MADISON - ST. CLAIR RECORD

Lawyers defending Maryville obstetrician James Dalla Riva, M.D. chose not to cross examine an emotional witness Wednesday afternoon, the third day of trial in a Madison County medical malpractice case.

Brett Rae, father of a three-year-old girl whose arm was injured at birth, told jurors how his wife had struggled during the onset of the child's delivery at Anderson Hospital on March 1, 2011.

His daughter Bailei Rae suffers permanent nerve root damage and brachial plexus injury – a condition that limits movement in her left arm – because Dalla Riva allegedly applied excessive downward traction or excessive tilting of Bailei’s head during birth.

Brett Rae's voice cracked toward the end of his testimony when questioned by plaintiff attorney David Zevan about concerns for his daughter as she grows older. Zevan asked if he had concerns about her physical limitations and how other kids might treat her.

"Yes," he said.

Brett Rae also told jurors that at the onset of what would be a vaginal delivery, his wife Jamie had asked for a Cesarean section delivery because she said she didn't think she could "do it." She became uncomfortable and was panicking, he said.

He said that Dalla Riva asked for nurses to help. Then, four or five more nurses came into the room, he said, and one climbed on the bed and pushed on his wife's stomach.

After Bailei was born, he said that his daughter's arm "was kind of hanging. Like there was nothing there."

Riva, according to Brett Rae, said "check her left arm."

Following a first surgery for Bailei, which was considered to be exploratory for a possible nerve graft, the surgeon realized a greater extent of damage that could not be repaired, Brett Rae said. Bailei has had three surgeries, and no further surgeries are planned because no further improvements can be made, he said.

"That's pretty much it," he said. Bailei can lift her arm shoulder high and hold items in her left hand weighing less than a pound.

The trial is under way in Circuit Judge William Mudge's court.

Neonatologist Gary Blake, M.D. of San Diego, Calif. also took the stand Wednesday as plaintiffs made their case.

Blake said that it is typical for out of state doctors to provide expert testimony in medical malpractice cases because local doctors don't like to testify against one another.

Blake told jurors that Dalla Riva should have done a C-section. "Her arm would be just fine today," Blake said.

He said that if the condition suffered by Bailei was caused by the forces of labor, as defense has argued, then it would be a more common injury.

"We should see it all the time," he said.

Defense attorney James Neville of Belleville sparred with Blake on cross examination and on re-cross over Blake's interpretation of medical reports, procedures and Dalla Riva's testimony.