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Maryland Court of Special Appeals overturns $205 million birth injury verdict against Johns Hopkins Bayview

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The Maryland Court of Special Appeals overturned one of the largest malpractice verdicts in the United States, a more than $205 million against Johns Hopkins Bayview Hospital, by saying the mother disregarded medical advice about the birth of her child.

In a unanimous ruling of three judges Monday, Judge Dan Friedman wrote for the court that evidence presented during trial was “not sufficient” to prove that Erica Byrom received negligent treatment or that Johns Hopkins Bayview Hospital withheld information about the delivery options for her daughter.


“Against Bayview’s clear advice, Ms. Byrom refused to consent to a cesarean section unless her own life was in danger,” Friedman wrote. “She chose to induce vaginal delivery despite Bayview’s warnings. The consequences were tragic. The injuries to the baby were just as Bayview warned. But the record clearly shows that Ms. Byrom received all of the material information necessary to make an informed decision about her care.”

Mary Koch, an attorney representing Byrom, said they are “disappointed” by the court’s ruling.


“We are disappointed in what we believe to be an incorrect ruling by the Court of Special Appeals,” she wrote in an email. “We will be requesting the Court of Appeals review the case.”

A spokesperson for Johns Hopkins Medicine said federal privacy laws prohibit hospital officials from discussing the case in detail, but “cases like these are tragic and our hearts go out to this child and the people who are caring for her.”

“Both the public record and the Court’s unanimous ruling demonstrate that the mother declined our strongly recommended care for both herself and her baby, and that we appropriately informed her multiple times of all of the risks associated with her decision,” the spokesperson wrote in an email.

In 2019, a Baltimore jury awarded Byrom and her daughter, Zubida, $229.6 million. The amount was later reduced to about $205 million due to state laws capping malpractice verdicts.

About five years earlier, Byrom — then 16 — was admitted to Hopkins Bayview with severe preeclampsia, a complication related to pregnancy that can cause such as seizures and premature birth. Her condition only worsened. At 25 weeks of pregnancy, her baby was viable outside the womb and doctors induced labor.

The teen mother said doctors told her that her baby would die or suffer brain damage. Facing that prognosis — which Byrom’s attorneys would later call mistaken — the teen decided to forgo a cesarean section, resulting in lasting brain injuries to her daughter.

Zubida’s brain was damaged by a lack of oxygen during the delivery. The Prince George’s County girl has cerebral palsy, a neurological disability that can affect muscle control throughout the body, and requires round-the-clock care.

Hopkins attorneys argued during the two-week trial in Baltimore Circuit Court that the doctors were not negligent, saying the child’s injuries happened after labor started and that Byrom refused a C-section.


The special appeals court wrote that experts who testified during the trial disagreed on the tone and emphasis of doctors’ recommendations at Hopkins Bayview and whether they gave Byrom too many options, not that they did not disclose risks or other important information for her and her daughter’s care.

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The special appeals court said it felt Byrom was “fully informed” about the various choices and the risks associated with them and that, just as doctors had predicted, the “consequences of that choice were disastrous.”

“A fully informed patient has the right to make the decisions about her own healthcare,” Friedman wrote. “A necessary corollary of that right, however, is that absent negligence by the healthcare professional, the patient is responsible for the consequences of the choices she makes.”

Maryland lawmakers have unsuccessfully proposed bills that would require doctors, hospitals and insurers to pay into a state fund for families whose children suffer such brain damage at birth. Proponents have argued a fund would help control medical malpractice costs and bring resolution to families without prolonged legal fights.

The $205 million award in 2019 well exceeded the region’s biggest malpractice verdicts in recent years.

In 2012, a Baltimore jury awarded $21 million to a Glen Burnie couple whose son was born prematurely in 2002 at Harbor Hospital. In their lawsuit, the boy’s parents said their son lost oxygen while in the womb and doctors should have performed a C-section rather than allow a prolonged vaginal birth. The boy was diagnosed with cerebral palsy.


Just a month earlier in 2012, a city jury awarded $55 million to a Baltimore couple whose son was born at the Johns Hopkins Hospital. The family also alleged their son lost oxygen in the womb and doctors should have performed a C-section sooner. This child, too, has cerebral palsy. At the time, the $55 million was among the largest medical malpractice verdicts in state history.

Baltimore Sun reporter Tim Prudente contributed to this article.