Doctor on trial in missed pregnancy of raped coma patient

Eight years after a Lawrence nursing home aide raped and impregnated a young woman as she lay in a coma at the facility, a trial began yesterday in a lawsuit against the doctor who allegedly failed to diagnose the pregnancy, which resulted in the birth of a brain-damaged baby.

As a result of the lapse by Dr. George A. Hasiotis, the woman went without proper prenatal care and delivered the infant girl about 14 weeks prematurely in October 1998 in an ambulance, according to a lawyer for the young woman's parents. The baby, who was born feet first, was deprived of oxygen for about 10 minutes and has been in a vegetative state since birth.

''This is a story which has two real tragedies," said Edmund P. Daley, the lawyer representing the parents of the young woman, who died nearly two years later at age 25 of an unrelated illness.

The first tragedy was the rape in April 1998, Daley told a Suffolk County jury in his opening statement. The second was the failure of Hasiotis to notice a fetus the size of a grapefruit in the women's abdomen during a routine exam when she was almost five months' pregnant at Town Manor Nursing and Rehabilitation Center.

Peter C. Knight, Hasiotis's lawyer, acknowledged that the story of the young woman, a native of Londonderry, N.H., was unrelentingly sad. But he urged jurors not to let sympathy for her parents obscure several facts.

Hasiotis, he said, had no reason to suspect that the woman might be pregnant. Nurses who treated her every day had no idea she was pregnant, Knight said. And expert witnesses for the defense will testify that she might have been less than 19 weeks pregnant when Hasiotis examined her, he said.

''Nobody expected any kind of a pregnancy," Knight told jurors, as his client sat stoically in the courtroom. ''Why would you expect a pregnancy in a situation like this?"

The young woman became a patient of Town Manor, now called SunBridge Care and Rehabilitation-Town Manor, after suffering a heart attack in April 1995 following a drug overdose. She survived on a feeding tube and respirator. The names of the woman, her child, and her family are being withheld by the Globe because the case involves the victim of a sexual assault. Her rape became known to officials at the nursing home when they discovered her pregnancy.

Police identified the rapist as a nurse's aide, Israel Moret, through DNA analysis. He admitted that he committed the rape at his 2000 sentencing, after which a judge imposed a prison term of 11 years followed by 10 years on probation.

Hasiotis, who has practiced medicine for 40 years and specializes in caring for patients at nursing homes, performed a routine physical on the woman on Sept. 2, 1998, said Daley, lawyer for the plaintiffs. He did not diagnose the pregnancy despite her weight gain, a ceasing of menstruation, and vomiting, Daley said.

''Proper care would have recognized that this was a young woman at a nursing home who was pregnant," he said.

It was not until an ultrasound and other tests were performed on Oct. 19 that doctors realized the woman was pregnant. Four days later, she went into labor prematurely and was taken by ambulance to Lawrence General Hospital.

An emergency room physician delivered the baby in the ambulance in the hospital parking lot, but the infant, who weighed less than 2 pounds, was severely brain damaged. The child, now 7, has been under treatment for years at New England Pediatric Care in North Billerica and is not expected to recover, Daley said. Her grandparents are her legal guardians.

Hasiotis's lawyer insisted that his client provided proper care and that he missed the pregnancy because the fetus was unusually small.

The trial before Superior Court Judge Thomas E. Connolly is expected to last about a week.

After reviewing the rape case, the state Department of Public Health recommended that the nursing home tighten its employment practices. The three-month review determined that the facility had provided ''appropriate care" to the woman but failed to do a background check on Moret.

Jonathan Saltzman can be reached at jsaltzman@globe.com.