Woman dies after uterine atony

Danville (Va) Circuit Court

Following the delivery of her third child, a 37-year-old woman suffered uterine atony leading to intermittent bleeding. Over the next several hours, the patient:

• received bimanual compressions with fundal massage, oxytocin, methylergonovine, and carboprost;
  
• underwent an emergency dilatation and curettage, after tests revealed disseminated intravascular coagulation and her vital signs began deteriorating;
  
• received further fundal massage, misoprostol, packed red blood cells, normal saline, Ringer’s lactate, and hetastarch;
  
• underwent an emergency hysterectomy.
  

Bleeding persisted following removal of the uterus, but neither the defendant nor an additional Ob/Gyn could find its source. A general surgeon was, for 1 hour, also unable to determine the source, though it was eventually located.

Though stable after surgery, the woman developed a cardiac arrhythmia and died due to a myocardial infarction.

In suing, plaintiffs claimed the defendant was negligent for his failure to consult a hematologist, follow up on lab results, and transfuse a sufficient amount of clotting factors before starting the hysterectomy.

The doctor claimed these actions would not have altered the outcome, noting that the woman’s blood volume was replaced nearly 7 times during the events.

• The jury returned a defense verdict
  

The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, of Nashville, Tenn (www.verdictslaska.com). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.

Danville (Va) Circuit Court

Following the delivery of her third child, a 37-year-old woman suffered uterine atony leading to intermittent bleeding. Over the next several hours, the patient:

• received bimanual compressions with fundal massage, oxytocin, methylergonovine, and carboprost;
  
• underwent an emergency dilatation and curettage, after tests revealed disseminated intravascular coagulation and her vital signs began deteriorating;
  
• received further fundal massage, misoprostol, packed red blood cells, normal saline, Ringer’s lactate, and hetastarch;
  
• underwent an emergency hysterectomy.
  

Bleeding persisted following removal of the uterus, but neither the defendant nor an additional Ob/Gyn could find its source. A general surgeon was, for 1 hour, also unable to determine the source, though it was eventually located.

Though stable after surgery, the woman developed a cardiac arrhythmia and died due to a myocardial infarction.

In suing, plaintiffs claimed the defendant was negligent for his failure to consult a hematologist, follow up on lab results, and transfuse a sufficient amount of clotting factors before starting the hysterectomy.

The doctor claimed these actions would not have altered the outcome, noting that the woman’s blood volume was replaced nearly 7 times during the events.

• The jury returned a defense verdict
  

The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, of Nashville, Tenn (www.verdictslaska.com). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.

Danville (Va) Circuit Court

Following the delivery of her third child, a 37-year-old woman suffered uterine atony leading to intermittent bleeding. Over the next several hours, the patient:

• received bimanual compressions with fundal massage, oxytocin, methylergonovine, and carboprost;
  
• underwent an emergency dilatation and curettage, after tests revealed disseminated intravascular coagulation and her vital signs began deteriorating;
  
• received further fundal massage, misoprostol, packed red blood cells, normal saline, Ringer’s lactate, and hetastarch;
  
• underwent an emergency hysterectomy.
  

Bleeding persisted following removal of the uterus, but neither the defendant nor an additional Ob/Gyn could find its source. A general surgeon was, for 1 hour, also unable to determine the source, though it was eventually located.

Though stable after surgery, the woman developed a cardiac arrhythmia and died due to a myocardial infarction.

In suing, plaintiffs claimed the defendant was negligent for his failure to consult a hematologist, follow up on lab results, and transfuse a sufficient amount of clotting factors before starting the hysterectomy.

The doctor claimed these actions would not have altered the outcome, noting that the woman’s blood volume was replaced nearly 7 times during the events.

• The jury returned a defense verdict
  

The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, of Nashville, Tenn (www.verdictslaska.com). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.