The 6-year-old daughter of a Pennsylvania State Representative has won over $40 million in compensation for a spinal cord injury she sustained at birth. On Tuesday, January 23, 2018, a jury for the Delaware County Court of Common Pleas concluded that the young girl had received substandard care from Dr. Steven M. Troy, an obstetrician at Delaware County Memorial Hospital, the Philadelphia Inquirer reports.

Birth Injury Verdict For Spinal Cord Damage

Daughter to Alex Charlton, the Republican State Representative for Pennsylvania’s House District 165, Grayson Charlton is today a happy six-year-old, but she is also paralyzed from the chest down. Her twin sister, Isabella, is not.

Surgical Team In OR

The girls were born in 2011 at Delaware County Memorial, a hospital in Drexel Hill, Pennsylvania owned by Crozer-Keystone Health System. Initially, the labor was managed by Dr. Stephanie Pearson, who attempted to induce labor using the drug Pitocin, court records show. Apparently wary of potential risks, Dr. Pearson ultimately decided that a Cesarean section would be the best option under the circumstances. She discussed the idea with the girls’ mother, Kira, who agreed to undergo the operation. Then, around 7 in the morning on March 3, 2011, Dr. Pearson handed care over to Dr. Steven Troy.

Obstetrician’s “Excessive Force” Caused Birth Injury, Parents Claim

Troy’s care, according to the family’s legal complaint, was “aggressive.” Instead of opting for the agreed-upon Cesarean section, Dr. Troy decided to deliver both of the children vaginally, court documents say. It was easier for Isabella, who, at the time of her delivery, was in the cephalic presentation. Like most children, Isabella was oriented head-first in the birth canal. She was delivered spontaneously, medical records show, without medical intervention.

Grayson, on the other hand, presented in the footling breech position. Her feet, not her head or pelvis, would be delivered first. That creates a significant risk for umbilical cord prolapse, when the umbilical cord is pushed out of the birth canal first. Cases of cord prolapse are relatively-rare, but can be extremely dangerous. The umbilical cord can become pinched, cutting off a baby’s oxygen supply. In many cases, the only viable option is an immediate delivery, usually through a C-section. And, while Grayson was not yet experiencing fetal distress, she was in a dangerous position, both figuratively and literally.

Manual Breech Extraction

Along with his birth team, Dr. Steven Troy chose to attempt a breech extraction, in which he would manually re-position Grayson inside the birth canal. The “extraction of Baby Grayson,” the family’s lawsuit says, “involved grasping her body and pulling her through [the] cervix and birth canal.” At the time, the parents say they heard a “popping sound.”

Grayson was delivered unresponsive, court records say, “requir[ing] resuscitation by vigorous stimulation and positive pressure ventilation.” After being resuscitated, the child displayed several signs of a spinal cord injury. Her blood pressure was low and her blood was carrying an insufficient amount of oxygen. Nurses noted hypotonia, an abnormally-low level of muscle tension, in the baby’s head, neck and upper limbs.

Spinal Injury Leaves Child Paralyzed

Pediatric neurologists at the hospital disclosed to the parents their fear that Grayson had suffered a spinal cord injury. The child was transported to the Children’s Hospital of Philadelphia (CHOP) for further care. At CHOP, doctors confirmed the diagnosis. Brain scans found evidence of subdural bleeding in the brain consistent with birth trauma. Further tests showed bleeding inside the child’s cervical spine, along with a growing build-up of cerebrospinal fluid.

All of these signs, the physicians determined, were linked to a nerve root avulsion injury. The nerves in the baby’s cervical spinal cord had been ripped away. And all of this damage, doctors wrote in medical reports, had been caused by “significant birth trauma.”

Today, Grayson Charlton goes to occupational and therapy a few times every week. In West Chester, she rides horses as part of the equine assisted therapy program at Quest Therapeutic Services, according to a story from Daily Local News. Now a first-grade student, she cannot sit or crawl unsupported.

Lawsuit: Doctor Lacked The Expertise To Handle Complex Birth

In their lawsuit, filed in February 2013, Grayson’s parents accused Dr. Steven Troy, Delaware County Memorial Hospital and Crozer-Keystone Health System of birth-related medical malpractice. While the defendants had assumed a duty to provide Kira Charlton and her children with “reasonable, proper, adequate and appropriate care,” Dr. Troy was utterly unqualified to handle such a complex delivery, the complaint alleges.

“Dr. Troy did not have adequate training, experience or qualifications to undertake to deliver twins vaginally with one twin in the footling breech position,” the parents write. At trial, the family’s attorneys expanded on their argument, saying Troy had failed to protect Grayson’s head and neck as he pulled her through the birth canal.

$40M Verdict Highest In County’s History, Attorneys Say

The jury agreed, awarding Grayson around $40.3 million for her long-term care and pain and suffering. Plaintiffs’ attorneys believe it may well be the largest jury award ever secured in Delaware County. In the wake of the verdict, Crozer-Keystone Health System, which owns the hospital where Grayson was delivered, issued a statement defending itself.

“We are deeply sympathetic to any patients and families who undergo such an experience,” the company wrote. “We strongly believe that the care provided in this case was compassionate, timely and clinically appropriate. The case predates the current management and ownership of the hospital and health network.” In January 2016, Crozer-Keystone Health System, along with the five Delaware County hospitals that it manages, were purchased by Prospect Medical Holdings, Inc.