Emory University Hospital Midtown complaint alleges failures to act on a newborn’s rising bilirubin before kernicterus
The complaint alleges a newborn delivered at Emory University Hospital Midtown in July 2019, was discharged two days after birth despite a rising bilirubin level. A pediatrician’s office saw him on July 19, 2019, ordered a bilirubin test, and sent him home. That afternoon the result came back critical, and the family was told to go to an emergency department. Emergency and intensive-care staff at Children’s Healthcare of Atlanta at Scottish Rite delayed intensive phototherapy. Only a partial exchange transfusion was performed, although a double-volume exchange was indicated. The complaint alleges that failures to properly diagnose and treat his acute bilirubin encephalopathy caused hearing loss, developmental delay, and cerebral palsy.
Overview
This page concerns a complaint alleging that providers at three facilities did not properly diagnose and treat a newborn’s rising bilirubin before it caused kernicterus.
Chronology
The complaint alleges as follows:
- The patient was delivered at Emory University Hospital Midtown in July 2019, with normal Apgar scores and facial jaundice noted on his newborn exam.
- The next day, NNP Tonya R. Selfridge ordered bilirubin testing and phototherapy. A transcutaneous level was 10.2 mg/dL and a serum level was 7.5 mg/dL.
- A repeat serum bilirubin level the next morning came back higher at 10.4 mg/dL. Selfridge discontinued phototherapy, and David Carlton, M.D. handled the discharge. He noted the level should be checked the next day, but that note never reached the parents. No testing was ordered to find why the level rose.
- On July 19, 2019 Nicola Chin, M.D. saw the patient at Morehouse Healthcare Howell Mill for a well-child visit. She noted jaundice over his face, trunk, and legs, ordered a bilirubin test, and sent him home.
- That afternoon the bilirubin result came back critical. Dr. Chin received the result at 1:08 p.m. It appears she called the family after 4:30 p.m., directing them to the emergency department at Children’s Healthcare of Atlanta at Scottish Rite.
- An emergency physician did not see the patient until about 6:20 p.m. The PICU agreed to take him but wanted a full sepsis workup and antibiotics before transfer. He reached the PICU at 10:26 p.m., and intensive phototherapy started at 10:42 p.m.
- Efforts to place an arterial line for the exchange transfusion started at 2:24 a.m. on July 20, 2019. A femoral line was placed at 3:58 a.m. Only a partial exchange transfusion was performed instead of the double-volume exchange described as indicated.
Alleged failures
The complaint alleges the following failures:
- NNP Selfridge and Dr. Carlton allowed the newborn’s discharge with no further investigation of why his bilirubin level rose despite phototherapy.
- Dr. Chin did not instruct the family to call an ambulance for the critical result. Dr. Mrosak recommended repeat ED labs instead of direct ICU admission.
- Emergency and intensive-care staff did not immediately start intensive phototherapy or perform the indicated double-volume exchange transfusion.
- The filing alleges that failure to properly diagnose and treat acute bilirubin encephalopathy, or kernicterus, caused bilateral hearing loss, developmental delay, and cerebral palsy.
- The complaint pleads negligence, gross negligence, vicarious liability, and direct liability of both hospitals for staff training, supervision, and policies. It also seeks punitive damages and attaches six expert affidavits under O.C.G.A. § 9-11-9.1.