Medical Malpractice Project

START

Varnika Ravi and Janina Thomas

fertility clinic's DNA mix-up

10. Works Cited

9. Conclusion

8. Resolution

7. Final Outcome

6. What Should Have Happened

5. Resulting Harm

4. Negligence

3.Major Issue

2.Case Overview

1. Introduction

INDEX

In vitro fertilization (IVF) - the joining of a woman's egg and a man's sperm in a laboratory dish

Nancy and Thomas Andrews received in vitro fertilization (IVF) treatment at New York Medical Services for Reproductive Medicine (NYMSFRM), a fertility clinic, in 2004. They looked forward to a happy experience of becoming parents, assuming they would have a child who was genetically related to both of them, through using Nancy's eggs and Thomas's sperm. Following the treatment, Nancy achieved pregnancy successfully. However, their anticipation turned to frustration when another person's sperm was utilized to fertilize Nancy's eggs.

INTRODUCTION

Jessica, the daughter conceived through IVF (left) and Thomas Andrews (middle)

In October 2004, their baby girl Jessica was born without Thomas's DNA. Shortly after her birth, they observed that Jessica had much darker skin than both parents. Her hair was characteristic of African or African-American heritage. So, the couple raised doubts about the IVF procedure. The Andrews received unhelpful answers from Dr. Keltz, the physician in charge of the procedure. Frustrated, they conducted a DNA test at home. It revealed that Jessica was not genetically related to Nancy's husband, but to an unidentified individual. This occurred due to a significant error: the clinic used another man's sperm instead of Nancy's husband's.

INTRODUCTION CONT.

Is the prospective client likeable?: Yes, the Andrews appear likable, showing commitment to their child despite the emotional distress and emphasizing the violation of their reproductive rights rather than rejecting their daughter. Aim: Nancy Andrews and her husband took legal action against NYMSFRM fertility clinic, Dr. Keltz, Dr. Puckett, and Carlo Acosta, the embryologist handling the eggs and sperm. The allegations they made consisted of malpractice, negligence, contract violations, fraud, lack of informed consent, and emotional distress.

Name: Nancy and Thomas Andrews Gender: Female (Nancy Andrews) and Male (Thomas Andrews) Date of malpractice: January 16, 2004 (date of IVF procedure) Date malpractice was discovered: December 2004 (after DNA testing of Jessica) Were they within the Statute of Limitations?: Yes, New York’s statute of limitations for medical malpractice cases is 2 ½ years from the time of discovery, which falls within this timeline.

CASE OVERVIEW

"While we love Baby Jessica as our own, we are reminded of this terrible mistake every time we look at her; it is simply impossible to ignore."

The main issue in this case was the clinic’s failure to make sure that the correct sperm was used in the fertilization process. The clinic negligently used another man’s sperm in the IVF process, resulting in a child who was not biologically related to the intended father, Thomas Andrews. The Andrews expressed severe emotional distress at having a child who was not their genetic makeup and a different race, though they loved Jessica. The issue of how this mix-up happened was the main focus of the case, and the plaintiffs wanted compensation for emotional harm, breach of trust, and mishandling of genetic material.

MAJOR ISSUE

Dr. Martin Keltz, a doctor involved in the case

The clinic showed negligence by failing to adhere to proper verification procedures, which are important in handling and identifying biological samples. Better care should have been upheld in a medical environment that was tasked with handling these sensitive procedures.1. Fertility Clinic Procedures: The clinic failed to ensure that the correct sperm was used in the IVF process. The error forced the couple to raise a child who is "not even the same race, nationality, colour...as they are." 2. Dismissal of Concerns: After Jessica’s birth, Nancy Andrews raised concerns about her skin color. According to court papers, Dr. Keltz simply told them that the child would "get lighter over time". This shows both negligence in the handling part of the event, but also in how the issue was addressed by the staff.

NEGLIGENCE

"There is continuing uncertainty...as to whether the genetic material of either or both of them has been inappropriately used for others and that they may have natural children or half-children that they are unaware of."

3. Failure in Record-Keeping and Sample Handling: The embryologist, Carlo Acosta, who was responsible for processing the sperm samples, didn’t make sure they were correctly labeled and matched. The process didn’t have any rigorous checks, such as proper labeling, double-checking samples, and quality control measures.In a medical setting, where the stakes are particularly high, any lapse in these protocols can have far-reaching consequences. The expectation is that healthcare providers maintain a high standard of care, prioritizing the safety and well-being of patients. The clinic's failure to do so reflects a disregard for basic responsibilities.

NEGLIGENCE

Loss of Biological Parenthood: Thomas cannot experience the unique bond of biological parenthood, a loss that disrupts their family’s continuity and legacy. The Andrews may also feel stigma or inadequacy, as biological parenthood holds cultural significance. Demonstrating Future Impact of Malpractice to a Jury: If not for the clinic’s malpractice, Nancy and Thomas Andrews would be raising their biological child, sharing memories and milestones together. They would experience irreplaceable moments like first steps and personal achievements, creating a deep and lasting bond. This loss of family connection and legacy leaves them with profound grief, highlighting the depth of their suffering for the jury.

Emotional Distress: The Andrews entrusted their fertility clinic with the creation and safekeeping of their embryos. This breach of trust causes further emotional turmoil and might lead them to mistrust medical providers in the future, affecting their willingness to seek care and impacting their quality of life. Uncertainty about Jessica’s Father: Jessica may grow up without clarity about her biological origins, which could lead to identity issues and cause distress for Nancy and Thomas. Concerns over inheritance, guardianship, or other rights may add further uncertainty and emotional strain for them as they navigate these legal complexities.

RESULTING HARM

Electronic verification technologies provide numerous benefits to companies.

Proper Sample Identification and Verification: Chain of custody protocols should have been applied to guarantee precise handling and matching of sperm samples in order to avoid confusion such as these. This would have made it possible for several departments and individuals to cross-check. To further reduce the possibility of human error, electronic verification technologies might have been used. Strict procedures include thorough labeling checks and physical sample verification by two or more people should be part of the standard of care for fertility clinics. These precautions might aid in error prevention.

WHAT SHOULD HAVE HAPPENED DIFFERENTLY?

Immediate Action When Concerns Were Raised: Dr. Keltz should have taken Nancy’s concerns seriously and conducted immediate tests to confirm the genetic parentage of the child when the issue was raised, rather than dismissing it with a superficial explanation.Better Informed Consent: Any dangers associated with IVF operations, no matter how remote, should have been disclosed to the couple. Another significant breakdown in patient care was the omission to disclose possible mistakes in the procedure.

WHAT SHOULD HAVE HAPPENED DIFFERENTLY?

• The court dismissed some claims, particularly those related to breach of contract, fraud, and assault and battery. The court ruled that there was no physical injury involved and that some emotional distress claims were too speculative for compensation.
• However, the court upheld the negligence claim against Carlo Acosta, the embryologist, under the doctrine of res ipsa loquitur, which states that certain errors are so apparent that they speak for themselves. This allowed the court to find Acosta liable for the sperm mix-up without needing further proof of his negligence.
• The case allowed the Andrews to recover damages for emotional distress, though not for all of the claims they originally brought.

FINAL OUTCOME

The Andrews family pursued legal action against the fertility clinic, and the case was eventually resolved. The clinic accepted its error and there was a settlement that addressed the family’s grievances. Specific case details are still not disclosed, but the lawsuit encompassed compensation for the emotional stress and negligence that caused the mix-up of sperms. This resolution gave some accountability, but there was still a significant impact on the family’s life.

RESOLUTION

The Andrews family, two years after the IVF mix-up incident.

Ultimately, the Andrews family chose to raise Jessica as their own child. Even though there were unusual circumstances surrounding her conception, they embraced her as part of their own family. This case showed the potential for medical errors in fertility treatments but was also a wake-up call for clinics across the country. So, in response, many fertility clinics began implementing stricter safety and procedural standards as they recognized the need for more accountability in their operations.

CONCLUSION

1. Arneill, Lisa. “NY Fertility Clinic Used Wrong Sperm.” Growing Your Baby | Parenthood from Pregnancy to Pre-School, Growing Your Baby, 22 Mar. 2007, www.growingyourbaby.com/ny-fertility-clinic-used-wrong-sperm/. Accessed 27 Oct. 2024.
2. CSRC Content Editor. “Chain of Custody - Glossary | CSRC.” Nist.gov, 2015, csrc.nist.gov/glossary/term/chain_of_custody#:~:text=Definitions%3A,the%20purpose%20for%20the%20transfer. Accessed 27 Oct. 2024.
3. “Electronic Visit Verification (EVV) | Texas Health and Human Services.” Texas.gov, 2016, www.hhs.texas.gov/providers/long-term-care-providers/long-term-care-provider-resources/electronic-visit-verification-evv#:~:text=EVV%20is%20a%20computer%2Dbased,more%20about%20EVV%20(PDF). Accessed 27 Oct. 2024.
4. Glaister, Dan. “US Couple Sue Clinic for Sperm Sample Mix-Up.” The Guardian, The Guardian, 23 Mar. 2007, www.theguardian.com/world/2007/mar/23/usa.danglaister. Accessed 27 Oct. 2024
5. “Jorie AI | 7 Benefits to Automated Insurance Eligibility Verification.” Jorie.ai, 2023, www.jorie.ai/post/7-benefits-to-automated-insurance-eligibility-verification. Accessed 27 Oct. 2024.
6. “Martin Keltz, MD.” Wphospital.org, 2024, www.wphospital.org/provider-directory/providers/martin-keltz/. Accessed 27 Oct. 2024.
7. “Res Ipsa Loquitur.” LII / Legal Information Institute, 2024, www.law.cornell.edu/wex/res_ipsa_loquitur. Accessed 27 Oct. 2024.
8. “Who’sMy Father?” ROSARY TIMES, 15 Mar. 2016, nshaljyan.wordpress.com/2016/03/15/an-unbelievable-medical-error/. Accessed 27 Oct. 2024.
9. Wikipedia Contributors. “In Vitro Fertilisation.” Wikipedia, Wikimedia Foundation, 25 Oct. 2024, en.wikipedia.org/wiki/In_vitro_fertilisation. Accessed 27 Oct. 2024.

Works Cited

Varnika Ravi and Janina Thomas

thank you!