Video Snafu Forces Malpractice Appeal To A Temporary Halt

Testimony Resumes To Determine Whether Negligence Led To Infant's Death

May 26, 1991|By Maria Archangelo | Maria Archangelo,Staff writer

WESTMINSTER — Four-and-a-half days of medical testimony in a county pediatrician'sappeal against a finding of malpractice ended abruptly Friday afternoon because of technical difficulties.

Testimony is set to begin again at 9:30 a.m. Tuesday in Dr. Karl Green's appeal of a decision bythe Maryland Health Arbitration Board in Sykesville that found the doctor negligent in his care of the infant son of Robert and Barbara Morris of Westminster.

About 30 minutes into the videotaped cross-examination of a Canadian pediatrician, the picture became jumbled and was difficult for the jury to see clearly.

After testing the tape in another courthouse videocassette recorder and finding that it didn't work, Circuit Judge Francis M. Arnold sent the jury of eight men and four women home for a long holiday weekend.

It was an unexpected early break in a civil trial dominated by technical medical terms, dueling experts and accusations of negligence and carelessness.

In July, the three-member board awarded the Morrises $550,000 in damages.

Carroll CountyGeneral Hospital also was named in the original suit but was not found liable by the malpractice panel.

Green, a county pediatrician for more than 20 years, appealed the decision to Carroll Circuit Court.

According to court testimony, Brett Morris was born at Carroll County General at 10 a.m. Sept. 21, 1986. He weighed 8 pounds 9 ouncesbut had breathing problems.

The baby died 19 hours later, before his parents had a chance to hold him.

The parents' attorney, LaVonna Vice of Baltimore, contends that Green failed to follow standard procedures of care for a baby suffering from acute breathing problems.

Vice maintains that Green did not give the baby enough oxygen, that he misread a chest X-ray and that he wrongly allowed the baby to be fed formula.

In court last week, the attorney pointed to the fact that the medical examiner's report showed the baby had pneumomediastynum, a condition in which air collects outside the lungs, creating pressure and causing breathing difficulty.

The condition can be treated with oxygen and by inserting a needle into the baby's chest to remove the air outside the lungs.

Vice also contends that the nurses in the newborn nursery did not do their job when they failed to call Green when the baby's condition worsened at 11:30 p.m.

Robert Morgan, attorney for the hospital, maintains the baby appeared to be improving until that point and the nurses had no reason to be alarmed until 2:20 a.m., when the he showed signs of respiratory distress.

Green and his attorney, Michael Baxter of Baltimore, dispute the parents' version of the events and say the baby died of "persistent fetal circulation," in which an infant has difficulty adjusting to breathing outside the womb.

In Friday's videotaped testimony, Dr. VictorChernick, a pediatric lung disease specialist from Manitoba, said hebelieved the baby "definitely did not die from persistent fetal circulation," because there was nothing in his clinical profile to indicate the syndrome.

He criticized Green for not making a diagnosis ofpneumomediastynum and for not taking early and appropriate action.

He said the chest X-ray taken 15 minutes before the baby's heart stopped beating was a "classical film for pneumomediastynum," and that Green should have immediately inserted a needle to remove the pent-upair.

Hospital records show the doctor did try to insert a needle to release air from the thorax, but Chernick said it was put in the wrong place.

"It didn't do anything except maybe puncture the lung," Chernick testified, adding that inserting a needle in a baby's chest can be a difficult process.

Chernick said that if the correct diagnosis had been made early enough and the baby treated with 100 percent oxygen, he would have had a good chance of survival.

"I think this was an infant that was salvageable," Chernick said.

The Canadian doctor also faulted the nurses in the newborn nursery for failingto call Green at 11:30 p.m. when the baby turned blue for the secondtime.

Chernick's testimony was videotaped May 17 at the courthouse because he was scheduled to leave for Switzerland a few days later.

Late Wednesday afternoon, a Washington-registered nurse testifiedthat the nursing staff at the hospital breached accepted standards of care and the hospital's own policies in its treatment of Brett Morris.

In testifying on behalf of the Morrises, Linda C. Carl said the nurses in the newborn nursery failed to document the baby's vital signs every hour and did not recognize that his temperature never stabilized.

Carl said that the nurses' failure to call Green at 11:30 p.m. was one of the most serious breaches of hospital policy.

Morgan attempted to discredit Carl and her testimony by saying that she works with Dr. David Charles Abramson, a Washington pediatrician who testified on behalf of the parents earlier in the week.

Baxter accused Abramson of being a hired gun who has testified against "hundredsof doctors and health-care providers" for money.

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