On appeal from Superior Court of New Jersey, Law Division, Warren County, Docket No. L-225-05.
NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION
Before Judges Fuentes, Grall and Waugh.
Plaintiffs, Joseph Greenleaf, Sr. and Kimberlee Greenleaf, as guardian ad litem for the minor Joseph Greenleaf, Jr. and Kimberlee Greenleaf, individually, filed this medical malpractice action against defendants*fn1 Belinda Silverthorn, a certified nurse midwife, and Warren OB-GYN Associates, Silverthorn's employer, alleging that they were negligent in the delivery of the infant plaintiff; and, as a proximate cause of such negligence, Joseph suffered a permanent injury to his left arm known as a brachial plexus injury.
The matter was tried for five days before a civil jury that returned a verdict of no cause for action. Plaintiffs now appeal arguing that the trial court committed reversible error in: (1) limiting the testimony of their expert pediatric neurologist, Dr. Adler; and (2) prohibiting their expert in obstetrics and gynecology, Dr. Ravitz, from bolstering his credibility by testifying that he donates his witness fees to charity.
After carefully reviewing the record, and in light of prevailing legal standards, we affirm. We will limit our factual recitation to those facts necessary to address plaintiffs' arguments on appeal.
Kimberlee Greenleaf was admitted to Warren Hospital on August 14, 2003, at approximately 3:00 a.m., complaining of labor pains after her "water broke." She was accompanied by her husband Joseph Greenleaf; Joanne Greenleaf, Joseph Sr.'s mother, arrived minutes later. Kimberlee was taken to the delivery room where an anesthesiologist administered an epidural injection; members of the nursing staff were also in contact with her.
The Greenleafs had agreed to have midwife Belinda Silverthorn deliver their child. Silverthorn examined Kimberlee to confirm dilation, at least once prior to the baby's birth. Kimberlee became fully dilated after about three hours and twenty minutes after her arrival at the hospital. At that point, Silverthorn instructed her to begin pushing.
Along with Silverthorn and Nurse Susan Wade, Joseph, Sr. and his mother Joanne were also present in the delivery room. A few minutes after Kimberlee began to push, Silverthorn, who was at the foot of the bed between Kimberlee's legs, abruptly directed Kimberlee to stop pushing. According to Silverthorn, she directed Kimberlee to stop pushing because she had seen a "turtle sign," which she defined as a situation where the baby's head comes out of the mother's vaginal canal, but then is pulled back, "like a turtle head is going back into its shell."
Silverthorn testified that a "turtle sign" is indicative of shoulder dystocia, a situation in which, after the delivery of the baby's head, the shoulders are impacted and do not promptly follow through with normal obstetrical movements. The shoulders do not deliver because they "hang up" or become "stuck behind a bony part of the mother's pelvis."
Once she detected the sign of shoulder dystocia, Silverthorn lowered the head of Kimberlee's bed and began to perform the "McRobert's maneuver," an obstetrical procedure used to free the baby's shoulder by retracting the mother's legs toward her chest and applying suprapubic pressure, or pressure to the lower part of the mother's abdomen.
At this point, Nurse Wade, who had been just observing, grabbed and pulled back Kimberlee's right leg, climbed over the top of her and started pressing on her lower stomach. According to Kimberlee, no one pulled on her left leg. Her mother-in-law Joanne testified, however, that her son Joseph Sr. was pulling back on Kimberlee's left leg. Joseph Sr. and Silverthorn both had no recollection as to whether Joseph Sr. held Kimberlee's leg. Silverthorn testified that while this was taking place, she was applying gentle downward and ...