In 2014, Kylie Frost sought out Laura Hamilton, the only midwife who does home births in Lewis County, to oversee her pregnancy and deliver her baby.
Hamilton, according to her lawyer, has delivered more than 4,000 babies across Southwest Washington in her 34 years of practice. She graduated with the first class at Seattle Midwifery School, has been a licensed practical nurse since 1977, and by some estimates she was delivering three-quarters of the babies in Lewis County in the early 1990s.
But despite that experience, Frost’s case went all wrong.
When she was a week shy of full term, Frost passed several fist-sized blood clots. Hamilton told her the discharges were normal and there was “nothing to worry about,” according to a wrongful death lawsuit Frost filed against Hamilton in April. Finally, after four more calls to Hamilton, Frost’s mother-in-law called Providence Hospital in Centralia. A nurse told the family to have Frost go see Hamilton or come to the hospital, according to the lawsuit.
At Hamilton’s Chehalis clinic — which she runs out of her home — Frost continued bleeding. Her contractions got worse, and she said she felt horrible abdominal pain when she tried to push, according to court records. Hamilton then checked the baby’s heart rate, but it was no longer detectable. Hamilton told Frost her baby was “gone” and called 911, according to the lawsuit. Frost delivered her stillborn baby, Oliver, by cesarean section at a hospital.
What Frost may not have known at the time was that Hamilton had already racked up dozens of complaints, several professional disciplinary orders and had been subject to multiple state Health Department investigations over the course of her career, including a 1994 case in which an administrative health law judge determined Hamilton’s negligence was a factor in the death of a 21-year-old mother.
Hamilton currently is under Health Department investigation in three cases, two of which have sparked lawsuits — including Frost’s and another by a cousin. She also faces another malpractice case that is under appeal.
Despite that track record, Hamilton, 60, continues to practice. In multiple interviews, officials from the state Department of Health couldn’t answer why Hamilton has not been barred from delivering children.
“She’s had some problems in the past, and it seems to be more than normal,” said Sim Osborn, one of the lawyers representing the plaintiffs in the two active malpractice lawsuits against Hamilton. “There’s never really any closure for this on anyone. There’s never a resolution of these cases. It’s good for the clients and good for (Hamilton) to get this resolved, but it is what it is. There’s no perfect system.”
Hamilton declined to be interviewed, but her lawyer, Donna Moniz, describes her as “a devoted, experienced licensed midwife.”
“Unfortunately, pregnancy, labor and delivery are not risk-free. Although it is hard for both parents and health care providers to accept, complications can and do occur through no fault of the delivery provider, whether physician or midwife,” Moniz wrote in a statement to The Daily News. Hamilton “sees her clients for every prenatal visit. She attends every birth herself barring unusual circumstances. She consults or refers to physician specialists for deviations from normal.”
Hamilton is denying the allegations, and she disputes some of the facts in Frost’s lawsuit, which will be heard in Lewis County Superior Court.
Birth: A legal minefield
Over her career, Hamilton has been subject to at least 22 complaints for her midwifery care, and the health department determined all but three of them were serious enough to warrant investigation. Kathy Weed, program director for midwifery at the state Department of Health, said in her three years with the department she has never encountered a midwife with as many complaints as Hamilton.
Obstetrics is a legally fraught area. Medscape, a medical industry newsletter, says OB-GYNS are the most frequently sued of all medical practitioners. A Medscape survey found 85 percent of OB-GYNS had been sued for malpractice at least once. Comparable statistics for midwives were not available.
At the same time, the number of home births — the rule a century ago — have more than doubled since about 2004, according to the Centers for Disease Control. Today, they account for 1.36 percent of all births, up from 0.56 percent in 2004. But in Washington and Oregon, more than 3 percent of births occur at home, the CDC estimates.
Most of these are supervised by midwives, of which there are 170 licensed in Washington. In this state, two midwifery associations have established standards of care most midwives choose to follow, but the state does not have any standard of care laws that are legally binding for midwives, meaning they enjoy a great deal of choice in what they can and cannot do, Weed said.
The law does state: “It shall be the duty of a midwife to consult with a physician whenever there are significant deviations from normal in either the mother or the newborn.” State law also outlines requirements for licensing and license renewal, what drugs may be administered during care for the mother or baby, and requires midwives to plan for consultations, emergency transports and transfers.
Some of most common and serious birth injuries, according to Standford Children Health, are infant cephalohematoma (a form of bleeding in the head that causes complications, such as jaundice); temporary or permanent facial paralysis due to nerve damage; fractures to the collarbone; and damage to the “brachial plexus” network of nerves that sends signals from the spine to the shoulder, arm and hand. (Statistics for injuries during midwife deliveries were not available.)
A brachial plexus injury from 2014 sparked a second lawsuit this year against Hamilton. It was filed by Seng Hamilton and her husband, who is Laura Hamilton’s cousin.
Seng Hamilton was under Laura Hamilton’s care in 2014. That April, Laura Hamilton drove to Seng Hamilton’s house to deliver her baby. They both had noted the baby was large, according to a medical malpractice lawsuit filed in Lewis County Superior Court this spring.
The suit states Seng Hamilton went through a long labor and the midwife attempted several maneuvers to deliver the baby, named Zachary. The suit alleges Laura Hamilton used “excessive traction and pulled and twisted Zachary’s head and neck to attempt to deliver him.”
Zachary was born with a limp arm, suffering permanent paralysis of and dysfunction in his arm and shoulder, according to court records. The suit alleges Laura Hamilton’s actions caused the injuries. The family is seeking general and special damages in an amount to be determined at trial; as well as damages for pain, suffering, mental anguish, emotional distress and others.
“Seng Hamilton’s child is facing a lifetime of medical issues and care and rehabilitation, and all that costs money. And there are certain things he’ll never be able to do,” said Osborn, lawyer for Seng Hamilton and Kylie Frost.
“The costs for that should be borne by the person that caused it. … If I could wave a magic wand and make the child better, or bring the Frost child back, of course I would, but that’s not possible.”
In response to the suit, Laura Hamilton’s lawyer counters that Seng Hamilton’s labor was not long, lasting four to six hours, that the statute of limitations has run out, and that their son’s injury was “caused by an act of God — the natural forces of labor,” according to court records.
In her statement to The Daily News, Moniz, Laura Hamilton’s attorney, wrote, “Complications are stressful for everyone. First and foremost, parents grieve the loss of a perfect baby. Midwives, nurses and doctors as part of the health team all wish the outcome was better. Babies may not survive even with hospital deliveries by physicians.”
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Seng Hamilton’s case has been investigated by the state Department of Health and is one of the two cases, including the Frost case, awaiting possible enforcement action against Laura Hamilton.
Hamilton was the midwife in another lawsuit involving a brachial plexus injury in a child born in 2010. The 2014 negligence suit alleged Hamilton twisted and pulled the child during delivery, causing the injury. A jury in 2015 cleared Hamilton of negligence, but the case is under appeal.
History of complaints
The State Department of Health archives are full of complaints against Hamilton. A few of them are as follows:
In 1989, officials with the department had proof Hamilton had written prescriptions for an antibiotic, as well as birth control pills, which was outside the legal scope of practice as a midwife, according to a report filed in 1992 with the board of practical nursing.
In a 1991 complaint, a healthcare official said Hamilton had no backup plan, as required by law, when problems developed during a delivery and Hamilton had to transfer the patient to the hospital. The official then went on to say the unmonitored home deliveries were unsafe and “allowing these conditions to persist will eventually result in a maternal death, a fetal death or a brain damaged child,” according to health records.
Also in 1991, a health department investigation determined Hamilton had violated the scope of her practice as a midwife and committed fraud by representing herself as a physician who could authorize prescriptions, according to health department investigative reports. The state took no action against Hamilton for the violations.
In 1993, the Medical Assistance Administration, which dealt with Medicaid payments and is now a part of the Health Care Authority, disciplined Hamilton. In order to continue accepting Medicaid patients, Hamilton had to take steps to improve her practice and have more detailed charting, data and notes regarding her care for mothers and their babies.
In several other complaints filed since 1993, Hamilton was investigated for a series of minor complaints, such as insufficient charting, breach of confidentiality or failing to follow disciplinary orders. The complaints were closed without action.
A mother’s death
The first time state health officials disciplined Hamilton followed the September 1994 death of 21-year-old Stephanie Luedke. Luedke went to Hamilton’s Chehalis clinic where Luedke delivered her second child, a boy, at around 10:30 p.m. For the next two hours, Luedke continued to bleed, became lightheaded and complained of nausea and abdominal and back pain, according to a 1995 ruling by a health law judge.
Nearly four hours passed before Hamilton called 911 to get Luedke to the hospital, time in which Luedke continued to bleed, while her blood pressure dropped and her pulse increased. When Luedke arrived at the hospital, surgeons performed an emergency hysterectomy, but Luedke died, according to the records.
The health law judge concluded in 1995 that Luedke’s death likely was the result of a postpartum hemorrhage that started at Hamilton’s clinic and was preventable. The judge found Hamilton’s negligence “was a matter of mistakes in judgment and was not a matter of any malice or willful inaction,” according to the records.
Hamilton was allowed to continue practicing, but the health department ordered her to undergo more training, heightened scrutiny and comply with additional terms and conditions for at least three years. Over the next three years, health officials received several complaints alleging Hamilton had violated the conditions.
In 1998, Hamilton was accused of failing to transport another woman to the hospital in a timely manner after she gave birth. Like Luedke, the woman had cervical lacerations, which required surgery and multiple blood transfusions. The woman survived. In resolving the case with the health department, Hamilton admitted no wrongdoing, but agreed to a stipulation that re-imposed conditions on her similar to those ordered in the Luedke case.
Despite numerous phone calls from The Daily News, neither Weed nor other health department officials could explain why Hamilton did not face more severe sanctions after the complaints from the 1998 case.
The third case under investigation at the health department, which also is awaiting a decision regarding enforcement actions, involves a baby who was exposed to heroin in utero in 2016.
The complaints, which were filed in 2016 by a social worker and Providence St. Peter Hospital in Olympia, allege that Hamilton mishandled the birth of Evan Copeland, a baby born in July that year, according to Health Department reports.
The baby was born in Hamilton’s car on the way to her Chehalis clinic. The baby’s mother is Hamilton’s niece. The complaints allege Hamilton provided care for the baby for two days until law enforcement and Child Protective Services removed the infant from the home and Hamilton failed to instruct the parents to seek medical attention for obvious signs of withdrawal, which include vigorous crying, jitteriness, poor feeding and excessive sucking, according to health department records.
The complaints state Hamilton should have immediately notified CPS when the boy was born because of the mother’s history of heroin use, but instead Hamilton notified CPS late the following day and she reported the baby and mother were fine, with no signs of withdrawal, according to health department records.
The baby was removed the next day and admitted to the hospital, where he screened positive for opiates and cannabis. The hospital’s complaint stated that “signs of withdrawal would have been very apparent while the baby was in (Hamilton’s) care.”
The infant was later placed in intensive care, treated and later placed in foster care, according to the records.
Moniz, Hamilton’s lawyer, said her client did notify CPS within 24 hours of the baby’s birth and child protective workers picked the baby up less than 48 hours after delivery. Moniz states the baby started showing signs of withdrawal sometime later, according to health department records.
Moniz told the Health Department that the “complaint involves frustration by CPS workers who did not follow their own procedures in taking the baby.” Hamilton did not believe her niece had used heroin during the pregnancy, Moniz said.
CPS has not filed charges against Hamilton. It is unknown when the Health Department is expected to issue its rulings and findings in the heroin and Seng Hamilton cases, or when it will complete investigating the Frost case. But whatever the outcome, the hurt of tragic deliveries will continue, Osborn said.
“I can’t imagine what the mothers are going through. It’s just horrible. It’s horrible.”
“I can’t imagine what the mothers are going through. It’s just horrible. It’s horrible.” Sim Osborn