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Obstetrician, Michael Geiling

This is a settlement for the Medical Malpractice lawsuit.

Raven Shoaf is a 7 year old girl with severe cerebral palsy. She was born Nov. 28, 1997 at Florida Hospital Altamonte. The obstetrician, Michael Geiling, was a first year doctor who was still counting his deliveries so he could become board certified. He had convinced Mrs. Shoaf to have a "VBAC": Vaginal birth after caesarean section, which was fairly popular in the mid and late 1990's. She had 2 prior children by caesarean section.

After a 3 day induction, the baby showed signs of distress. Instead of performing a c-section, Dr. Geiling used a vacuum extractor on the baby. He used it over a 48 minute period and when the baby would still not come out, he ordered the nurses to apply "fundal pressure" , which is a very controversial (and often forbidden) technique of pressing down at the top of the uterus to push the baby down the birth canal. The greatest risk in a VBAC delivery is a rupture of the uterus, because the uterus already has a scar from the prior c-sections. A ruptured uterus is catastrophic for mom and baby -- it destroys the blood supply to the baby and can kill the mother if the bleeding is not stopped.

Due to the prolonged induction, combined with the vacuum extractor and the fundal pressure, Sandra Shoaf's uterus ruptured ("blew out" according to the defense expert). Baby Raven was deprived of oxygen before she was finally delivered vaginally. She sustained severe brain damage that resulted in extreme neurologic injury. She has almost no use of her limbs, cannot speak, is fed through a tube into her stomach, and cannot control her bowel or bladder. There was substantial evidence at the 3 week trial that Raven has moderate or normal intelligence, thereby "locking her into" a body that will not function. She communicates through eye gaze and is beginning to use a computerized device for communication. Sandra was rushed to emergency surgery where she was transfused and had an emergency hysterectomy. Her bladder was also ruptured from the pressure exerted, requiring surgical repair. The emergency surgery required an intubation, and in the course of doing that Sandra's vocal cords were damaged. She later required surgery to repair them. She is no longer able to have children. The Shoafs are separated now but work together in taking care of their daughter, who attends a special education class in public school. By the testimony of the school personnel, she has the most significant neurologic disability at the school that cares for neurologically injured children.

Procedural History:
This case has already been on appeal 3 times, as the defense claimed that this fell under Florida's Birth Related Neurologic Injury Compensation Act, which would have exonerated the doctor and hospital. After an administrative trial, a judge determined that this did not fall into the act as it was not proven that Raven was substantially mentally impaired, which the law requires. The defendants then appealed the case to Florida's 5th District Court of Appeal and the initial 3 judge panel reversed the administrative law judge by a 2-1 decision. The attorneys then sought further review from the court, and for the first time in 10 years the entire Fifth District heard a case 'en banc' (all the judges of the court) and the plantiff won 8-2. The defendants then sought review by the Florida Supreme Court, who declined, thus ending their attempt to avoid a trial on the merits.

After 7 years of delays and appeals, trial began on May 16, 2005 in Courtroom A of the Seminole County Courthouse. Senior Judge Harry Stein was appointed to hear the case. Counsel for Defendant Geiling were Thomas Dukes and Pierre Seacord of Orlando. Counsel for the Shoaf family was John Elliott Leighton, Mark A. Sylvester, and Patricia Kennedy of Leesfield Leighton & Rubio in Miami, Jay M. Levy of Miami, and John Fisher of Fisher, Rushmer, Werrenrath, et al. of Orlando. A guardian for Raven Shoaf was appointed: Steven Laurence of Altamonte Springs.

Raven Shoaf was seen live by the jury only once for about 25 minutes, when she was brought in and demonstrated her ability to communicate with her father.

Nurses involved in the delivery testified - as adverse witnesses - that this was the longest period of time that they had seen a vacuum extractor used. Some also testified that they should have refused to apply fundal pressure. Contrary to the defendant obstetrician, the charge nurse testified that fundal pressure could cause a ruptured uterus. The defendant and his expert denied that fundal pressure could possibly cause a ruptured uterus. The jury of 4 women and 2 men deliberated 7 hours on Saturday after closing arguments concluded Friday night at 7:30 p.m. The jury awarded a total of $24.1 million to the Shoaf family, with over $19 million awarded for Raven's past and future medical expenses. This is the largest verdict in Seminole County history. Dr. Geiling only carried $250,000 in liability insurance. There will be post trial motions made and the case will again go on appeal. Testimony at trial was that Raven would live to be between 50 (defendant's expert) and 80 (plaintiff's treating neurologist). Defense expert life care planner opined that Raven would not benefit from much of what the Plaintiff's life care plan provided and that her life care plan, as he devised, had a present value of just over $3 million.



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Published on Jun-16-05


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