A DeKalb County jury cleared two doctors and a nurse of liability for the premature delivery and death of an infant whose mother was suspected of having a cervical problem shortly before giving birth.

The treating obstetrician, along with a maternal fetal medicine specialist and his nurse-midwife, were accused of failing to perform a procedure to close the mother's "incompetent cervix"—a condition in which certain cervical muscles are weak and there is a danger of premature birth—when an ultrasound indicated there might be a problem.

Weathington Firm partner Gabe Banks, who represented the MFM doctor and nurse, said the case was complicated by the fact that the mother showed up for trial 32 weeks pregnant, after having undergone the very procedure—a cerclage—the defendants were accused of failing to perform.

A cerclage involves stitching up the cervix to hold it shut.

"In this case, the issue was whether she was a candidate for a cerclage, and we found out on the first day that a cerclage was in place and working," said Banks, who served as lead counsel with partner Paul Weathington.

"It's always a very tragic situation when you have a fetal demise. It just pulls at the heartstrings of everyone—the jurors, lawyers, everyone at the trial," Banks said.

Scott Bailey, Huff Powell Bailey, Atlanta. (Photo: John Disney/ALM)

Huff, Powell & Bailey partner Scott Bailey, who represented the OB/GYN with associate Lindsay Cotsakis, said the plaintiff's subsequent pregnancy after having undergone the procedure "may have turned out to be a positive for us."

The mother, Shayla Jackson, had successfully carried two babies to term prior to the preterm birth. Afterward, she had yet another preterm delivery—which is also the subject of separate litigation.

Those justified doctors in ordering the procedure, he said.

"She became a candidate for [the cerclage] by virtue of the fact that she'd had a preterm pregnancy before," Bailey said.

Jackson's attorney Roger Krause of Decatur's Krause Law Firm did not respond to requests for comment.

According to the defense lawyers and court filings, Jackson went to DeKalb Medical Center in June 2015 complaining of a headache and vaginal bleeding. The emergency room doctor ordered a sonogram, which "revealed a concern over an incompetent cervix and premature labor."

Jackson, who was accompanied by a young infant she had given birth to earlier that year, was admitted to the labor and delivery unit. After a few hours she left and went home because she needed to care for another child there.

She returned later and was seen by OB/GYN Shirley Echols, who "deferred a pelvic exam in fear of rupturing membranes or risking infection."

Echols sought out a consultation with MFM doctor Dexter Page. He was not available, but his nurse-midwife, Ruby Henderson, who was covering for him, examined Jackson instead.

Henderson reported her findings back to Page, who never saw Jackson but advised that she could be discharged and should see him again in a few days.

Jackson went into labor that night, and her mother or husband called 911. She gave birth in the ambulance, and the baby died a few hours after they arrived at the hospital.

Jackson sued Echols, as well as Henderson, Page and his practice, Atlanta Perinatal Associates, in DeKalb County State Court.

The defense lawyers said there were multiple demands made to settle the case, but none of the defendants were interested.

During a trial that began before Judge Alvin Wong on Dec. 9, the defense lawyers said the OB/GYN, Echols, had the stronger case because she did everything she was supposed to do. "She raised the right questions, and deferred those questions to the MFM who was our client," Banks said.

"The issue we had to overcome was that he didn't show up at [Jackson's] bedside," he said. "He sent his nurse-midwife."

Another issue, said Banks, was that Jackson was not a candidate for cerclage at the time, as she had already given birth twice with no problems.

He said key experts included MFM doctor Michelle Owens of University Hospital in Jackson, Mississippi, for the defense. Krause relied on Charleston, South Carolina, OB/GYN Charles Rittenberg.

In closing, Banks said Krause asked the jury to award between $4 million and $6 million.

The jury retired for deliberations at about 1 p.m. on Friday and were back with a defense verdict in about an hour, he said.

"Ms. Jackson presented as a very sympathetic plaintiff, and Roger Krause did a good job trying the case," Banks said.

"It was a good win here at the end of the year, when we've heard so much about nuclear verdicts and outrageous verdicts," said Bailey. "It's good to know you can still win a case defending good medicine in a venue most people don't really think of as defense friendly."