Hospital, doctor found not liable in childbirth death following religious refusal of blood

The jury sided with the defendant in a $1.5 million medical malpractice case involving the death of the mother after childbirth and birth injury to the baby.

A St. Louis County jury sided with defendants Timothy Philpott, Women’s Care Consultants and Missouri Baptist Medical Center after six hours of deliberation Jan. 28 following a three-week trial.

The case stems from the August 2017 death of Lacey Powell, after she gave birth to a baby girl, V.P. by emergency Cesarean section on Aug. 22, 2017. During a prenatal visit with Philpott, Powell informed him that since she was Jehovah’s Witness, she would not accept blood products of any kind in the course of labor and delivery, including blood transfusions or reinfusion of cell saver blood.

Powell was admitted to Missouri Baptist Hospital for induction and signed several hospital forms confirming her refusal to accept blood products.

During labor, there were some concerning patterns in the baby’s heart rate. The baby was also positioned facing the mother’s back, making it harder for the head to move down the birth canal. Philpott remained hopeful the baby would turn to a better position naturally. After trying some pushing, Powell was repositioned to help relieve the heart rate issues and encourage the baby to turn.

However, later that day, Powell suddenly experienced severe fundal pain and bright red blood appeared on her gown. The baby’s heart rate dropped significantly, and the mother began having very rapid contractions. Philpott diagnosed this as the placenta separating from the uterus wall too early, which cut off oxygen to the baby. An emergency C-section was performed using epidural anesthesia, and the baby was immediately delivered and given to the pediatric team for emergent resuscitation.

Powell’s blood loss was estimated at 1,200 milliliters; however when she was lifted off the operating room table to be sent to post-op recovery, an additional 1,000 milliliters of blood loss was estimated on the sheet where the surgery was performed. An additional approximately 800 milliliters was also expelled from her uterus, raising the total blood loss volume to 3,000 milliliters, over half of Powell’s total blood volume.

Philpott took steps to control the blood loss through medications and placement of a device to tamponade uterine bleeding. While Powell was still conscious, and with her husband Richard Powell at her side, Philpott told her she could die without a blood transfusion. Powell reiterated her refusal of blood products, and she was admitted to the ICU.

On Aug. 29, Powell succumbed to her blood loss from hypoxic end-organ failure and died. The baby, V.P., was treated at St. Louis Children’s Hospital after she was resuscitated. She eventually improved and was diagnosed with cerebral palsy involving certain aspects of her motor function, including speech clarity. Her cognitive brain function was not affected.

One of the plaintiff’s obstetrician experts was critical that a C-section was not performed earlier due to a “hostile uterine environment.” The plaintiff’s nursing expert supported the obstetrician, criticizing the nursing care and interpreting the electronic fetal monitoring strips as showing concerning features.  Another expert for the plaintiff was critical a hysterectomy was not performed after Powell’s 3,000 milliliter blood loss, and was also critical of Philpott’s planning for the labor and delivery, including Philpott’s failure to recommend alternative blood products like Hemopure — a non-FDA approved bovine hemoglobin used as an alternative to transfusions — given Powell’s refusal to accept blood products.

Philpott and defense experts testified that the treatment before and during labor met the standard of care, and that no other planning or preparation such as the use of non-FDA approved blood products was necessary to address Powell’s refusal to accept blood products. The experts noted first-time mothers usually take longer to deliver and as long as both the mother and baby are stable, labor can proceed normally. However, the placental abruption, something that was neither foreseeable nor preventable, required the emergency C-section. As for the hysterectomy, the defense experts testified she likely would not have survived the surgery given the blood loss and her condition that interrupts blood’s ability to clot. The defense experts said the only alternative treatment to save her life was a blood transfusion, which couldn’t be administered due to Powell’s refusals.

During the trial, evidence was presented about V.P.’s abilities and disabilities. Richard Powell claimed that her cerebral palsy required significant accommodation and future care. He also argued that V.P. would have reduced earning potential as an adult. The defendants disagreed, arguing that while V.P. did have some limitations, they weren’t as severe as claimed and wouldn’t require extensive accommodation or future care that the plaintiff’s experts suggested.

Potential jurors received questionnaires to check if they could attend a three-week trial and if they would be biased in a case involving someone refusing blood transfusions due to religious beliefs. The jury did side with the defendants on nearly all counts, but did find Missouri Baptist Medical Center at fault for not providing medical records in a timely manner when requested, as required by Missouri law.

Spataro said the trial was a “long ordeal” due to days lost from winter weather and holidays, but that Philpott was an “outstanding client to have” who was trusted by other medical professionals and ultimately the jury.

“I always thought … you have the right to your religious beliefs,” Spataro said. “(But) you can’t tie the doctor’s hands in treating you in a life-or-death situation.”

He added that the trial was also about two different situations: the child that survived and the mom.

“Whether or not the mom accepted blood had nothing to do with her, the child,” said Spataro.

Brockland could not be reached for comment.

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Medical Malpractice

Verdict for defendant

Type of action: Medical malpractice

Venue: St. Louis County Circuit Court

Case Number/Date: 22SL-CC05241, 1/28/2025

Caption: Richard Powell, Individually and as the Plaintiff Ad Litem for Lacey Powell, Richard Powell, Individually and as the Plaintiff Ad Litem for Lacey Powell, and V.P., by and through her natural Father and Next Friend, Richard Powell v. Missouri Baptist Medical Center, Timothy Philpott, MD, Women’s Care Consultants, LLC

Injuries alleged: Death, birth-related injuries

Special Damages: For the wrongful death of Lacey Powell: $2,164,211 ($561,920 for ability to provide financial support; $31,650 related to employer contribution toward retirement; $1,570,641 for ability to provide family services). For birth injuries related to V.P.: $8,854,748 ($780,572 in reduced earning capacity; $8,074,242 in life care costs).

First pre-trial demand: $4 million, made believing it to be policy limits for the combined exposure of Timothy Philpott and his employer, Women’s Care Consultants. When plaintiffs were told the policy limits were $2 million, a new demand was made for that.

Last pre-trial demand: $1.5 million, made during trial

Plaintiff’s Attorneys: Lead attorney Anne Brockland, along with Matthew Devoti, Matthew Casey and Alexa Hillery, of Casey Devoti & Brockland in St. Louis.

Defendant’s Attorneys: Lead attorney Peter Spataro and Bryce Pfalzgraf, of Brown & James in St. Louis; and Marliee Clausing of HPS Law in Chicago.

Insurance carrier(s): The Doctors Company, for defendants Woman’s Care Consultants and Timothy Philpott

Plaintiff expert(s): Dr. Daniel Adler, Nancy Bond, Dr. Richard Luciani, Dr. Michelle Murray, Steven Shedlin, Dr. William Rogers and Dr. Thomas Sullivan.

Defendant expert(s):  : Dr. Joseph Akerson, Dr. Christopher Bartlett, Dr. Aaron Caughey, Dr. Richard Davis, Dr. Gil Goss, Dr. Neel Shah. Dr. Gordon Sze, Susan Drummonds (nursing specialist) and Kim Kushner.