Group B Strep Leaves Baby With Quadriplegia And Mental Retardation After Pediatrician Missed Signs

A Group B Strep infection can have severe consequences on a baby and can develop and cause injury suddenly and quickly doctors generally agree that antibiotics should be administered as soon as a baby shows signs of infection rather than wait for test results which can take 48-72 hours. If test results later come back negative, antibiotics can be stopped. Failure to recognize the signs of infection or to treat them immediately with antibiotics may result in medical malpractice.

Consider, for example, a reported case in which the baby’s mother had tested negative for Group B Strep during the pregnancy and neither the mother nor the baby showed any of the risk factors for neonatal sepsis (such as preterm delivery, rupture of the membranes lasting longer than 18 hours prior to delivery, and infection of the placental tissues and amniotic fluid).

The pediatrician was present in the delivery room. Within three hours of being born the baby started experiencing respiratory distress, had problems feeding, and his extremities started showing diminished perfusion (which can lead to decreased tissue oxygen delivery).

The pediatrician was called two times by the nurses about these developments. The pediatrician ordered pulse oximetry but did not examine the baby. Pulse oximetry is a noninvasive method of monitoring the oxygenation of the baby’s hemoglobin. The results were normal as were the results of the CBC and urine bacterial antigen tests ordered by the pediatrician after the baby’s birth. Over the course of the next 11 hours after the initial onset of symptoms, the baby’s respiratory and feeding problems seemed to resolve but the perfusion problems did not change.

The pediatrician claimed to have examined the baby 14 hours after birth. There was no record in the chart of the pediatrician conducting a full examination of the baby. There was only an entry indicating that the baby was normal in all respects, active, pink, alert and feeding well. The pediatrician then left the hospital.

Entries in the chart over the course of the next 12 hours documented that the baby’s perfusion problems continued. Then, 26 1/2 hours after being born the baby again developed respiratory and feeding problems. The staff called the pediatrician approximately 1 1/2 hours after these symptoms returned.

The pediatrician immediately returned to the hospital, diagnosed the baby with septic shock, and transferred him to the Intensive Care Unit. The baby required resuscitation. He was transferred five hours later to a medical center where he could receive more specialized care and remained there for an extended stay.

The baby had suffered from meningitis due to a Group B Strep infection. The meningitis, in turn, resulted in quadriplegia and mental retardation. Had the pediatrician administered antibiotics prior to leaving the hospital, the baby would not have developed meningitis and would not suffer from quadriplegia or mental retardation.

A lawsuit was filed on behalf of the baby and his parents. The case went to trial where the plaintiffs presented evidence that the pediatrician (1) should have conducted a full sepsis workup 3 hours after delivery, when the baby first started showing symptoms (2) should have immediately started the baby on antibiotics and (3) should have left clear instructions for the nurses to contact him immediately of any change in condition. The jury returned a verdict in favor of the plaintiffs and the law firm that represented them reported the case then settled for $1.0 Million, the policy limits.

This case illustrates the importance of reacting quickly to signs of infection in a newborn. While the pediatrician took the position that the initial respiratory and perfusion problems were explainable as side effects of issues other than infection, that the feeding problems had resolved before he left, and that the test results were negative, the fact remains that the baby did have a Group B Strep infection and that early administration of antibiotics, as most doctors would recommend, would have prevented his lifelong disabilities.