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Butts v. United States

United States Court of Appeals, Fourth Circuit

July 11, 2019

KAYLA BUTTS, Individually and on behalf of her daughter A.F., a minor, Plaintiff - Appellee,
v.
THE UNITED STATES OF AMERICA, Defendant-Appellant, and BERKELEY MEDICAL CENTER; WEST VIRGINIA UNIVERSITY HOSPITAL, INC.; SHENANDOAH WOMEN'S HEALTH CENTER; SHENANDOAH COMMUNITY HEALTH CENTER; SHENANDOAH MIDWIVES; AVINASH PUROHIT, M.D.; TRACY SWALM, CNM; SARA SPURGEON, R.N.; SHELLY PALKOVIC, R.N.; REBECCA PFENDER, CNM; SARAH HARDY, M.D.; SONYA JUSTICE, R.N., Defendants.

          Argued: May 7, 2019

          Appeal from the United States District Court for the Northern District of West Virginia, at Martinsburg. Gina M. Groh, Chief District Judge. (3:16-cv-00053-GMG-MJA)

         ARGUED:

          Joshua Marc Salzman, UNITED STATES DEPARTMENT OF JUSTICE, Washington, D.C., for Appellant.

          Barry John Nace, PAULSON & NACE, PLLC, Washington, D.C., for Appellee.

         ON BRIEF:

          Joseph H. Hunt, Assistant Attorney General, Mark B. Stern, Civil Division, UNITED STATES DEPARTMENT OF JUSTICE, Washington, D.C.; William J. Powell, United States Attorney, OFFICE OF THE UNITED STATES ATTORNEY, Wheeling, West Virginia, for Appellant.

          Matthew A. Nace, PAULSON & NACE, PLLC, Washington, D.C.; D. Michael Burke, BURKE, SCHULTZ, HARMAN & JENKINSON, Martinsburg, West Virginia, for Appellee.

          Before HARRIS, RICHARDSON and QUATTLEBAUM, Circuit Judges.

          Quattlebaum, Circuit Judge

         This case arises from a tragic set of events involving A.F., a baby born with severe respiratory problems who developed permanent brain damage. Kayla Butts ("Butts"), A.F.'s mother, brought this action claiming A.F.'s brain damage was caused by the medical malpractice of Dr. Sarah Hardy. More specifically, Butts contends that Dr. Hardy should have transferred A.F. from the hospital where A.F. was born to a hospital with a neonatal intensive care unit ("NICU") that could have provided the care A.F. needed in the hours after her birth. After a bench trial, the district court agreed and awarded Butts over seven million dollars in damages. On appeal, we consider whether Butts presented sufficient evidence to establish that Dr. Hardy violated the applicable standard of care. Because the district court's finding on this issue was clearly erroneous, we reverse the district court's order and vacate the judgment against Dr. Hardy.

         I.

         Butts delivered A.F. at Berkeley Medical Center ("Berkeley") in Martinsburg, West Virginia. Berkeley did not have a NICU, so infants who required additional support were cared for in Berkeley's "Max Care Nursery." The Max Care Nursery offered specialized care to newborn infants, including an oxygen-delivery system and equipment to provide intubation. However, the Max Care Nursery did not have all the equipment found in a NICU, including a breathing device known as a continuous positive airway pressure ("CPAP") machine. Infants delivered at Berkeley who needed specialized care Berkeley could not provide were often transported to the NICU at Winchester Medical Center ("Winchester") in Virginia.

         At the time of these events, Berkeley was working to establish a NICU of its own. To that end, Berkeley hired Dr. Avinash Purohit, a board-certified neonatologist, to establish and manage a NICU. But Dr. Purohit arrived at Berkeley only a ...


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