FACTUAL BACKGROUND

8. On or about _________________________ presented to the _________________________ when she was approximately eight weeks pregnant. Blood taken for testing that visit indicated that _________________________’s blood was type O, Rh negative. The significance of this finding was that if her baby’s blood was Rh positive, she would be making antibodies to her own baby, which could be problematic for the baby and for any future pregnancies.

9. The pregnancy continued uneventfully until approximately ________________, when _________________________ had an episode of vaginal bleeding prompting her to go to the hospital for evaluation. An ultrasound was performed and everything appeared fine with the pregnancy.

10. On or about _________________, another episode of vaginal bleeding occurred when _________________________ was approximately 21 weeks pregnant. _________________________ returned to the emergency room for evaluation and once again, everything appeared fine.

11. During that ER visit, _________________________’s blood type was checked again and it revealed that not only was she O negative, but the antibody screen was negative, indicating that as of that time she had not been sensitized to Rh positive antigens.

12. As a precaution, however, _________________________ was given Rhogam due to the vaginal bleeding to prevent the sensitization from occurring and then sent home. (Rhogam is a medication given to Rh negative mothers, who potentially are carrying an Rh positive baby, so that the mother does not become sensitized and make antibodies to her own baby. If antibodies are made, that could be harmful to the baby she is carrying as well as any future pregnancies).

13. Thereafter, the pregnancy continued uneventfully. Given these circumstances, when _________________________ reached 28 weeks gestation, the standard of care dictated that she undergo further testing to check for Rh sensitization and to administer Rhogam if she was indeed sensitized. (In fact, there is a preprinted form for prenatal care that has a reminder box for the 28-week testing).

14. The medical records indicate that _________________________ was not tested at 28 weeks and that Rhogam was not administered then in violation of the applicable standard of care. (The prophylactic Rhogam administered to _________________________ at 21 weeks gestation would not be sufficient to prevent _________________________ from becoming sensitized through the end of the pregnancy. Moreover, if Rhogam was not going to be administered at 28 weeks, a repeat Rhogam injection should have been given approximately 12 weeks after the first dose in other words at 33 weeks, and that would have protected _________________________ from becoming sensitized).

15. The lack of appropriate Rhogam coverage directly led to _________________________ becoming sensitized. Consequently, all of her future pregnancies will be considered high risk, as there is a chance of damage and death to future babies born.

16. On or about April 27, 2001, _____________ delivered her baby without complications.

17. Before the customary dose of Rhogam was to be given after the delivery, _________________________ once again had an antibody screen. This time, however, she was found to be very strongly positive for the Rh antigen. In other words, _________________________ became sensitized sometime between the negative test of December 11, 2000, and the positive test of April 20, 2001. _________________________ never would have become sensitized had the Defendants adhered to the standard of care and timely given Rhogam.

18. _________________________ became pregnant again in 2001, and through careful management of the pregnancy including serial amniocentesis, (obtaining fluid samples from the amniotic sac to conduct laboratory studies to assess for fetal well- being) a healthy baby was born.

19. _________________________ became pregnant another time in 2003. Unfortunately, this pregnancy did not go so well. Due to _______________________’s Rh sensitization, serial intrauterine blood transfusions had to be performed periodically throughout the pregnancy in order to address the Rh issues to ensure fetal well-being.

20. The last transfusion was on January 13, 2004, when _____________________ was at 32 weeks gestation. During the procedure, apparently the needle hit the umbilical cord causing a severe drop in the baby’s heart rate. An emergency cesarean section ensued, but despite this, baby _________________________, sustained a severe brain injury due to lack of oxygen to the brain and prematurity.

21. The pathologist found a fresh perivascular hemorrhage when examining the placenta and umbilical cord.

22. Had _________________________ never been sensitized, none of her subsequent pregnancies would have required serial transfusions, and any complications from those transfusions would have been avoided as well.

23. In this case, had the Defendants adhered to the standard of care, more likely than not, _________________________’s brain injury would have been avoided.

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