Missouri Woman Sues Obstetrician For Infant’s Shoulder Dystocia

A Missouri woman filed a birth injury lawsuit last month against an obstetrician at Maryville’s Anderson Hospital, after her baby was born with shoulder injuries known as shoulder dystocia after a difficult delivery.

According to reports, Chris Ninness filed the lawsuit on Sept. 17, on behalf of her baby daughter, against Dr. James Dalla Riva, the obstetrician and gynecologist who delivered the infant at Anderson Hospital in Feb. 2013. Ninness was a patient of Dr. Riva, and was getting regular, monthly prenatal checkups after she was informed that her glucose levels were too high and her abdomen size was too large for the infant’s gestational age. However, although Ninness gained 53 pounds over eight months of pregnancy, court documents state that she was never given any nutritional advice or planning.  In addition, Ninness claims she was never given an ultrasound to measure her daughter’s weight and a scheduled cesarean section (C-section) was never recommended.

Per court documents, when Ninness’ daughter was being delivered, her shoulders became lodged in her mother’s pelvic area. In an attempt to delivery the baby before she experienced oxygen deprivation, Dr. Riva allegedly exerted too much pressure on the infant’s neck and head, which resulted in severe shoulder injuries.

Ninness, who accuses Dr. Riva of negligence is seeking over $500,000 in economic damages for both medical costs and court expenses.

According to the American Family Physician (AFP), shoulder dystocia, a term defined as an infant shoulders becoming lodged in the mother’s pelvic area during labor and delivery, can often be remedied without causing harm if a doctor applies maneuvers and techniques to deliver the baby, such as the McRoberts maneuver or internal rotation. Most instances of shoulder dystocia occur in infants with macrosomia (large fetal size and weight) and with mothers who have gestational diabetes. However, with proper prenatal monitoring, including weighing the infant via an ultrasound and scheduling a C-section if necessary, many cases of shoulder dystocia can be eliminated. 

In some instances, infants with normal weight and with mothers who are healthy will still experience shoulder dystocia, and often without warning. It is in these instances in which physicians typically utilize medical maneuvers to deliver the baby without causing physical harm.

Infants who experience shoulder dystocia face a heightened risk of injuries, including Erb’s palsy, Klumpke’s palsy, oxygen deprivation, and in rare instances, broken bones. Other factors that contribute to the risk of an infant going through shoulder dystocia include:

  • A post-term pregnancy
  • Previous pregnancies in which shoulder dystocia occurred
  • Maternal obesity
  • Abnormal weight gain during pregnancy

In many cases shoulder dystocia will heal on its own over time. In some instances, however, infants may need surgery and long-term physical and occupational therapy. Other infants may never fully recover the use of affected limb. If oxygen deprivation occurs, babies may develop a host of medical problems, including cognitive disorders, autism, behavioral problems, and cerebral palsy (CP).


  1. http://www.aafp.org/afp/2004/0401/p1707.html
  2. Madison County Circuit Court case number: 14-L-1284