BRECKENRIDGE - Texas obstetrician Sebastian Faro testified Thursday that a Caesarian section would have saved Susanna Martens' unborn baby girl despite Martens' uterine bacterial infection.

Faro's testimony came on day four of a $1.5 million medical malpractice suit against Dr. Patricia Duletsky, who practiced in Frisco for nearly 10 years.

The lawsuit was filed by Silverthorne resident Rob Small for the wrongful deaths of his wife, Martens, and their unborn baby girl. It is being tried in Summit District Court in front of Judge Terry Ruckriegle.

Martens initially visited Duletsky on March 14, 2000, at 6 p.m. because she was vomiting, had diarrhea and had experienced two uterine contractions.

Duletsky diagnosed Martens with the stomach flu and sent her home. Martens, who was 36-and-a-half weeks pregnant at the time, later went to Summit Medical Center when her symptoms persisted.

She died early the next morning after suffering a cardiac arrest as a result of a uterine bacterial infection, later identified as Group A streptococcus.

The plaintiffs are arguing that Duletsky should have done more to save the baby.

"This lady reached a viable pregnancy and should have been delivered," Faro said.

Duletsky, who is a family medicine doctor, is not qualified to perform C-Sections, but Faro said she should have called in an obstetrician to handle the surgery.

Duletsky did call in an obstetrician to the labor and delivery room, but not until 1 a.m., 30 minutes before the baby died.

Just after midnight, Martens discovered blood on her bed garment, a sign that could have indicated a placental abruption, in which the placenta tears away from the uterus before the baby is born, Faro said.

"With an abruption, there's no point in waiting," Faro said. "The best thing to do is deliver the baby and not wait. I don't know what you're waiting for."

Faro added that a reasonable physician would have at least ordered an ultrasound.

In the cross-examination, the defense, represented by Cooper and Clough of Denver, established that the occurrence of Group A strep is very rare, especially when a patient's water hasn't broken, as in Martens' case.

Faro agreed that Group A strep is very difficult to diagnose and acts rapidly.

He reluctantly agreed with defense attorney Paul Cooper that Martens did not meet the criteria for a uterine infection during her first visit to Duletsky. The criteria was taken from a medical journal for which Faro serves as editor.

Faro added that he didn't believe Duletsky's initial assessment of Martens was complete, which is why she didn't meet those diagnoses.

Faro conceded that the blood on the bed garments wasn't necessarily an indication of placental abruption and could have come from another part of her body.

Many of Faro's statements and subsequent testimony from infectious disease specialist, Dr. Armando Correa, revolved around the administering of antibiotics to Martens.

Both doctors testified that if antibiotics would have been given to Martens during her initial doctor visit, she and the baby would "more likely than not" have survived.

Although symptoms are similar to the flu, Martens' fever should have alerted Duletsky, Faro said.

"It's always bacterial until proven otherwise," he said.

Cooper argued that patients who are treated for a bacterial infection can still have complications and may sometimes even die. Faro agreed that toxins can continue to do damage after the bacteria is killed.

During his testimony, Faro asserted that Duletsky did not meet the standard of care for a reasonable physician when she gave two doses of Terbutaline to Martens on the night she died.

The Terbutaline was administered to stop Martens' uterine contractions, but has dangerous side effects, including pulmonary edema, the medical name for when the lungs fill with liquid.

Martens' autopsy report verified she had pulmonary edema.