Medical Malpractice Case Report: $800,000 plus to premature infant and family for failure to timely remove umbilical artery catheter

April 2009

Firm Partner Peter A. Schmit achieved a settlement of more than $800,000,on the behalf of a premature infant and his family in a failure to diagnose medical malpractice case involving a failure to timely remove the umbilical artery catheter in the infant resulting in acute kidney failure and the loss of a kidney. Read the following Minnesota Case Report, Vol.28, No.2, Apr. 2009

Selected Result*

(Excerpts taken with permission from Minnesota Trial Lawyer Association’s (MTLA) “Minnesota Case Reports”)

(North Dakota) J.R. was born at 26 and 1/2 weeks gestation and was classified as an extreme low birth weight baby. J.R. required extensive intervention including the placement of an umbilical vein catheter and umbilical artery catheter (“UAC”).  The lines were used for frequent monitoring, nutrition and medications.
Within a few days after birth, difficulties with the UCA line were noted by health care providers.  The UAC was replaced. Even after replacement, more problems were noted by the nursing personnel.  These difficulties were communicated to the physicians in charge. The UAC line was again replaced at 17 days of age. Following the second replacement, toes on J.R. appeared dusky and were cool. At 26 days of life, nurses continued to encounter difficulty in using the line to draw blood and these difficulties were communicated to the physician who ultimately ordered the UAC pulled on 10/25/04. A few days later, J.R. began to experience kidney failure and hypertension (high blood pressure.)

J.R. was transferred to a different facility where an ultrasound revealed the presence of a clot impacting blood flow to both kidneys. The clot originated from the UAC line. Ultimately, one kidney was removed as it was nonfunctioning and it was hoped that removal of the kidney would improve the child’s hypertension.

Unfortunately, J.R. continues to suffer from hypertension although his current kidney function is normal. The primary ongoing harm is the hypertension which requires heavy medication therapy. Side effects of such therapy include excessive hair growth and gum growth impacting the development of J.R.’s teeth leading to a gingivectomy (surgical removal of gum tissue) J.R. is currently in school and receiving therapies for developmental issues related to his prematurity. When the child is older, an attempt to stent the artery to improve blood flow to the remaining kidney will be attempted. It is hoped that such stenting will resolve the ongoing hypertension thereby removing the need for medication therapy.

Plaintiffs’ theory was that given the multiple signs and symptoms of difficulty with this line, and the known risk of clot development with UAC use, the line needed to be removed earlier, no later than 14 days of life. Plaintiffs’ claim was supported by a board certified pediatrician, pediatric neonatologist, pediatric nephrologist, and other experts as well as  literature.

Defendants contended that given J.R.’s prematurity, the UAC was a life line necessary to care for this child. Defendants also contended that establishing future medical needs was not possible given J.R.’s current normal kidney function although there is no dispute that he required ongoing hypertensive medications.
The case settled for $800,000 which included subrogated medical specials of $85,000. The net proceeds were used to purchase an annuity for J.R. which had a guaranteed payout of over $1.5 million.

Peter A. Schmit


Chair, National Personal Injury and Medical Malpractice Group

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