Failure to Diagnose TTTS: $1.75 Million Settlement
2024 Medical Malpractice Case Report
By Attorney Krysia J. Syska
Hampden Superior Court, Massachusetts
Failure to perform proper testing results in twin-to-twin transfusion syndrome (TTTS) and neurologic injury in triplet
May 2013 plaintiff was pregnant with triamniotic dichorionic triplets. Triplets B and C were monochorionic. Twin-to-twin transfusion syndrome (TTTS) is a known risk for monochorionic pairs with abnormal nuchal translucency, oligohydramnios and polyhydramnios in the donor and recipient twins and weight discordance as early signs of the syndrome. Testing to monitor AFI and growth was done every two weeks to monitor for the condition and intervene if necessary, with delivery.
At 12 weeks plaintiff underwent a scan which revealed abnormal nuchal translucency in Triplet C. This was noted to be associated with early TTTS. Between July 2013 and October 2013, plaintiff underwent numerous scans with the maternal fetal medicine defendants. During this time, polyhydramnios in Triplet B was consistently diagnosed and the pocket of fluid around Triplet C ranged from normal to low-normal. Concern was raised for TTTS, but defendants felt no intervention or further testing was warranted.
In August 2013, there was a fetal weight discordancy of 25% for Triplet C. No biophysical profile was performed. By September, Triplet C had subjective oligohydramnios and a fetal weight discordancy of 24%. Still no additional testing was performed. This continued through October with AFI around Triplet C returning to low-normal.
On 10/12/13 plaintiff reported decreased fetal movement. Scanning revealed Triplet C had died. The most likely explanation for Triplet C’s death was TTTS yet no doppler studies had ever been performed to diagnose this condition. She was admitted and due to decelerations with Triplet A & B’s FHRs the babies were delivered via emergent cesarean section delivery. Triplet A was found to be healthy without any injury, however, Triplet B who shared an amniotic sac and placenta with deceased baby C had suffered significant neurologic injury due to TTTS.
The claim was settled for $1,750,000 in the month prior to trial.
Lubin & Meyer attorneys Andrew C. Meyer and Krysia J. Syska represented the plaintiff in this medical malpractice lawsuit.
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