Brittany Hamilton periodically dabbed tears from her eyes Tuesday in Barren Circuit Court, the final day of a civil trial that ended in a jury's decision to award the young mother and her son nearly $18.3 million after the child suffered a brain injury during his birth at T.J. Samson Community Hospital in 2007.
The jury deliberated for less than 90 minutes before the announcement of its judgment, which went solely against the hospital. In 2011, the boy, Tristan Hamilton, by and through his mother, sued the hospital and Kelly Dirig, the obstetrician-gynecologist who delivered him.
Dirig was cleared of the accusation of medical negligence. In fact, during closing arguments, the Hamiltons' attorney, Tyler Thompson, told the jury he had grown to respect Dirig and her honesty during the legal process. He asked the jury to not find against Dirig, outlining reasons the hospital should be held entirely responsible.
Almost immediately after court adjourned, Dirig went to the plaintiff's table and shared an embrace with Brittany Hamilton.
Tristan's diagnoses include spastic quadriplegia, which is a form of cerebral palsy, global developmental delay, epilepsy and drooling, according to court documents. Now 7, he takes at least five medications regularly and will require continued physical and occupational therapy until at least the age of 21. Tristan also must have speech therapy, an augmented device for communication and must learn sign language.
“There is no amount of money in the world that can bring back all the damages to my son. None," Brittany Hamilton said after the verdict was read. "But this money will help him survive or get along a little easier in case something were to happen to me in the future."
T.J. Samson attorney Jeff Herbert provided the Daily Times with a prewritten statement at the conclusion of the trial:
“T.J. Samson has been committed to providing the best healthcare possible to our community since 1929. We take the concerns presented in this case very seriously, and our hearts go out to Tristan and his family. The high quality of care we provide to our patients every day is the result of a continuing commitment of our dedicated caregivers and physicians. Such care is evident in the more than 1,200 babies that T.J. Samson proudly delivered last year alone.”
Laura Belcher, chief of planning and business development for T.J. Samson, said in an email Wednesday that the hospital was unable to comment further at this time.
The civil trial began Nov. 12 and was in session for seven days across the two-week period. The central issue in the case was how much Pitocin – a drug commonly used to induce labor – should be used during the birth process, at what frequency and under what circumstances.
Dirig's written standing orders were to not go above a certain dosage without a separate order from her. But more than that amount of Pitocin was administered, with the dosage being increased gradually at least three times.
The registered nurses involved in the delivery – Angela Scales and Angela Dawn Turner – said Dirig must have given a verbal order, but no such order was documented in the patient chart, argued both Dirig's attorney, Scott Whonsetler, and Thompson during closing arguments.
Further, the nurses failed to tell Dirig important information about fetal heart rate and other details between the doctor's visits to the room, those attorneys said.
T.J. Samson attorney Brian Pack said the dosage information was on the pump from which the medication was administered intravenously and that the record from the fetal heart rate monitor was available to Dirig all along. But the other attorneys, citing expert witnesses that had testified, said it was not Dirig's job to supervise the nurses and that Dirig was entitled to the reasonable expectation that they were following her orders.
Meanwhile, Dirig also learned that an epidural was not stopped when she ordered it to be halted because it was hindering the mother's ability to push the baby on down the birth canal. With her inability to push further stalled, more problems were created, Whonsetler said.
Dirig testified that had her orders been followed, the complications would not have occurred because she would have chosen to perform an operation to deliver the baby about two hours earlier.
Thompson told the Daily Times on Wednesday that attorneys don't know all the facts when a lawsuit is filed, and that “more of the truth comes out” as the proceeding advances. Despite learning about the discrepancy regarding the Pitocin and Dirig's standard protocol, for example, Dirig had to remain in the case in the event the jury believed the nurses instead of her, Thompson said. Based on the record, though, Thompson does not believe Dirig gave permission to exceed her written orders.
Thompson also said he also didn't want to be too hard on the nurses themselves, because their behaviors reflected poor training, and it was the hospital's responsibility to ensure they were trained properly.
Whonsetler said he was surprised Thompson spoke in favor of his client during closing arguments. He said he is happy about the outcome for Dirig, who he called “an exceedingly bright OB-GYN.”
Ten of the 12 jurors concluded it was the duty of the hospital and its employees in caring for the mother and baby “to exercise the degree of care and skill ordinarily expected of reasonably competent and prudent hospitals under similar circumstances,” and that the hospital failed in that duty. After agreeing on that point, jurors then had to decide that the failure “was a substantial factor in causing Tristan Hamilton's injuries.” Again, 10 jurors agreed on that finding.
The wording was virtually identical in what the jury was asked to decide about Dirig, except “hospitals” was replaced with “OB-GYN physician.” The jurors' answer was unanimously “no” on the first question relating to the doctor, rendering the second question irrelevant.
The total award of $18,270,052.37 was unanimous as well, and it includes amounts for medical, hospital and prescription-related expenses to date ($462,917.37) and in the future, based on a calculated life expectancy of 75 years ($9,000,797); impairment of power to labor and earn money ($1,505,940); and mental anguish and pain and suffering in the past ($2,800,000) and the future ($4,500,398).
The total amount requested by the Hamiltons was $24,276,392.37.
Both Thompson and Whonsetler said they appreciated the jury's willingness to learn about the complex medical issues in the case.
“(Tristan) was injured just about as badly as a child could be,” Thompson said, “so the amount reflected the extent of the injury.”
Dirig is not an employee of T.J. Samson but has held medical privileges at the hospital since 2002. She initially declined to comment, but then confirmed she still practices at T.J. Samson, where she said she delivered four babies Monday. She said her relationship with the hospital has not been strained during the case.
“The physicians and the staff have been wonderful,” she said.