On September 19, 2003 the now deceased male infant was born at 36+ weeks gestation; labor had been induced because of concerns about possible infection due to maternal fever. Defendant neonatologist examined the newborn, determined he was healthy, and ordered CBC and bacterial cultures in light of the mother’s fever. These tests were all normal except for a platelet count of 91,000; parties disputed whether this was considered low. Defendant pediatrician assumed care of the baby on September 20 and discharged him from the hospital on September 21. Prior to discharge, the infant was having problems feeding, was seen by multiple lactation specialists, and lost approximately seven ounces of weight.On September 23, the baby was brought to defendant pediatrician’s office due to jaundice and continued poor feeding. The pediatrician believed the poor feeding was related to his prematurity and referred him to defendant hospital for a bilirubin test, which showed physiologic jaundice. At home that night, the child began having breathing problems and was not feeding at all. The parents called defendant pediatrician and were told to take the infant to the defendant hospital emergency room. The infant was admitted to the pediatric intensive care unit and diagnosed with viral sepsis and septic shock. On the morning of September 25, he was transferred by helicopter to another hospital for dialysis due to renal failure, but he suffered cardiac arrest and died less than an hour after arrival there. Cultures showed the child had a viral infection known as an enterovirus, specifically an echovirus, and the autopsy determined he died from echovirus sepsis.The estate contended defendants prematurely discharged the baby from the hospital on September 21, he should not have been discharged due to his low platelet count and poor feeding, a full septic workup including a spinal tap should have been ordered due to evidence of infection, and his viral infection would have been detected earlier if he had remained in the hospital. The estate maintained that although the child’s echovirus infection was untreatable, earlier detection of the infection would have allowed for early supportive care such as fluids and ventilation, and appropriate supportive care would have prevented his dehydration and death. The estate further claimed that the defendant pediatrician was negligent in not admitting the infant to the hospital at the time of the September 23 office visit despite signs of dehydration and 10% weight loss.The defense, including HSPRD partner Stacey A. Cischke, argued there was no reason to keep the baby in the hospital on September 21 as all of his vital signs and lab results were completely normal, he did not have any signs or symptoms of infection, the 91,000 platelet count was within the normal range for a newborn or only slightly abnormal with no significance, the platelet count did not warrant a complete sepsis workup, the September 21 discharge was appropriate and consistent with the standard of care, and defendant pediatrician’s care during the subsequent office visit was also appropriate and complied with the standard of care. However, defendant pediatrician admitted under cross-examination that his discharge of the child was not consistent with AAP standards and therefore violated the standard of care. The defense asserted the child had a rare complication of his birth – the communication of a high-dose virulent echovirus for which there was no treatment, and earlier supportive care would not have reversed this process. The defense further argued that once the child was readmitted to the hospital on September 23, his aggressive viral infection had taken hold and there was nothing defendants could have done to prevent his death. The defense contended the virus had a greater than 80% mortality rate, while plaintiff maintained it was 10-11% or less. The jury returned a verdict of not guilty on behalf of all defendants.
