On July 30, 2020, Valley Regional Medical Center, a hospital located in Brownsville, Texas, was the latest health care defendant to fail in challenging a trial court’s entry of judgment based on a jury award to the plaintiff for future medical care.
The case is styled Columbia Valley Healthcare System, L.P. d/b/a Valley Regional Medical Center; No. 13-18-00362-CV, 13th Court of Appeals, Corpus Christi/Edinburg, Texas. Here are links to the appellant’s (hospital's) brief and appellee’s (family's) brief.
Brain injured baby
A pregnant mom was receiving prenatal care from her OB/GYN, Dr. Dagoberto Martinez. One day, her membranes prematurely ruptured and she rushed to Valley Regional Medical Center and was admitted to the labor and delivery unit.
She was placed under continual nursing management because of high risk factors including age, premature rupture of membranes, and premature labor.
The first thing that caught my attention about this case is that her membranes ruptured on Friday, and she had not delivered as of the wee hours of Monday morning. In my experience a Houston, Texas birth injury attorney, most obstetrical experts believe that delivery should occur within 24 hours of ruptured membranes.
Shortly after midnight on Monday, the electronic fetal monitoring began showing dips in the baby’s heart rate, called decelerations. The standard of care requires labor and delivery nurses to look for fetal heart rate decelerations because they can signal that the baby is getting a lack of oxygen. If they are prolonged or deep, the nursing staff needs to notify the obstetrician immediately.
After the third round of decelerations within 40 minutes, the labor and delivery nurses attempted nursing resuscitation interventions, including changing the mom’s position, starting intravenous (IV) fluids and repositioning the fetal monitoring equipment. Despite losing the fetal heart rate altogether on monitoring equipment, the appellate record reflects that the nurses did not call the obstetrician, Dr. Martinez, for seven minutes.
Meanwhile, the nursing staff did not relocate the mom to the operating room for an emergency C-section delivery. According to the Valley Medical Center medical staff bylaws, this could only happen when the obstetrician was physically present on site at the hospital.
It took the obstetrician 19 minutes to arrive at the hospital and he immediately ordered a stat ultrasound. There had apparently been a lack of coordination between the physician and the nursing staff, because an ultrasound technician was not immediately available, which led to another five minutes being wasted.
Some 18 minutes after the doctor arrived at the hospital, he delivered the baby, with the nuchal cord (umbilical cord) wrapped twice around his neck. This is a dangerous medical condition that can deprive the baby of oxygen and cause permanent brain damage during the stress of labor.
The healthcare team worked to resuscitate the baby and then arranged his transfer by air to a Corpus Christi hospital, where he could receive a higher level of neonatal intensive care.
As a result of the delay in the emergency delivery that he desperately needed, the little boy was left with severe and permanent brain injury because of hypoxic-ischemic encephalopathy, or birth asphyxia, caused by a lack of oxygen during labor and delivery. He has been diagnosed with severe spastic quadriplegia, a form of cerebral palsy.
The jury award
After hearing the evidence, the jury agreed with the plaintiffs that this baby will require permanent around-the-clock care for the rest of his life. The jury awarded the following elements of damages for medical and healthcare expenses:
• $62,000 in past healthcare expenses
• $9,060,000 in future healthcare expenses.
The judgment
The Texas tort reform statute applicable to all state court medical malpractice cases allows healthcare defendants, such as Valley Regional Medical Center, to make an election to request that the court order any jury award for future medical expenses to be paid out through periodic payments, rather than a lump-sum.
Valley Regional Medical Center, like other Texas healthcare defendants, made the mistake in thinking that its election required the trial judge to allow the hospital to pay all future periodic payments out over time. As other Texas appellate courts have found, this is simply not what the statute says, though. (You may read my article about a significant Texas Supreme Court case on this topic here).
The court of appeals rejected the hospital’s argument and affirmed the trial court’s judgment in favor of the plaintiff’s, which included:
• Five periodic payments in the amount of $604,000 for the child’s future damages.
• The balance of the jury verdict, in the amount of $7,310,000, to be paid as a lump sum.
In my view, both the Texas Supreme Court and the Corpus Christi/Edinburg Court of Appeals have separately reached the only reasonable conclusion after interpreting the future periodic payments statute. This tort reform law, Texas Civil Practice errors and Remedies Code Section 74.503(a) provides that:
“At the request of a defendant physician or health care provider or claimant, the court shall order that medical, health care or custodial services awarded . . . be paid in whole or in part in periodic payments rather than by lump-sum payment.”
Clearly, there is no language in the statute that requires the trial court to order periodic payments for all future medical expenses awarded by the jury.
If you’ve been seriously injured in Texas because of poor medical or birth -related care, then contact an experienced, top-rated and rated Houston, Texas medical malpractice lawyer for help in evaluating your potential case. Attorneys with significant experience in this complex area of the law can help guide patients and their family members to the significant hurdles and requirements of Texas law.
