A wrongful birth suit nets $14 million

I’d be curious in hearing an OB’s opinion on this case:

A jury in New Brunswick has awarded a North Brunswick couple $14 million to help them with the long-term care of their 5-year-old son, who was born with a genetic birth defect that will require him to have blood transfusions the rest of his life.
The jury deliberated less than two hours on Friday after hearing evidence that the obstetrician caring for Aradhana Sharad during her pregnancy in 2000 noted that the Indian-born woman had all the genetic markers for thalassemia, a group of blood diseases that involve abnormalities in hemoglobin, the oxygen-carrying part of the red blood cells, but failed to follow up on the findings with additional tests.

(via Overlawyered)

Comments

storkdoc
Well, there’s not much info from the article to deal with. But apparently the doctor noted that there was a low Hgb and thus should have worked up the patient for thalassemia. Perhaps…..
The most common cause of anemia in pregnancy is physiological. There is a greater increase in the liquid portion of the blood, than in the cell mass. Thus the values for anemia are different in the pregnant patient than in the non-pregnant patient. Normals in the non pregnant pt for an H/H are 12/37 and for the pregnant pt 10/30.
The next most common cause is iron deficiency anemia, and that is why we usually have patients on PNV with FE while pregnant.
So we don’t know what the rest of the CBC showed and we don’t know if it was followed and whether it stayed low despite being on iron.
Here in the US it is standard of care to get a sickledex test or a Hgb electrophoresis on African American because of the high risk of Hbg SS. I don’t know of any other ethnic group that I routinely get a Hgb electrophoresis on.
But if anemia does not improve with iron therapy, other cause should be entertained.
That being said this seems like it might be a wrongful birth case. That is if they had known prior to birth they might have terminated. SInce obviously each parent is a carrier, the next time she’s pregnant she’ll need a CVS or amnio to determine the baby’s status
storkdoc
The article doesn’t state whether this was alpha or beta thalassemia. IF it was alpha it may not hvve been detected by electrophoresis. Alpha is more common in Asians, and Beta is more common in people of Mediterrean descent.
As UPTODATE.com state”Alpha thalassemia — The genetics of alpha thalassemia are somewhat more complex because of the duplicated nature of the alpha globin genes on chromosome 16. Since uncomplicated alpha thalassemia trait is frequently asymptomatic and barely detectable, prospective identification of families at risk is less likely. Individuals of African descent are rarely at risk for giving birth to infants with severe forms of alpha thalassemia. Counseling to make individuals aware of the condition is usually adequate. More intensive counseling is needed if the individual partners are non-African individuals from alpha thalassemia endemic areas. (See “Fetal blood sampling: Indications and invasive fetal therapy”).
Hemoglobin H disease or hydrops fetalis — Families in which Hb H or hydrops fetalis has previously occurred are clearly at risk of giving birth to additional infants with these conditions [39]. The principles of genetic counseling and antenatal diagnosis that should be followed are similar to those outlined above for beta thalassemia. Early monitoring of pregnancies at risk for the presence of a hydropic fetus is important, because of the increased risk for polyhydramnios and other obstetrical complications.”
Samson Isberg
I find this verdict disgusting, but then I’m biased, I find all “wrongful birth” cases disgusting.
If I meet a stupid woman and see that she has an equally imbecile spouse, should I then advice the couple that they’re going to have an equally idiotic offspring? And can I then be sues after twenty years when his final IQ-results are in and are at room-temperature level?
Or if the mother is a lawyer and the father also (which has happened to me twice) should I advice them that their offspring is going to be a born psychopath?
The parents make the children. They’re responsible. If they think I will take the blame for what they have done in their marital bed – without consulting me – I’ll see them damned first.
Sorry about the emotionality, but this case really pissed me off big time…

A wrongful birth suit nets $14 million

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