Can hospitals be held liable for birth injuries from Pitocin or Cytotec?

Yes. Hospitals have a duty to ensure patient safety and prevent foreseeable injuries. Roughly 1 in 5 labors involve induction, including through the use of labor drugs like Pitocin (synthetic oxytocin) and Cytotec (misoprostol). If these drugs are used improperly, or the baby and mother are not properly monitored during their use, the baby can become extremely oxygen-deprived and develop a permanent brain injury, called hypoxic-ischemic encephalopathy (HIE).  This can result in cerebral palsy (CP), and intellectual and developmental disabilities.

Items that can constitute negligence on behalf of a hospital system include:

  • Administering too much Pitocin or Cytotec
  • Not recognizing that a baby is not getting enough oxygen on the fetal monitor
  • Not providing the mother with informed consent about the risks.
  • Not following  hospital protocols in for use of Pitocin or Cytotec.
  • Not properly training it’s physicians and nurses or having qualified physicians and nurses on staff
  •  Not  recognizing and treating excessive uterine activity and fetal heart rate changes that indicate the baby is not tolerating labor (signs of fetal distress).
  • Not delivering in time when a baby is not getting enough oxygen
  • Not changing the plan from vaginal birth to cesarean section and delivering in time to prevent a baby from suffering brain injury from not getting enough oxygen

Hospitals are liable if they fail to uphold standards of care

A hospital system has a duty to:

  • Use reasonable care in the maintenance of safe and adequate facilities and equipment;
  • Select and retain only competent physicians;
  • Oversee all people who practice medicine within its walls as to patient care; and
  • Formulate, adopt, and enforce adequate rules and policies to ensure quality care for patients
  • Be able to perform a cesarean section in time to prevent a baby from suffering a brain injury from not getting enough oxygen (HIE)
  • Have a qualified staff able to recognize when a baby is not getting enough oxygen and deliver in time to prevent brain injury.

Courts have held that hospitals have a duty to act and protect patients when the likelihood of some type of harm is sufficiently foreseeable that a reasonable hospital can anticipate the risk of injury. This means that when high alert and off-label drugs are used, hospitals must:

  • Have labor induction drug education programs for the medical team to ensure they are adequately trained and qualified
  • Have protocols in place for use of high-risk and off-label drugs
  • Inform mothers about the risks of Pitocin and Cytotec before they are used
  • Obtain informed consent from the mother

Due to the grave risks associated with Pitocin and Cytotec, education of the medical team must include training and information regarding the following topics:

  • How to recognize excessive uterine activity (uterine tachysystole) and abnormal fetal heart rate patterns
  • How to perform timely and meaningful interventions when excessive uterine contractions and abnormal fetal heart rate patterns occur.
    • Interventions include delivery by emergency C-section, which is the only reliable method of removing a baby from oxygen-depriving conditions. It is negligence if a hospital gives a mother Pitocin or Cytotec and does not have the capability to quickly deliver the baby by C-section.

The risks of Pitocin and Cytotec have long been recognized, and researchers have concluded that the well-being of the fetus may be in jeopardy when drug-induced uterine tachysystole (hyperstimulation) occurs during labor. It therefore is very important that the drugs be used only when necessary and that hospitals have procedures in place to educate and train the medical team on proper use of these drugs. In addition, the medical team must be trained on how to properly monitor the mother and baby and perform timely interventions when needed.