For the first time in 20 years, the state's medical board has administratively punished two doctors who gained immunity from suit in catastrophic, birth-injury cases.

In hearings last week, two Northern Virginia obstetricians -- Dr. Evelyn Anna Ruelaz of Fairfax County and Dr. Regina Burton of Woodbridge -- received formal reprimands for their handling of births that resulted in devastating, lifelong injuries to infants during delivery.

The reprimands become part of a doctor's permanent record and appear on a physician's public profile at www.vahealthprovider.com/search.asp, where they are expected to appear in several days. They carry no monetary penalty and do not affect a doctor's ability to practice.

The sanctions reflect a tougher scrutiny of rare birth-injury cases; both incidents occurred before changes in 2003 that reduced the threshold for punishment.

In 2006, 209 sanctions were issued by the board among 34,813 holders of a state medical license. But no sanctions ever had been made in birth-act generated cases before last week.

Sobbing and pausing to regain her composure, Lee Ann Hershberger told a medical board panel last week how her son was born, unable to ever care for himself after Ruelaz left her unattended for long stretches of time.

Records show that Hershberger labored alone at Inova Fair Oaks Hospital in Fairfax County for hours as her baby's heart rate slowed and oxygen was shut off to him in utero from multiple medical complications.

"I saw in their faces that they were scared," Hershberger said of medical staff, reading from a journal of her emergency, surgical delivery in June 2003. "I could feel [Ruelaz] cutting into me," she said, describing how painkillers had worn off before she was anesthetized. "I screamed . . . and kept screaming from the pain."

Ruelaz left the hearing, also crying, when Hershberger spoke.

Joseph is now 4 and needs care and monitoring 24 hours a day. He has cerebral palsy, has no coordinated use of his limbs and can't speak. He has major neurological deficits. Hershberger's mother cares for him during the day while his parents work.

Blocked from suing the doctor and hospital because of the state's 20-year-old, no-fault Birth-related Neurological Injury Compensation Act, the Hershbergers instead have been promised lifetime medical care and other benefits for their son by the program.

They've received about $250,000 in housing improvements, a vehicle and other medical costs.

"I can't object at this point too much about the program," Hershberger said. "But we are coming to a point where Joseph will need more help" from trained nurses and therapists.

The birth-injury program was the nation's first -- it was copied only by Florida -- and was created by the legislature in 1987 to preserve obstetrical care and get medical help to injured children without going to trial.

Each case is reviewed by the state's Board of Medicine. But in the more than 130 program-generated cases reviewed by the board, no doctor had been sanctioned until Ruelaz and Burton.

In Burton's case, the board found that in 2002, she negligently failed to adequately assess a pregnant patient with a history of hemorrhaging during childbirth. That child also is in the birth-injury program.

Both doctors said they did not pay adequate attention to patient and baby's deteriorating condition.

Hershberger said last week that punishing the doctor was never her intent.

"I wanted to make sure that someone is watching the system. The point is that no family should have to go through what we did in the delivery of our son because a doctor didn't have time to pay attention."
Contact Bill McKelway at (804) 649-6601 or bmckelway@timesdispatch.com.