Did doctor warn parents?

Two weeks into their trial, plaintiffs in a lawsuit for medical malpractice against the Wood River Medical Center and two doctors have told stories that contradict much of the testimony presented by the defendants.

Plaintiffs Sandy and Quinn Kirkland contend that Dr. Ross Donald, Dr. Randall Coriell and nurses at the hospital’s Hailey campus acted negligently while caring for Sandy the night of Aug. 16, 1995 while she was pregnant with her now almost four-year-old son, Bryce.

The trial is being held in federal court in Boise. The plaintiffs wrapped up their case last week with testimony from both plaintiffs. Defense attorneys are scheduled to present their cases during the next two weeks.

The plaintiffs claim that a fetal blood vessel was punctured during an amniocentesis performed by Dr. Donald. That procedure involves withdrawing amniotic fluid from the uterus with a syringe.

Following the amniocentesis, the plaintiffs contend, Dr. Coriell and the nurses failed to notice that Bryce was bleeding inside Sandy’s uterus. As a result, they say, Bryce sustained severe brain damage.

Questioned by her Seattle attorney, Paul Luvera, Sandy told jurors that Dr. Donald did not inform her that he would need to insert the needle through the placenta to reach a pocket of amniotic fluid. Earlier expert witnesses presented by the plaintiffs testified that a trans-placental amniocentesis is an unusual and risky procedure.

"If he had said that to me, I would have asked a lot of questions," Sandy said.

She added that before the procedure, she asked Dr. Donald, "Is this going to hurt me or my baby in any way?" and that he responded, "Oh, no, this is safe."

Dr. Donald has not yet testified. However, in a videotaped deposition presented to the jury, he said that he "explained very carefully to this couple what can happen in an amniocentesis." He said he did not recall whether he informed Sandy and Quinn that inserting the needle through the placenta involves increased risks.

Quinn, who said he was present during the amniocentesis, told jurors that he watched Dr. Donald draw three vials of fluid. The first, he said, appeared to be almost pure blood. Dr. Coriell testified near the beginning of the trial that Dr. Donald told him he had drawn only a small amount of "skin blood."

Dr. Zane Brown, a professor of obstetrics at the University of Washington School of Medicine, who was called by the plaintiffs as an expert witness, testified last week that any amount of blood drawn by the syringe indicates that a blood vessel has been perforated.

Dr. Brown told jurors he believed Dr. Donald to have breached a reasonable standard of care by performing a trans-placental amniocentesis when its risks outweighed its benefits, by not informing the Kirklands of those risks and by not informing Dr. Coriell and the nurses at the Hailey campus that he had drawn blood.

Records show Sandy was connected to a fetal heart monitor about 4 p.m. and that the monitor was disconnected about midnight. It was reconnected at 3 a.m.

In the meantime, it recorded a disturbingly flat line. The nurses and hospital have conceded that they should have noticed the graph’s warning that Bryce may be in trouble.

Dr. Coriell, who has so far been called as a witness only by the plaintiffs, testified that he visited Sandy in her room twice during the afternoon and evening after she returned to the hospital in Hailey. He said he did not look at the fetal heart-monitoring strip because he had no reason to believe the fetus may be in trouble and because he assumed the nurses were keeping an eye on it.

However, both Sandy and Quinn told jurors that they do not remember Coriell coming into the room at all during that time.

Dr. Brown faulted Dr. Coriell for not transferring Sandy to St. Luke’s hospital in Boise when she arrived, for not looking at the strips when he visited her, and for not coming to the hospital immediately when he was notified of Bryce’s condition at 4:30 a.m. the following morning. Dr. Coriell has testified he waited an hour to come in after giving instructions to the nurse to get Bryce moving.

However, Dr. Brown added that "everything depends on whom you choose to believe, because everybody’s story is different, remarkably different."

Sandy also testified that she told nurses three times during the afternoon and evening that she couldn’t feel Bryce moving as much as he normally did. She testified that the nurses told her he was probably just sleeping and to relax about it.

Joan Anderson, the nurse on duty at the time, had testified earlier that neither Sandy nor Quinn expressed any concern to her about a lack of fetal movement.

At about 3 a.m., Sandy testified, she told Quinn, who was sleeping in the room, that Bryce had stopped moving, and that he passed that information on to a nurse.

She said the nurse arrived, tore off a piece of the heart-monitoring strip and left the room. She returned about an hour later, Sandy said, and gave her some juice and put her on her side (actions, the nurses have testified, that are done to induce fetal movement).

Sandy said the nurse returned after another hour, at about 5:30 a.m., and asked her if things had improved. When she told her no, Sandy said, the nurse said she would call the doctor. She said Dr. Coriell appeared a few minutes later.

Sandy testified that Quinn told Coriell at that time of his impression that he had seen a blood-filled syringe during the amniocentesis. She said Coriell said, "What?" and left the room in a hurry.

He came right back, she said, and told her she would need an emergency caesarian section.

By the time Bryce was delivered, the plaintiffs’ expert witnesses have testified, loss of blood had irreparably damaged his brain.

Despite Bryce’s limited intellectual and motor skills, Sandy expressed pride when telling jurors about his accomplishments.

Alternately beaming and fighting back tears, she told them he had developed a vocabulary of about 50 words and had learned to move by sliding along on his back. She said she had told Quinn they ought to have a party to celebrate Bryce’s learning to roll over.

"Do you love Bryce?" attorney Luvera asked her.

"I love him a lot," she said.