Fierro v. Anonymous Hospital/Medical Group

Dr. Fagel negotiated a settlement of $10,000,000 on behalf of a child who now has Short Bowel Syndrome and mild mental retardation as a result of medical professionals’ failure to diagnose a malformed anus and a bowel obstruction during his neonatal care. Although the plaintiff was born prematurely at 31 weeks to an 18 year old with a history of illegal drug use, he was healthy at birth and did not have any respiratory distress. Shortly after his birth, the baby was examined by a series of nurses and neonatologists, none of whom noted any abnormalities. During the first night after the plaintiff’s birth, a nurse changed his diapers and did not notice any stool, which is quite uncommon for a newborn. Another neonatologist then examined the child, but did not discover any abnormalities. The next morning, the baby had still not had a bowel movement and his abdomen circumference continued to increase. Another neonatologist examined the child, but still did not note any abnormalities in regard to the anus. The baby’s abdomen circumference continued to increase throughout the day, and a neonatologist finally discovered a malformed anus. An x-ray was ordered, which showed a perforation of the bowel, and the baby was immediately taken to surgery. The surgery revealed a large tear in the rectum and stool in the peritoneal cavity. Much of the small bowel was also found to be necrotic as a result of the child developing Necrotizing Enterocolitis (NEC). An additional surgery was performed approximately one month later, and a large amount of the baby’s small bowel had to be removed. Since then, the child has been hospitalized ten times due to bowel problems. As a result of his injuries, the child suffers mild mental retardation and cannot digest solid food, requiring him to be placed on Total Parenteral Nutrition (complete IV diet) with nursing care at home.

The defense contended that the Necrotizing Enterocolitis, a known risk of premature birth and the cause of the plaintiff’s injuries, developed as a result of the plaintiff’s prematurity and was not related to the initial bowel perforation. The defense also claimed that the mother’s history of drug use could have contributed to the development of NEC. However, Dr. Fagel showed that the nurses and neonatologists’ failure to quickly diagnose an imperforate anus and bowel obstruction (from the lack of an anal opening) until after the bowel perforation was a significant factor in causing the NEC and consequent necrotic bowel. Had the hospital staff acted within the proper standard of care and noticed the plaintiff’s troubles in a timely fashion, his injuries would have been prevented.