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Infant Death Blamed on Nursing Malpractice

A Murrieta Hospital was recently cited and fined by the California Department of Public Health for a nursing malpractice incident that killed a fetus during delivery.

 CDPH officials found that nurses at the Rancho Springs Medical Center failed to follow the hospital's procedures concerning infant heart rate monitoring and this failure contributed to the child's death.

The child's mother was already in labor when she came to the hospital in 2010. An investigation by state health officials found that the nurses failed to report their problems determining the fetus' heart rate upon the mother's arrival. Typically, a doctor should be called if nurses are unable to determine a fetus' heart rate because an abnormal heart rate can signal potentially fatal fetal distress.

Nurses measured weak heart rates at least twice without informing a doctor of their findings. The hospital's policies provide that a doctor should be summoned immediately if a fetus' heart rate is under 110 beats per minute. The fetus in this case had 105 bpm levels which are indicative of distress.

The failure of the nurses to notify the doctors of the heart rate abnormalities prevented the proper intervention from being taken and was a direct cause of the child's death according to the CDPH investigation.

A doctor was not notified of the problem until about an hour after the mother's arrival in the hospital. By the time the doctor delivered the child, it was too late and the child was essentially a still birth. The placenta, which provides oxygen to the fetus, separated from the uterus prematurely. This was likely the cause of the low heart rate of the child.

Source: California Department of Public Health, "CDPH Issues Penalties to 13 Hospitals," June 1, 2012

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