A Buffalo, N.Y., neonatalogist testified yesterday that nurses at Carroll County General Hospital followed accepted medical standards in their care of an infant who died, but other testimony showed the samenurses breached hospital policies.
Mark Hudak, head of the newborn intensive-care unit at Children's Hospital, testified via videotapeduring the third week of testimony in a Westminster pediatrician's appeal of a state malpractice court's decision.
In July, a three-member Maryland Arbitration Board in Sykesville found Dr. Karl Green negligent in his care of the infant son of Robert and Barbara Morris of Westminster.
The board awarded the Morrises $550,000 in damages.
Carroll County General Hospital also was named in the suit but was not found liable by the arbitration board.
Green, the first pediatrician at the county hospital, is appealing the decision in Carroll Circuit Court.
The baby was born at CarrollCounty General at 10 a.m. Sept. 21, 1986. He weighed 8 pounds, 9 ounces but had breathing problems.
The baby died 19 hours later, before either of his parents had a chance to hold him.
The Morrises and their attorney, LaVonna Vice of Baltimore, contend that Green failed to give the baby enough oxygen, that he misread a chest X-ray and that he wrongly allowed the baby to be fed formula.
A medical examiner's report said one of the causes of the baby's death was a pneumomediastynum, a condition in which air collects outside the lungs, causing pressure.
It can be treated with oxygen and by inserting a needle into the baby's chest to remove the air outside the lungs.
Hospital records show the doctor did try to insert a needle to release air from the thorax, but a Canadian doctor testified earlier in trial that it was put in the wrong place.
The parents also maintain thatthe nurses breached accepted standards of care when they failed to alert Green when the baby took a turn for the worse at 11 p.m.
The nurse on the 3 to 11 p.m. shift that night, Dean Smith, testified Monday that she called Green about 10:50 p.m. and told him Brett Morris was turning blue.
Green and his attorney, Michael Baxter of Baltimore, dispute the parents' claims and say the baby died of "persistentfetal circulation," an often fatal condition in which the baby cannot adjust to breathing outside the womb.
The doctor also denies receiving the nurse's call at 11 p.m. and maintains he was not notified of the baby's turn for the worse until 2:20 a.m.
Robert Morgan, attorney for the hospital, contends that the baby appeared to be improving until then and that the nurses had no reason to be alarmed.
Onthe witness stand, Smith said that while she is sure that she calledGreen to tell him the baby's lips were blue before she left for the night, she did not record the call on the infant's chart.
Under cross-examination by Baxter, Smith admitted that she "forgot to write it (the call) down in the notes," which is a breach of hospital policy.
Hudak, testifying on behalf of Smith and nurses Libby Fuss and Barbara Baldwin by videotape, said the women "conformed very well to the standards of care for this baby," in spite of the omission of the phone call on the baby's chart.
Hudak was the final witness and the final expert to testify in the case that began May 17. It has been dominated by sparring medical experts, technical testimony and frequent objections.