Midstokke sentenced in connection to infant's death

A local woman has been sentenced to 30 days in jail for practicing medicine without a license in connection to the death of a newborn baby in January.

Originally facing charges of involuntary manslaughter and destruction of evidence, Denice E. Midstokke, 64, will spend five years on supervised probation upon release from the Bonner County Jail.

Midstokke signed a Rule 11 agreement on Oct. 6, submitting an Alford guilty plea. A Rule 11 plea agreement is where both the prosecution and defense agree on what a potential sentence should be, and submit it to the court in exchange for the defendant's guilty plea. If the judge does not follow the agreement, the defendant can recant their guilty plea.

An Alford plea is where the defendant pleads guilty but believes they are innocent. A defendant submits an Alford plea on the knowledge that there is enough evidence to result in a guilty plea if the case goes to trial.

First District Judge Lamont Berecz decided to follow the Rule 11 agreement, and formally withheld judgment against Midstokke. Withholding judgment is a once-in-a-lifetime sentence where the court does not file documents finding the defendant guilty of a crime. This allows the defendant to dismiss the case once they finish the terms of sentencing — preventing the crime from going on their record.

In exchange for the withheld judgment, Midstokke will not be able to appeal the sentence. She was ordered to divest from Pend Oreille Midwifery. Further, she will not be able to provide medical services or advice of any kind. Midstokke surrendered her midwifery license on Oct. 6, and will not be able to apply for licensure in the future.

Midstokke will also have to pay restitution to the child’s family, although the exact amount remains undisclosed. She will also participate in the Sheriff’s Inmate Labor Program in exchange for reduced jail time.

“I am really sorry that this ever happened,” Midstokke said during sentencing. “I would have never ever wanted to hurt a family maliciously or by not being careful enough. I lost a child. And I understand that I’ll have to live with that for the rest of my life. They’re a neat family. They did so many things smart and right. She’s dear to my heart, and I’m just so sorry.”

Before binding the court to the Rule 11 plea agreement, Berecz took a moment to clarify what this case was not about.

“This case is not about midwifery generally. This isn’t about parents’ rights to choose where their baby is born. This case is not about persecuting Ms. Midstokke. This case is not about medical freedom,” Berecz said.

“Put plainly, Ms. Midstokke, this case is about you stepping beyond your training and your expertise in violation of midwifery rules with a result that the baby died. The evidence suggests that in the aftermath of this tragic preventable death, that your actions were to misrepresent or lie.”

The Daily Bee is not publishing the family’s names in order to protect their privacy.

On Jan. 15, when the child’s mother was 37 weeks pregnant, Midstokke inserted a medical device with the intent to induce labor, an effort that was unsuccessful, according to court records. The next day the device was reinserted, causing the mother a great deal of pain, according to her testimony. An exam was further performed at the family’s home instead of in a medically sterilized environment.

Eleven days later, the child’s mother went into labor while running a temperature of 100.5. Midstokke and another midwife arrived at the home shortly after and attempted to deliver the child. However, midwifery guidelines require that a mother be transferred to a medical facility if she's running a temperature of 100.4 or higher. The parents testified that neither midwife checked the mother’s temperature or heart rate, according to court documents.

The child, a female, was delivered at 10:53 p.m. According to first-hand observations, the child never took her first breath. Twenty-two minutes later, Midstokke called 911 at the father’s demands.

The child passed away at Bonner General Health less than two hours later.

An investigation was launched after Bonner General Health staff submitted a complaint to the board of midwifery, according to information provided by Bonner County Deputy Prosecutor Daniel Rodriguez at sentencing.

An autopsy, conducted in Spokane on Jan. 29, found the infant had intrauterine pneumonia, possibly caused by infection acquired during insertion of the medical device on Jan. 15.

"This was not salvageable," Spokane County Medical Examiner Dr. Sally Aiken wrote. "There wasn't a way that she could have been successfully resuscitated at birth because her lungs had no capacity to absorb oxygen."

A coroner’s jury was assembled on April 16 to look into the death. A coroner’s jury, also known as a coroner’s inquest, is a jury made of experts in fields related to the nature of the crime. In this case, the coroner’s jury included a licensed nurse midwife, an emergency room nurse and physician, a pediatrician, an EMS lieutenant paramedic, and an obstetrician-gynecologist.

“[Midstokke] failed to adequately recognize and respond to potential infection even after fetal tachycardia was noted,” read the jury’s finding on April 16. “Post delivery, [the child] was in profound respiratory distress and poorly presenting. Inadequate resuscitative efforts were undertaken leading to cardiac arrest and, what we believe, a preventable death due to willful and wanton negligence. The death of [the child] was caused by criminal means on the part of Denise Midstokke."

This is Midstokke’s eighth case in the Idaho court database; all other cases are for minor infractions.