County May Pay $770,000 to Settle in Injury to Baby

A 5-year-old girl who suffers from cerebral palsy and severe developmental delay as a result of mistakes made during her birth at a county hospital should be paid $770,000, a county board recommended Wednesday.

Jennifer A. Lazaro, who was born at a time when county doctors were attempting to avoid costly caesarean section deliveries, was injured during her 1992 vaginal delivery at L.A. County-USC Medical Center, according to a report to the county claims board, which was scheduled to hear the case on Tuesday.

During the delivery, physicians failed to respond to a “suspicious” heartbeat and a subsequent lack of oxygen that rendered Jennifer’s blood extremely acidic, the report said.

The report, which was prepared by the county’s lawyers, criticized the medical team for failing to speed up the delivery after distress was noted, but did not specifically mention caesarean section as a way to do that.

Although an early caesarean might have prevented Jennifer’s injuries, failure to perform the operation was not cited as a cause for the lawsuit, said Nancy Singer, a county auditor who serves on the three-member board.

“I asked that question and was told that caesarean was not part of this case,” Singer said.

Rather, she said, the county was liable for actions that occurred before the decision to perform a C-section might have been made: for failing to properly note that the baby was in extreme distress in the first place.

In addition, she said, hospital staff lost crucial records of the baby’s heartbeat, known as fetal monitoring strips.

“One of the primary factors was a loss of critical records,” Singer said.

Lazaro’s attorney, Peter J. McNulty, could not be reached.

County lawyers would not comment on whether the doctors involved in the case were disciplined, and would not release a Health Department report that details corrective actions--if any--that were taken as a result of the case.

Senior Assistant County Counsel Lloyd Pellman, who also sits on the claims board, said that the corrective action reports are confidential because they name doctors and are used in the medical peer review process. According to the documents prepared by the county’s risk management lawyers, Jennifer’s mother, Ruth Lazaro, came to the hospital for a prenatal examination on June 11, 1992. Doctors noticed that Jennifer’s heat rate was “suspicious,” and admitted Ruth Lazaro to the hospital to have labor induced.

Jennifer’s heart rate dipped several times, generally an indicator of fetal distress. But because her heart soon recovered, doctors did not intervene.

Then, for a period of seven minutes, the fetal monitor was not attached. When it was reattached, her heartbeat was abnormal, but still no intervention occurred.

When Jennifer was born, she was limp and blue, conditions that indicate a lack of oxygen during the birth process.

Tests of the umbilical cord, which can indicate oxygen levels in the blood, were ordered, but “apparently not performed, as test results cannot be located,” according to the report.

The fetal monitoring strips for the 21 minutes preceding Jennifer’s birth were also missing, the report said.

“The failure to locate these records could subject the county to liability for spoilation of evidence,” county lawyers said in their report.

Had the case gone to trial, the report said, the county would have faced damages of up to $3.75 million. Under the terms of the proposed settlement, the county will pay $770,000 to Jennifer and her mother, with $221,000 of that going to cover legal fees.

The county would also cover all of Jennifer’s future medical needs by offering her lifetime care at its public hospitals. The proposed settlement must be approved by the Board of Supervisors, and will likely be heard in the next several weeks, Singer said.