Jury deliberating in stillborn fetus case in Bangor court

By Nok-Noi Ricker, BDN Staff
Posted Oct. 19, 2010, at 12:42 p.m.

BANGOR, Maine — Two Eastern Maine Medical Center doctors who discovered the 16-week-old fetus Lorraine Morin was carrying in 2007 had died and sent her home testified in U.S. District Court on Tuesday in the civil lawsuit Morin has brought against the hospital.

Dr. Paul Reinstein, an emergency room doctor at EMMC, and Dr. Robert Grover, an obstetrician who was on call for EMMC on the day Morin went to the hospital experiencing cramping and pain, told the two-man, six-woman jury that sending women experiencing miscarriages home is common procedure.

“All our miscarriages go home,” Reinstein said. He later modified his testimony to say “the majority” are sent home.

Morin claims that hospital staff violated the Emergency Medical Treatment and Active Labor Act when they sent her home on July 1, 2007, without stabilizing her condition. She delivered her dead fetus in the bathroom of her Millinocket home later in the day.

The EMTALA prevents a hospital from discharging a patient who is in an emergency medical condition, even if the person is uninsured. Morin was insured at the time. The Morins are asking for unspecified damages in the civil action.

Morin testified Monday that she was experiencing cramping and pain and went to the emergency room at EMMC around 4:30 a.m. July 1, 2007. She was discharged at 6:15 a.m. and delivered the dead fetus around 9 p.m.

The next morning, she called her obstetrician-gynecologist, Dr. Pamela Gilmore, who immediately admitted her into EMMC for surgery to stop her bleeding and to remove the remaining placenta.

Tuesday’s testimony began with the cross-examination of Lorraine Morin by EMMC attorney George Schelling.

Morin described her experiences at EMMC as inhumane, grotesque behavior and brutal torment and said, “To not care is unforgivable.”

During testimony by Reinstein, who said he has a vague recollection of Morin’s visit, he said he conducted an ultrasound on her and then called in Grover, who did a pelvic examination and another ultrasound and confirmed the fetus she was carrying had no heartbeat. Grover, who said he remembers Morin’s visit, discharged her shortly after his examination.

Morin said “she was unhappy about going home and wanted to be admitted,” Reinstein said. “She wanted this taken care of at the hospital.”

Reinstein said he addressed her concerns with Grover, who “said it would be risky to do a procedure.”

Reinstein went back to Morin and her now-husband, Roger Morin, and explained to the couple Grover’s plan to discharge them and “let nature take its course.”

“It seemed like a reasonable plan,” Reinstein testified. “I thought she would come back if she started hemorrhaging or having severe pain.”

Morin then asked him what she should do with the remains if she delivered at home, Reinstein said.

Roger Morin testified Monday that Reinstein “mentioned that I should dispose of my baby.”

“I did not say that,” Reinstein testified Tuesday. “The data was misconstrued.”

He said he discussed “options for disposing of the fetal remains” with the couple, including taking them to her obstetrician, calling a funeral home or bringing them to the emergency room.

“So she was to deliver alone at home?” Morin’s attorney A.J. Greif asked.

“That was not her only option,” Reinstein said. “She was told to return.”

The couple testified Monday that they had been upset when being discharged and said a nurse and Reinstein threatened to call security if they did not leave the hospital. Reinstein denied making any threats.

Lorraine Morin said she didn’t return to EMMC because of the experience earlier in the day.

“We didn’t feel welcome there,” she testified Monday. “We didn’t leave on very good terms.”

Grover testified that Morin’s cervix was not dilated, but she was experiencing contractions when he discharged her from the hospital. He said he did not know exactly when she would expel the fetal remains.

“I thought it would take a period of hours,” Grover said. “I expected it would be later that day, in the evening, or possibly the next day.”

Greif asked Grover why he did not admit her and allow her to pass the remains at the hospital, and he responded, “that doesn’t seem to be an appropriate use of the facility.” He added later that in his decades as an obstetrician, “I have never admitted anybody under those circumstances.”

Greif also asked Grover why Morin wasn’t offered any options to speed along the dilation of her cervix, including drugs and tools commonly used by obstetricians.

“Actually, sir, I felt the best thing to do … was to let nature take its course,” Grover responded, saying there are risks associated with any of the intervention procedures.

Both doctors testified they did not offer Morin any counseling and did not call the hospital’s clergy to help her deal with her loss.

In addition to the two doctors, two nurses involved in Morin’s treatment in 2007 also testified Tuesday.

Angela Burbine, an emergency room triage nurse, testified that she did not remember Morin and answered her questions solely based on Morin’s medical record.

Nurse Kim Lugdon testified that Morin was upset. “She wanted to stay and have it taken care of. She didn’t want to go home.”

Morin had testified Monday that she continues to have nightmares about delivering her 16-week-old son in her bathroom.

Schelling asked Morin on Tuesday why she didn’t mention her nightmares when deposed in 2009. “I asked about symptoms … and you never told me about that,” he said.

When her attorney was allowed to redirect, Greif referred to a letter Morin wrote to the hospital a couple weeks after her stillbirth delivery, which mentioned her nightmares. The letter was entered into evidence during the deposition, he and Schelling said.

“It’s like a movie being played over and over in my mind,” Morin said, reading from the letter.

Schelling also asked if she had any counseling for her postpartum depression, and how her emotions differed from her previous pregnancies.

The Millinocket woman’s medical history had included two live births, one by cesarean section; a previous miscarriage; and treatment for cervical cancer. In May, she successfully gave birth to a baby girl, according to testimony. Morin was a certified nurse’s aide at the time and was studying to be a registered nurse through the University of Maine at Augusta program. She was working full time at Millinocket Regional Hospital in 2007. She now works as an emergency room nurse at St. Joseph Hospital in Bangor.

After Morin’s testimony, which ended around 10:15 a.m., Schelling asked for a summary judgment, which Judge Woodcock denied.

Testimony from another doctor is expected to take place today before final statements are given, Woodcock told jurors at the end of Tuesday’s session. Jury deliberations will follow.

http://bangordailynews.com/2010/10/19/news/bangor/jury-deliberating-in-stillborn-fetus-case-in-bangor-court/ printed on December 26, 2014