Mother filing malpractice lawsuit against IU Health

Nancy Koger & Denise (WTHR photo)

Indiana's largest health system just earned top national rankings in at least 10 specialty programs.

Missing from that elite list is the care of pregnant women. In fact, IU Health and its partners have come under fire for what a whistleblower says is happening to the most vulnerable mothers.

When Nancy Koger gave birth there in January 2013, a medical team had to frantically work to clear her newborn daughter Denise's airways of fluid.

The moment was caught on video shown to 13 Investigates. Baby Denise doesn't make a sound. She's limp and in distress after birth by emergency c-section at IU Methodist on January 27.


Two days earlier, Nancy had come to the hospital to be induced. She was 10 days past her due date and in distress, but with little progress and no delivery, Nancy said a certified nurse-midwife stopped the meds and sent her home.

"I was trusting what she was telling me to do because that's her job," Nancy told 13 Investigates.

What Nancy did not know was her daughter's heart monitor strip was also showing signs of distress. Her attorney, David Stewart, says the certified nurse-midwife missed that critical piece of information.

"Mom and baby were both in a bad place. Had she stayed there in the hospital, not been sent home, baby Denise would have had a much better chance of a better outcome," Stewart explained.

After two days at home with no relief, Nancy returned to the E.R.

"Then I remember an actual doctor showing up and her being alarmed and carting me right off to surgery," recalls Nancy. She said she knew right away there were problems.


On the video tape of Denise's birth, Nancy's mother can be heard asking, "Can she breathe?" referring to Denise.

A staff member replied, "Yes she's breathing."

"I don't hear any crying, so I ask if she's breathing and my mother was the only one that answered me and she told me that she was breathing," said Nancy reflecting on that moment.

Denise was quickly taken to the neonatal intensive care unit. She had suffered brain damage from a lack of oxygen.


Now a toddler, Denise lives with a seizure disorder - cerebral palsy - and is fed through a tube. When we were with them, her lunch was a large syringe filled with specialized formula.

It's not the life Nancy dreamed of for her daughter.

"Everything that could have gone wrong, did," said Nancy. "Everything that they could have did wrong, they did wrong. And everything they asked me to do, I did. I listened to them because I thought they were the professionals and knew what they were talking about," she said with frustration.

Nancy Koger is considering a lawsuit against IU Health and its partner, HealthNet. A former director of women's health at both Methodist and HealthNet said she has good reason.

In an unsealed federal whistleblower lawsuit against IU Health, Dr. Judith Robinson refers specifically to the care Koger received, saying, "After delivery, various physicians reviewed the monitor strip from Nancy Koger's...induction and determined that with the abnormal tracing that was evident...[she] never should have been sent home."

"I expressed concern about patient care and safety issues," Dr. Robinson told 13 Investigates.


According to Dr. Robinson, she alerted HealthNet and ultimately IU Health about Nancy's case. She says baby Denise was one of three babies who suffered permanent neurological injury within a six-month period at the hands of certified nurse midwives caring for high-risk, low-income pregnant women.

Under Medicaid law, that is a violation. Only doctors are to care for high-risk pregnant women.

Robinson reported there were also 17 examples of patient harm or near-misses.

At the same time, Robinson says IU Health was bilking taxpayers out of millions of dollars by fraudulently charging Medicaid for doctors' rates instead of the lower rate for midwife services.

In an email, Robinson warned HealthNet, saying we "need to help devise a process to fix a broken system." HealthNet's Chief Medical Officer responded, "I believe these meetings you are requesting are premature."

"Nobody did anything about it, and their response was not to meet with me, not to meet with the other physicians, not to let me take it higher up," added Robinson.

"We weren't just one isolated case of 'oops'," said Nancy after hearing about the other cases.


Since the federal lawsuit was filed last year, there have been some changes on the HealthNet website.

Initially the site said, "Most women do not see a physician during their pregnancy or birth. However, a physician is available at all times for consultation."

A portion of the site now reads, "Patients with a high-risk condition are scheduled to meet with an OB/GYN physician who will lead the plan of care during your pregnancy."

"I want them to admit that they did wrong," said Nancy with indignation.

She says the idea of a health system putting mothers and babies at risk to make money is incomprehensible. But she won't allow herself to linger there too long. She needs to stay upbeat knowing Denise feeds off every touch.

"They need to give care - proper care - and follow the laws they have in place for people's safety, instead of treating people like second-class citizens. Give people the care they deserve, even if they're broke," said Nancy.

In a written statement, HealthNet told 13 Investigates, "The health and safety of our patients is top priority....We take matters like this seriously. We deny allegations of wrongdoing, but given the litigation, we cannot discuss details....HealthNet has worked closely with the government to review each of the allegations."

Nancy Koger's attorney says his firm is reviewing similar cases and is seeking legal complaints against IU Health and its network on behalf of four other mothers.