, or cerebral palsy. For families, the emotional and financial toll of losing a child or caring for a disabled child can be overwhelming.
In Kevin’s case, the neonatal intensive care unit (NICU) documented severe metabolic acidosis and sepsis, conditions that could have been prevented with timely antibiotic administration. You can learn more in this article that discusses how to prove a hospital-acquired infection medical malpractice claim.
How a Texas Medical Malpractice Attorney Can Help
If you or a loved one has been affected by a hospital, doctor, or nurse’s failure to properly manage GBS, you may be entitled to compensation for medical expenses, pain and suffering, and other damages. As a Texas medical malpractice attorney, I work with families to hold negligent healthcare providers accountable.
In Texas, medical malpractice claims must meet specific requirements, including the submission of an expert report within 120 days of filing a lawsuit, as outlined in Chapter 74 of the Texas Civil Practice and Remedies Code. That’s why it’s important to consult with an experienced and qualified medical malpractice attorney about a potential claim.
Seeking Justice for Your Family
The loss of a child or the injury of a newborn due to GBS-related malpractice is a tragedy that no family should endure. If you suspect that medical negligence contributed to your child’s injury or death, it’s critical to act quickly, as Texas has a two-year statute of limitations for medical malpractice claims. Contacting an experienced medical malpractice attorney can help you understand your rights and pursue justice.
If you believe your family has been impacted by a healthcare provider’s failure to manage GBS or other medical negligence, don’t wait to seek help. Contact your Texas medical malpractice law firm for a free consultation. We are here to listen, answer your questions, and guide you through the legal process.
