Jurors in Madison County Circuit Judge William Mudge’s court were fixed on a fidgety three-year-old girl brought before them in the lap of her mom Tuesday afternoon.

Her brief appearance was made as subject of a medical malpractice case at trial against Maryville obstetrician James Dalla Riva, M.D.

Jamie Rae of Staunton sued in 2012 claiming 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 at Anderson Hospital on March 1, 2011.

St. Louis attorney David Zevan represents Rae and called neurologist Michael Noetzel, M.D. to the stand as a treating physician.

Noetzel stood in front of Balei and performed a test that demonstrated her right arm functions properly, but showed that she cannot raise or bend her left arm. Balei cooperated for a short time but became fussy and was taken out of the courtroom by her mother.

According to Noetzel, Balei is diagnosed with autism, but he said the condition is not related to her arm injury.

The lawsuit claims that during labor and delivery, Dalla Riva had noted a shoulder dystocia, and tried multiple maneuvers which failed to deliver the posterior shoulder. It also states that after turning Balei, Dalla Riva delivered her right shoulder followed by the turned left shoulder. Upon delivery, her Apgar scores were 7 and 9 and her left arm was “floppy,” the suit says.

Jamie Rae claims that Balei was born 9 pounds, 2 ounces, and that because of her large size she should have been delivered by Cesarean section.

Noetzel testified that any further surgery Bailei undergoes would be to keep from losing any gains she has made in previous procedures and therapy, but would not be curative.

Noetzel is director of the Division of Pediatric and Developmental Neurology at Washington University School of Medicine in St. Louis.

He said that in his experience he has seen injuries such as Bailei’s through active, hands-on birthing.

On cross examination, Noetzel told defense attorney James Neville of Belleville that there are a number of different causes of brachial plexus. He said that forces of labor and pushing by the mother are also known to cause the condition.

Anderson Hospital had been named an original defendant in the case. Mudge dismissed the hospital from the case without prejudice on April 23.

Madison County case number 12-L-736

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