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Mother Hopes Malpractice Award Is Education for Others

Mar 10, 2002 | The Virginia Pilot The short life of Stevie Mosley was a few scant lines on the obituary page in December 1999. It was five weeks and a day of desperate medical intervention mingled with a few hours of hope. It was 18 final hours of fight in a tiny boy, struggling for breath after life support systems were removed, until he died.

Now, it's $6,375,030. That's the amount a Newport News Circuit Court jury awarded Stevie's family for medical malpractice on the part of the attending obstetrician after a three-day trial.

The jury verdict on Feb. 27, reduced by a judge to the state cap of $1.5 million on medical malpractice awards, is among the highest of its kind ever in the state. A companion suit on behalf of Stevie’s mother for emotional distress will be filed next week, her lawyers said.

The money, minus medical and legal costs, will be a financial boost to the Newport News family of three children, a stay-at-home mother and truck-driver father.

The lawsuit brings public awareness to a common medical condition, Group B Streptococcus, a disease that can be fatal to a newborn but that is largely preventable if standard antibiotics are administered to an infected mother during labor.

The Mosleys are glad that this case may prevent a similar tragedy. But despite the multi-million-dollar lawsuit, there is little peace.

“I can’t be happy,” Stevie's mother, Shannon Mosley, said last week, crying as she talked about the case. “I’d rather have my child here than any amount of money in the world.”

Most unsettling is the idea behind the lawsuit, the refrain that the family’s lawyers and their medical experts repeated to the jury: Stevie didn’t have to die.

“If it couldn’t have been prevented and he would’ve died anyway, then I think I would be at ease,” Mosley said.

But after learning the facts about the condition, commonly called GBS, and discovering that the doctor forgot to administer antibiotics during her labor, peace doesn’t seem possible.

“It eats at me,” Mosley said, and she thinks of Stevie constantly. “It eats at me every day.”

A baby on the way
Mosley, 25, and her husband already had two girls and knew a baby boy was on the way. He would be named Steven Jr., after his father.
During an ordinary office visit one week shy of Mosley’s due date, her Newport News obstetrician, Jewell M. Barnett, decided she should be induced to deliver. The doctor detected some kind of mild fetal distress and wanted the baby delivered as a cautionary measure, said one of Mosley’s lawyers, Douglas L. Hornsby.

Barnett and his attorneys for the case, John Heilig and Carolyn Oast of Virginia Beach, did not return calls for this story.

Barnett left the examining room that day in November 1999 and telephoned Riverside Regional Medical Center to schedule a room for Mosley at the hospital the next day. He faxed Mosley’s medical records to the hospital.

What Barnett failed to do, according to his own testimony, Hornsby said, was to alert the staff by telephone that Mosley had tested positive for GBS in a swab culture taken several weeks earlier.

GBS is a bacteria carried by 20 to 25 percent of all pregnant women in their birth canal areas, where a fetus may come in contact with it during delivery, according to information provided on the Centers for Disease Control's Web site. It is not known how people get infected. Adult GBS carriers typically have the condition temporarily and don’t get sick or have symptoms.

To newborns, however, the disease is extremely serious: One of 20 babies with GBS dies. GBS is the most common cause in newborns of blood infections and meningitis, or infection of the brain lining and fluid. Infected babies that survive may have long-term problems such as hearing or vision loss or learning disabilities.

Prevention is the standard treatment. Antibiotics, usually penicillin or ampicillin, administered intravenously during membrane rupture or labor can in most cases prevent GBS from spreading from mother to baby -- reducing the chances of delivering a GBS baby to 1 in 4,000, according to the CDC. Odds increase to 1 in 200 if antibiotics are not given.

Mosley had never heard of GBS when, 36 or 37 weeks into her pregnancy, tests revealed that she was a carrier. Her doctor, Barnett, prescribed several days of oral antibiotics. The CDC's Web site says oral antibiotics before labor do not prevent the disease from being transmitted to newborns.

Mosley testified that Barnett did not explain to her the seriousness of the condition. Barnett testified that he did and that he told her he would be administering antibiotics during her labor, Hornsby said.

At the trial, the doctor said he forgot to mention the GBS when he called to schedule Mosley’s delivery, and he forgot to administer the antibiotics during the baby’s birth, Hornsby said.

The defense expert, a pediatric infectious disease specialist from New Mexico, acknowledged that the baby died of GBS-related complications, Mosley attorney Robert J. Haddad said. He testified, however, that the baby was already infected in the womb, so antibiotics during delivery would have made no difference and the baby would have died anyway, Haddad said.

Three experts for Mosley’s case, however, said that with proper treatment of the mother, the baby would have lived, Haddad said. And if the baby were born with GBS, the infection almost certainly would have been mild, he said.

Neonatal specialist Gary R. Gutcher, who treated Stevie after he was transferred to the Medical College of Virginia in Richmond, testified it was unlikely the baby was infected before birth because he was delivered rosy and healthy, Haddad said. Stevie’s APGAR score, which measures signs such as reflexes and breathing, was the highest possible at 9.9 at one and five minutes after he was born.

A baby is born - and dies
Stevie was born after a 22-hour labor. Mosley held him briefly before nurses whisked him off to get him cleaned up. Two hours passed, and Mosley began to get annoyed that Stevie still had not been returned to her.
Worried after more time passed without news, Mosley and her grandmother, Linda Hartley, decided to walk to the nursery.

When they got there, “We stood at the doorway and we saw them all gathered around this one baby,” Hartley said. “And I pretty well assumed it was ours.”

A doctor came to Mosley’s room and explained that the baby was very, very sick, and that he had ordered an ambulance that would take the baby to MCV in Richmond. There, Stevie would be hooked up to a heart-lung machine, through which his blood would be circulated and cleansed.

Specialists at MCV kept Stevie on the heart-lung machine and administered nitric oxide therapies for days. Mosley recalls that he was given an anesthetic and medication to paralyze his muscles so that he wouldn’t move and hurt himself during treatments. She remembers being able to hold his small fist – he hadn’t learned to move his fingers yet, she said.

“He had his days where he did good and everything was fine,” Mosley said. “And then he had his days where he just absolutely looked horrible, and I thought I was going to lose him that day.”

For a while, Stevie’s condition improved. Doctors took him off the machine. It looked as if Mosley would be able to make good on her promise that her daughter Andrea, then 6, would get to hold her new brother when he got home.

But the intensive therapies had taken their toll. Stevie got sick with candida sepsis, or fungal blood infection, which traveled to his brain.

One morning at 1 or 2 a.m., Mosley got a call from MCV saying that Stevie had developed a mycotic aneurism, a weakened pocket in the wall of a blood vessel that had burst and filled his brain with blood. Come quickly, they said.

The blood could be drained from his brain, but it would fill up again, doctors said. With 95 percent of Stevie’s brain function lost, the family decided it was time to let Stevie go.

“I wasn’t going to put my son through anything else,” Mosley said. “He had been through enough in this little bit of time that he was here, and I wasn’t going to make him hurt any more.”

The MCV staff said that once Stevie was taken off the ventilator, he would die within five to 20 minutes.

One by one, family members held their newest addition, finally free of needles and tubes. The nurses agreed to take newborn photographs, Mosley said.

Stevie didn’t open his eyes or move. He looked very bad, but somewhat peaceful, Mosley said. Except that he didn’t die nearly as quickly as predicted. Stevie lived 18 more hours, gasping for air, until he finally passed away.

For Mosley, her husband and their daughters, it was a time for mourning.

For Stevie’s maternal great-grandmother, Linda Hartley, it was a period of such intense distress that she found herself needing answers. Why did a baby born so seemingly healthy end up so sick?

She searched the Internet and was shocked by what she found: that GBS in newborn babies was virtually preventable and had been so since 1996, when the CDC issued aggressive guidelines for prenatal screening and treatment.

Hartley printed out the material and placed it before her great-granddaughter. Mosley read for just a moment before she began to sob: "Grandma, you mean he didn’t have to die?"

A mission of education
During the trial, when the jury left the courtroom to deliberate, Barnett hugged Mosley and apologized, she said. The doctor, who had delivered numerous babies in her family for generations, "was very emotional, choked up," Mosley said. "He could barely get it out – but he did get it out."
His apology meant a lot, Mosley said. And if she feels some anger, Mosley never let it get the best of her, she said.

It took 1½ hours for the jury to return a verdict. It was the highest jury verdict in a medical malpractice case in the state over the last year, said Paul E. Fletcher, publisher and editor of Virginia Lawyers Weekly newspaper, and the largest of its kind he knows of in Virginia.

At a news conference last week, Mosley told the story of Stevie. She hopes that educating people about the disease will encourage pregnant women, and women going into labor, to take an active role in making sure they are diagnosed and treated.

Her daughters, Andrea and Alexis, were at the news conference, as was Hartley, holding Mosley’s new son, Angel, born in January. Angel is a special name for her boy, whom Mosley wants never to feel that he was conceived to replace his brother.

No one can take Stevie’s place, Mosley said. "My son is a one and only."

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