Failure to Perform Repeat Bilirubin Test for Infant at High Risk of Jaundice, Kernicterus Prompts $46.5M Verdict

​A family physician and his clinic in Arkansas were held liable for the majority of a $46.5 million verdict resolving allegations of failure to repeat a bilirubin test for an infant at high risk for jaundice who later suffered severe injuries as a result of a delay in treatment, according to a report from the August 2018 Medical Malpractice Verdicts, Settlements & Experts (subscription required). Two hours after the infant was born via cesarean delivery, her bilirubin level was 5.5 mg/dL, indicating "a high risk of hyperbilirubinemia." While the infant remained hospitalized over the next two days, nurses noted that she was "mildly jaundiced." The defendant family physician discharged the infant, informing her mother that everything was normal and instructing her to follow up in 10 days. The infant became increasingly lethargic and her complexion yellowed, and three days after she was discharged, the mother left a message at the defendant's clinic saying that the infant was lethargic, crying shrilly, and seemed to be in pain. The mother brought the infant to the defendant's office the following morning. The defendant drew blood, noted jaundice, and sent the infant home. When he received the blood results later that day, he called the family at 12:28 p.m. and told them to take the child to a hospital. They arrived at 1:43 p.m. Just after 2 p.m., the infant underwent phototherapy. Two hours later, she was transferred to another hospital, where testing revealed a bilirubin level of 33.4 mg/dL, indicating severe hyperbilirubinemia and jaundice. The child sustained irreversible brain damage (kernicterus).