Renee Cortes as Guardian Ad Litem for Michael Markert, a minor, and Michael Markert in his own right v. Shore Memorial Hospital et al

Case Background

Plaintiff Renee Cortes, Michael Markert’s guardian ad litem filed a medical malpractice lawsuit against Shore Memorial Hospital and its staff for medical negligence and substandard care provided during the birth of Michael Markert.

The case was filed in Atlantic County Superior Court, New Jersey. Judge Danielle J Walcoff presided over this case. [Case number: ATL-L-002298-15]

Cause

On June 10, 2008, Plaintiff Michael Markert suffered an ischemic stroke during childbirth at Shore Medical Center, affecting the left side of his body. That morning at 9 a.m., Michael Markert’s mother was admitted, being 36 weeks pregnant and one day past her due date. Initially, her labor proceeded without complications. However, around 1:30 p.m., the fetus experienced a prolonged bradycardia, from which he later recovered. At 5:30 p.m., the medical staff administered the first dose of Pitocin, starting with two milliunits per liter. The plan involved increasing the dosage by two milliunits every 20 minutes until the mother achieved three good contractions.

The order specified that the contraction pattern and fetal response should be monitored every 15 minutes, with all findings documented. The Plaintiffs claimed that the mother achieved five good contractions within the first half-hour after starting Pitocin. Instead of reducing the dosage, the nurses increased it steadily to 10 milliunits by 8 p.m., reaching the maximum allowable level. Notably, there was no documentation explaining the reasons for these increases.

During this time, the mother experienced excessive uterine activity, with insufficient resting periods and frequent contractions. A layperson had to inform the nurse that the baby’s head was emerging. Finally, at 9:08 p.m., the nurse delivered the baby due to the urgency of the situation, as there was no time to call the doctor.

Plaintiff Renee Cortes, Michael Markert’s Guardian ad Litem sued Daley, Venesz, Ciceron, and Shore Medical Center on behalf of the child. The Plaintiffs argued that the defendants did not meet the standard of care required, which constituted medical malpractice.

Injury

Michael was born with normal Apgar scores and showed no signs of birth injury. However, four months later, his mother noticed he could not use his left arm and leg. Concerned, they consulted a pediatric neurologist, who performed an MRI. The results revealed that Michael had suffered an ischemic stroke during childbirth due to medical malpractice, affecting the left side of his body. He was subsequently diagnosed with cerebral palsy.

After his diagnosis, Michael underwent regular monitoring. As he grew older, he began to wear leg braces. He received extensive physical and occupational therapy to aid his development. Additionally, he had multiple Botox injections to help manage his muscle tone. At one point, he used an electronic walking boot on his left foot.

Over the years, Michael went through 35 to 45 different braces as his needs changed. His treatment was ongoing, emphasizing the importance of adapting to his condition. By the time of the trial, he continued to receive occupational and physical therapy. His medical team closely monitored his progress and health.

Damages

Michael walked independently, but he had a severely impaired gait. He also lacked motor skills in his left hand, which he used mainly for guidance. At the time of the trial, the Plaintiffs claimed that Michael, who was 16, faced permanent disability because of the Defendant’s medical malpractice.

To address his challenges, the Plaintiffs sought compensation amounting to $3,045,923 for future lost earnings. Additionally, they requested around $5 million to cover future medical expenses. They also sought damages for Michael’s disability, impairment, and loss of enjoyment of life. Furthermore, they included claims for pain and suffering in their request for compensation.

Key Arguments and Proceedings

Legal Representation

Claims

The Plaintiffs alleged medical malpractice. They claimed that labor and delivery nurses Carol Daley and Susan Venesz failed to monitor the mother and fetus adequately. They also mismanaged the administration of Pitocin to the mother. Additionally, they claimed that obstetrician-gynecologist Asuncion Ciceron provided substandard care during the birth process.

Nurse Connie Cox was also named in the lawsuit but settled for an undisclosed amount before the trial began. Physician Blair Bergen and Nurse Elaine Spears were identified as Defendants as well, but they were dismissed prior to the trial.

Defense

The defense denied allegations of medical malpractice and argued that they adhered to the standard of care during the Plaintiff’s labor and delivery.

Expert Testimony

Plaintiff’s Experts

The Plaintiffs’ obstetrics expert, Dr. Barry S. Schifrin, testified that contractions reduce blood flow to the baby’s brain. Therefore, he emphasized the importance of having adequate resting periods between contractions. Dr. Schifrin explained that the excessive Pitocin administered to the mother led to extended contractions, denying the baby those necessary resting periods. This lack of rest resulted in decreased blood flow, which ultimately damaged the baby’s brain.

The Plaintiffs’ nursing expert, Dr. Michelle Linda Moise Murray, stated that nurses Daley and Venesz violated both the hospital’s nursing guidelines and the manufacturer’s instructions for Pitocin. These guidelines specify that excessive uterine activity and prolonged contractions require stopping Pitocin, as failure to do so can cause brain damage. Dr. Murray criticized Venesz for not documenting whether she checked the mother’s contractions and fetal heart monitor, noting that hospital protocol required monitoring and documentation every 15 minutes. Venesz increased the Pitocin without assessing the condition of the mother and baby.

The Plaintiffs’ pediatric neurology expert, Dr. Michael D. Katz, testified that the negligent administration of Pitocin reduced blood flow to Michael’s brain. This reduction caused a stroke, leading to cerebral palsy and hemiplegia. Dr. Katz explained that Michael’s diagnosis was common for victims of this type of injury. He noted that since the brain stem was unharmed, Michael’s Apgar scores would appear normal or nearly normal. Ultimately, he concluded that Michael’s condition would be permanent, resulting in lifelong disabilities.

Lastly, the Plaintiffs’ life-care planning expert, Dr. Joseph Carfi, outlined Michael’s future medical needs, which included physical therapy, medication, and potentially living in a group home when his parents could no longer care for him.

Defendant’s Experts

The defense’s nursing expert, Lindsay B. McDevitt, M.S.N., R.N., testified that Daley and Venesz adhered to accepted care practices when administering Pitocin in their specified dosages and timeframe. However, she acknowledged that, based on documentary evidence, Venesz did not follow nursing standards.

The defense’s obstetrics expert, Dr. David Miller, questioned the credibility of the Plaintiffs’ obstetrics expert, noting that the American College of Obstetricians and Gynecologists had censured him. This expert did not provide any opinions about the care and treatment of the mother or fetus, nor did he suggest what caused the baby’s brain injury.

The defense’s pediatric neurology expert, Dr. Daniel G. Adler, testified that the baby’s injuries were not caused by an ischemic stroke at birth. He claimed the injury must have occurred between 32 to 35 weeks of gestation. However, during cross-examination, he changed his position, acknowledging that research indicates strokes frequently occur near the time of birth.

Dr. Adler also noted that, since the injury was ischemic rather than asphyxial, it was not expected for the baby to have poor Apgar scores or appear damaged at birth. This acknowledgment underscored the complexity of the situation and the ongoing debate regarding the timing and nature of the baby’s injuries.

Jury Verdict

After a trial that lasted seven weeks in this medical malpractice case, the jury deliberated for one day before reaching a verdict on July 31, 2024. The total award for Plaintiff Michael Markert amounted to $37,548,096, which was awarded to his mother, Renee Cortes.

This sum included $5,481,023 for future medical costs and $3,045,923 for future lost earnings. Additionally, the jury granted $29,021,150 for disability, impairment, loss of enjoyment of life, and pain and suffering.

Court Documents:

Available upon request