Twaylla Taitague gave birth to twin girls at the Guam Regional Medical City on Sept. 16, 2018, but five days later, she would lose one of her daughters.
The infant's death has led to the latest multimillion-dollar lawsuit filed in the Superior Court of Guam against health professionals, as well as a challenge to Guam's mandatory medical malpractice arbitration law.
Parents Twaylla and Charles Taitague are seeking $11 million in damages and a determination that the mandatory arbitration law is unconstitutional and inorganic for violating due process and equal protection rights.
The defendants include Dr. Katrina Ibonia, GRMC and their insurance company, listed as "John Doe."
Neonatal intensive care
After birth, one of Taitague's girls was admitted to the neonatal intensive care unit at GRMC. The baby was premature and had respiratory distress and feeding concerns, among other issues, according to the lawsuit.
The next day, an intravenous line was inserted into the newborn's right hand. On Sept. 18, 2018, the IV was found to be leaking and was removed, the lawsuit states. A foul smell and yellowish fluid were observed from the area where the IV was inserted, the lawsuit states.
The wound was cleaned and Bacitracin was applied, allegedly on the doctor's orders.
A physician was notified the next day to assess the wound. It appeared to slightly tunnel, had scant amounts of yellow or orange discharge, and the surrounding tissue was warm to the touch, according to the lawsuit. Tylenol was ordered to lessen the baby's discomfort, the suit added.
On Sept. 20, a nurse noticed that the infant's right arm was swollen, red and had pus. The dressing was removed and medication applied to the arm and exposed to dry.
A nurse noted the baby was moaning on and off throughout the night and into the morning. The nurse tried to soothe her using Sweet Ease, a natural sucrose solution, when Tylenol could not yet be administered, the lawsuit states.
On Sept. 21, the baby's heart rate spiked to 174 beats per minute. There was swelling around her right wrist, the lawsuit states. She was moaning and crying and her heartbeat was excessive, the suit stated.
That night, Ibonia was allegedly notified that the baby was still in discomfort after Tylenol was administered an hour earlier. She allegedly ordered to increase the dosage from 10 milligrams to 15 mg every six hours as needed.
Thirty minutes later, after the doctor was informed the baby was still crying and moaning, she allegedly ordered Tylenol to be given at midnight, two hours earlier than scheduled.
The infant's death
In the early morning hours of Sept. 22, Ibonia ordered lab tests after being notified of the baby's condition, the lawsuit states.
Later that morning, the baby went into cardiac arrest. The baby died at 9:49 a.m.
Twaylla Taitague watched as medical staff attempted to revive her baby. In the end, she was asked permission to end those efforts and witnessed her daughter pronounced dead.
Blood tests would later show a positive result for Methicillin-resistant Staphylococcus aureus, the lawsuit states. It's a type of antibiotic-resistant bacterium that causes difficult-to-treat infections, according to the U.S. Centers for Disease Control and Prevention.
Ibonia and GRMC acted negligently, according to the lawsuit, and improperly administered an IV, failed to treat the resulting infection and repeatedly failed to recognize symptoms of sepsis, the lawsuit claims.
A GRMC representative was reached for comment after regular work hours Wednesday but was unaware of the lawsuit.
Law prevents relief
Normally, the case would first need to go through arbitration, as required by Guam's medical malpractice arbitration law, before going to the courts. But the parents do not have the financial ability to initiate the arbitration process or pay fees to arbitrators, according to the suit.
The parents and their lawyer are seeking an injunction on arbitration proceedings.
There have been previous challenges to the three-decade-old arbitration law, but none have yet succeeded.
David Lubofsky filed a lawsuit challenging the law before the Taitagues filed theirs. That outcome is still pending. Lubofsky also requested that senators review the law. The Guam Daily Post sought opinions from lawmakers on that request, but none have responded as of press time.
The Superior Court of Guam took up the equal protection and due process issues in 2005, after a lawsuit in 2003, but determined that the law did not violate those rights.