The Fallacy of "30-Minutes from Decisions to Incision"

In fetal distress or birth asphyxia cases resulting in cerebral palsy, the argument in the case is always over whether the doctor moved quickly enough to perform a emergency C-section once there were signs that the baby was experiencing problems during the labor process.

Over the years, doctors who have been sued for moving too slowly have often relied upon a so-called principle that says that the doctor has done nothing wrong so long as there is no more than 30minutes “from decision to incision.” What this “principle” means is that supposedly the doctor has acted properly so long as no more than 30 minutes goes by from the time he makes a “decision” to do an emergency C-section until he is in the delivery room making the “incision” for the C-Section. This principle originated many years when many deliveries were done in hospitals that did not have the capability to quickly mobilize and perform an emergency C-section. For example, there may not have been an anesthesiologist on duty round the clock, so someone would have to be summoned from home to travel to the hospital to do the anesthesia necessary for the C-section.

In the more modern medical context, where anesthesia and other staff are typically present in the hospital 24 hours/day, the principle has no application. It is a fallacy, if not an outright joke, to suggest that in such a well-equipped hospital a doctor can take 30 minutes to perform an emergency C-section.

When a baby is demonstrating fetal distress sufficient to warrant an emergency C-section, the doctor’s obligation is to rescue the baby as soon as possible. If that can be done in 10 minutes, as is often the case, then that is the obligation of the doctor. To suggest that a doctor, once having made the “decision” that an emergency C-section is required, can take his good old time so long as he is the operating room and making his “incision” within 30 minutes is ridiculous. It would be analogous to suggesting that firemen who realize that a nearby building is burning can sit at the station house for 29 minutes eating donuts so long as they show up at the scene within 30 minutes of when they first saw the flames.

Lawyers or families who get involved in lawsuits involving a delay in performing an emergency C-section leading to birth asphyxia and cerebral palsy should not fall into the trap of the “30 minutes from decision to incision” argument. The bottom line is this: When the baby is in trouble, the doctor’s obligation is to move as fast as humanly possible to rescue the infant. End of discussion!