A Maryland appeals court Monday overturned a $205.38 million birth injury verdict against Johns Hopkins Bayview Medical Center, saying the mother disregarded medical advice that her child be delivered via cesarean section rather than by induced vaginal delivery due to severe pregnancy complications.
In its 3-0 decision, the Court of Special Appeals held that the trial judge was wrong to accept the jury’s conclusion that the Baltimore hospital had failed to receive Erica Byrom’s informed consent to forgo the cesarean, saying she was well-informed of the risks to her fetus.
The Baltimore City Circuit Court jury had awarded nearly $300 million to Byrom in her lawsuit alleging that Bayview’s medical malpractice had caused her baby to be born severely brain damaged. Judge Audrey J.S. Carrion reduced the verdict to $205 million, citing Maryland’s cap on noneconomic damages in medical malpractice cases.
Bayiew appealed, saying the evidence showed Byrom — 16 years old at the time of delivery — was told of the risks but chose the induced delivery.
“A fully informed patient has the right to make the decisions about her own healthcare,” Judge Dan Friedman wrote for the Court of Special Appeals.
“A necessary corollary of that right, however, is that absence negligence by the healthcare professional, the patient is responsible for the consequences of the choices she makes,” Friedman added. “Precisely as her doctors predicted, the consequences of that choice were disastrous. The jury, obviously and understandably sympathetic to Ms. Byrom, found in her favor.”
But Carrion, the presiding judge, should have granted the hospital’s motion for a judgment notwithstanding the verdict because the evidence at trial was that Byrom’s doctors recommended she have a cesarean as “the best way to minimize the risk of disability and give the fetus the best chance for survival,” the appellate court stated in its unreported decision.
Byrom “chose to induce vaginal delivery despite Bayview’s warnings,” Friedman wrote.
“The consequences were tragic,” he added. “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.”
Byrom’s appellate attorney, Andrew H. Baida, said he and his client are “disappointed” in the decision and will seek review by Maryland’s top court, the Court of Appeals.
Baida is with Rosenberg Martin Greenberg LLP in Baltimore.
Johns Hopkins Medicine said in a statement Tuesday night that it appreciates the Court of Special Appeals’ review of the case.
“Cases like these are tragic and our hearts go out to this child and the people who are caring for her,” the statement read.
“Federal privacy laws limit our ability to discuss the details of a specific case, but 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 the risks associated with her decision,” the statement added. “We remain confident that the Johns Hopkins care team, including expert doctors, nurses, and social workers, provided Ms. Byrom with the best possible medical counsel and care for both her and her baby.”
The case had become a focal point in the debate over whether Maryland should create a birth injury fund. During last year’s legislative session, hospital executives pointed to the award, saying that the state’s medical malpractice climate could make it harder for hospitals to continue to offer baby delivery services and arguing in favor of a fund to pay for birth injuries.
The bill’s opponents said that the legislation would create a bureaucratic system that makes it harder for families to pay for the services needed to treat birth injury patients.
Byrom, who was 15 when she became pregnant, went to the hospital on Oct. 20, 2014, and was transferred to Bayview because she had severe preeclampsia at 25 weeks gestation.
On Oct. 23, doctors induced labor.
Byrom’s daughter, Zubida, was immediately transferred to the neonatal intensive care unit without a heart rate and not breathing, according to court papers. She was resuscitated in the neonatal intensive care unit.
The Baltimore City Circuit Court jury returned its $229.64 verdict on July 1, 2019.
The award included $200 million for Zubida’s future medical expenses, $3.62 million in past medical expenses, $1.02 million in lost earning capacity and $25 million in non-economic damages. Carrion reduced the non-economic damages to $740,000 due to the state’s cap.
Bayview then sought review by the Court of Special Appeals.
Friedman was joined in the opinion by Judges Donald E. Beachley and Patrick L. Woodward, a retired jurist sitting by special assignment.
The Court of Special Appeals rendered its decision in Johns Hopkins Bayview Medical Center Inc. v. Erica Byrom et al., No. 1585 September Term 2019.