Nashville jury awards record $47 million malpractice judgment

Cayce Boughton of Nashville, TN, delivered her daughter Vivian at Ascension St. Thomas Hospital Midtown in 2018.^[] Boughton was admitted to the hospital around 4 pm and delivered her daughter the next morning around 9 am. Reportedly, there were signs of fetal distress just after midnight, but no action was taken. Brain injuries were observed after Vivian’s birth, and the infant was transferred to a neonatal intensive care unit. Now five years old, Vivian has cerebral palsy, developmental delays, and brain damage. In May 2024, a Nashville jury ruled in favor of the Boughton family and awarded a record $46,993,500.

The delivery

Cayce Boughton was admitted to Nashville’s Ascension St. Thomas Hospital Midtown on September 29, 2018. She was transferred to a labor and delivery room around 7:35 pm. Signs of fetal distress presented throughout Boughton’s labor; however, the lawsuit alleges that no additional monitoring was performed and no actions were taken. Vivian Boughton was born at 9:18 am. and was reportedly “lifeless, limp, gray in color, and not breathing.”

The neonatal intensive care unit diagnosed Vivian with hypoxic-ischemic encephalopathy. She was transferred to Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center for further care. Vivian has cerebral palsy, epilepsy, developmental delays, and brain damage.

The lawsuit

In 2019, the Boughton family brought a malpractice suit against St. Thomas Midtown Hospital and Tennessee Women’s Care, along with Boughton’s obstetrician, Sa Cara Shaw, MD. The Boughtons resolved their claims against Dr. Shaw and Tennessee Women’s Care, while the case against St. Thomas went to trial in 2024.

The Bouhgtons’ suit alleges that the health providers caring for Cayce on the night of September 29, 2018, failed to take action and expedite Vivian’s delivery, leading to oxygen loss and permanent disability. Although the portion of the suit initially filed against Dr. Shaw was resolved outside the courtroom and with no fault assigned to her, the trial against St. Thomas Midtown included discussions of Dr. Shaw’s patient care. During the weeks-long trial, jurors also heard about the care provided by two St. Thomas nurses: Jackie Smith and Melissa Groome.

The verdict

In its final verdict, the jury found Smith and Groome liable for 75% of Vivian Boughton’s injuries, and assessed 25% of her injuries against Dr. Shaw 25%. Since the Boughtons’ legal case against Dr. Shaw has been resolved, Dr. Shaw will not be responsible for any portion of the payout. Speaking to the press about the case, Dr. Shaw’s lawyer, James Sperring, stated:

“Dr. Shaw’s presence on the verdict form was only the result of a comparative fault defense by the hospital and does not constitute a judgment against Dr. Shaw,” Sperring said. “Dr. Shaw retained multiple experts in her defense with decades of experience, all of whom were prepared to testify that the care she provided to Ms. Boughton and her daughter was appropriate and met the standard of care.”

Since the charges against Dr. Shaw have already been resolved, St. Thomas is responsible for paying 75% of the total award, or just over $35 million. According to local news station WSMV, the jury awarded the Boughtons $23 million for future medical expenses and more than $20 million for pain and suffering.^[] However, Tennessee caps non-economic damages at $750,00.^[] This will likely significantly reduce the final award sum. 

OB/GYNs and malpractice

There’s no way to prevent the risk of malpractice suits entirely, and physicians across medical specialties can sometimes face malpractice cases. However, statistics show that some specialties are more likely to face malpractice cases. In repeated surveys and data-gathering studies, OB/GYNs and surgeons the list of physicians who are most often the subject of medical malpractice suits. 

In a recent American Medical Association survey, 62.4% of OB/GYNs reported having been sued for malpractice over the course of their careers. Only 8.6% of surveyed endocrinology and diabetes specialists had ever been sued.

Pregnancy and childbirth are complex, and even in modern times, delivering a child can be dangerous. In 2022, the maternal mortality rate in the United States was 22.3 per 100,000 live births.^[] Common causes of death include preeclampsia, postpartum hemorrhage, puerperal sepsis, venous complications, embolism, cardiomyopathy, and preexisting hypertension.^[] Additionally, birth trauma injuries to newborns are estimated to occur in approximately 29 per 1,000 deliveries in the US.^[] This doesn’t mean that any negligence or other malpractice has occurred or that a suit will be filed, but it could be a window into why this specialty faces so many cases.