After selecting a jury in Delaware County, Pa, attorneys Carol Nelson Shepherd and Peter M. Newman negotiated a $2.3 million settlement for a five-year-old girl who sustained severe neurologic injuries caused by the failure of the defendant physicians to diagnose and treat twin-to-twin transfusion syndrome (“TTTS”). TTTS is a phenomenon that occurs only in monochorionic (shared placenta) twin pregnancies when the arterial circulation of one twin is in communication with the venous circulation of the other twin through arteriovenous anastomoses. Blood is transfused from the “donor” twin to its “recipient” sibling such that the donor becomes growth restricted while the recipient develops circulatory overload with associated complications. A confidentiality clause in the settlement agreement precludes disclosure of the names of the defendant physicians and institutions.
Plaintiff’s mother was 10 weeks pregnant when an ultrasound revealed a twin gestation. Unfortunately, the radiologist interpreting that ultrasound failed in his duty to determine whether the twins shared a placenta. Monochorionic twins (that share a placenta) are at increased risk for complications, including TTTS.
A second ultrasound, performed eight weeks later, noted an 18 percent discrepancy in the weight of the twins, a large discrepancy in their abdominal circumferences, and an amniotic fluid imbalance, all signs and symptoms of TTTS. Unfortunately, the defendant obstetricians failed to take action to monitor and treat the evolving syndrome. Treatment options for TTTS include serial amnioreduction therapy (redistribution of amniotic fluid) and fetoscopic laser occlusion (surgery to separate the blood vessels that connect the twins). A third ultrasound performed at 29 weeks gestation revealed the intrauterine demise of the smaller twin, resulting in her death. Blood shunted from the surviving twin to the demised twin then caused the surviving twin to suffer hypoxia and resulting neurologic injury.
Plaintiff was prepared to present testimony at trial from experts in the fields of obstetrics, radiology, pediatric neurology, perinatology, pediatric neuropsychology as well as a life-care planner and an economist in support of her claim.
However, the case was strongly contested by the defendants who proposed to call experts from the fields of obstetrics, radiology, pathology, pediatric neurology, perinatology, pediatric neuropsychology, and forensic economics, to testify not only that there were other possible causes of injury to the minor-plaintiff, but also that treatment options for TTTS, if present, were experimental in nature and would not likely have avoided injury to the plaintiff.
The settlement will be held in trust for the 5-year-old plaintiff to meet her future needs.
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