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Jury: Patient at fault for skipping follow-up

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Brazos County (Tex) District Court

A 42-year-old woman with a 4×6 cm mass on her left ovary was given hormone suppression therapy and told to return in a month. She did not return for a year, at which time the mass was found to have enlarged to 9×11 cm and surgery was recommended.

Because of adhesions, a laparotomy was performed. The next day the woman complained of back pain, and it was discovered that a ureter had been cut. The woman underwent surgery to repair the ureter.

In suing, the woman asserted the physician was negligent in failing to protect the ureter from injury during the laparotomy. She claimed she had back pain, chronic depression, loss of bladder control, and disfigurement as a result of the injury.

The physician contended the ureter was injured during clamping of deep pelvic blood vessels to control bleeding and that the ureter had been visualized as intact prior to closure. The physician also claimed negligence on the part of the woman, for failing to return for a follow-up examination when recommended, leading to the growth of the mass, which complicated the surgery.

  • 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Brazos County (Tex) District Court

A 42-year-old woman with a 4×6 cm mass on her left ovary was given hormone suppression therapy and told to return in a month. She did not return for a year, at which time the mass was found to have enlarged to 9×11 cm and surgery was recommended.

Because of adhesions, a laparotomy was performed. The next day the woman complained of back pain, and it was discovered that a ureter had been cut. The woman underwent surgery to repair the ureter.

In suing, the woman asserted the physician was negligent in failing to protect the ureter from injury during the laparotomy. She claimed she had back pain, chronic depression, loss of bladder control, and disfigurement as a result of the injury.

The physician contended the ureter was injured during clamping of deep pelvic blood vessels to control bleeding and that the ureter had been visualized as intact prior to closure. The physician also claimed negligence on the part of the woman, for failing to return for a follow-up examination when recommended, leading to the growth of the mass, which complicated the surgery.

  • 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

Brazos County (Tex) District Court

A 42-year-old woman with a 4×6 cm mass on her left ovary was given hormone suppression therapy and told to return in a month. She did not return for a year, at which time the mass was found to have enlarged to 9×11 cm and surgery was recommended.

Because of adhesions, a laparotomy was performed. The next day the woman complained of back pain, and it was discovered that a ureter had been cut. The woman underwent surgery to repair the ureter.

In suing, the woman asserted the physician was negligent in failing to protect the ureter from injury during the laparotomy. She claimed she had back pain, chronic depression, loss of bladder control, and disfigurement as a result of the injury.

The physician contended the ureter was injured during clamping of deep pelvic blood vessels to control bleeding and that the ureter had been visualized as intact prior to closure. The physician also claimed negligence on the part of the woman, for failing to return for a follow-up examination when recommended, leading to the growth of the mass, which complicated the surgery.

  • 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Incontinence follows hysterectomy

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Incontinence follows hysterectomy

Unknown Massachusetts venue

A 33-year-old woman with a history of heavy menstrual bleeding underwent a total abdominal hysterectomy. She was discharged a week after the surgery despite continuing complaints of lower abdominal pain. An intravenous pyelogram after readmission revealed ureter injury.

After several unsuccessful attempts to place a stent to repair the injured ureter, a nephrostomy tube was inserted in the women’s kidney for urine drainage and she was transferred to another hospital.

During repair surgery, the ureter was found to be encased in suture material, necessitating ureteral reimplantation. Several years after recovery from this surgery, the woman had urinary incontinence that she blamed on the reimplantation.

In suing, the woman claimed her physician was negligent in suturing her ureter during the hysterectomy.

The physician contended that ureter injury is a known risk of hysterectomy and that the current incontinence was unrelated to the ureter reimplantation.

  • The case settled for $150,000.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Unknown Massachusetts venue

A 33-year-old woman with a history of heavy menstrual bleeding underwent a total abdominal hysterectomy. She was discharged a week after the surgery despite continuing complaints of lower abdominal pain. An intravenous pyelogram after readmission revealed ureter injury.

After several unsuccessful attempts to place a stent to repair the injured ureter, a nephrostomy tube was inserted in the women’s kidney for urine drainage and she was transferred to another hospital.

During repair surgery, the ureter was found to be encased in suture material, necessitating ureteral reimplantation. Several years after recovery from this surgery, the woman had urinary incontinence that she blamed on the reimplantation.

In suing, the woman claimed her physician was negligent in suturing her ureter during the hysterectomy.

The physician contended that ureter injury is a known risk of hysterectomy and that the current incontinence was unrelated to the ureter reimplantation.

  • The case settled for $150,000.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

Unknown Massachusetts venue

A 33-year-old woman with a history of heavy menstrual bleeding underwent a total abdominal hysterectomy. She was discharged a week after the surgery despite continuing complaints of lower abdominal pain. An intravenous pyelogram after readmission revealed ureter injury.

After several unsuccessful attempts to place a stent to repair the injured ureter, a nephrostomy tube was inserted in the women’s kidney for urine drainage and she was transferred to another hospital.

During repair surgery, the ureter was found to be encased in suture material, necessitating ureteral reimplantation. Several years after recovery from this surgery, the woman had urinary incontinence that she blamed on the reimplantation.

In suing, the woman claimed her physician was negligent in suturing her ureter during the hysterectomy.

The physician contended that ureter injury is a known risk of hysterectomy and that the current incontinence was unrelated to the ureter reimplantation.

  • The case settled for $150,000.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Was surgery to blame for ectopic pregnancy?

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<court>Boyle County (Ky) Circuit Court</court>

During laparoscopic surgery to correct endometriosis in a 20-year-old woman, a blood vessel in the abdominal wall was nicked. The gynecologist switched to an open procedure with a transverse incision to repair the bleeding vessel. Patient recovery was prolonged, with slow healing of the incision. A year later, the woman had an ectopic pregnancy.

In suing, the woman claimed that the ectopic pregnancy was related to the open procedure. She asserted that the physician was negligent in nicking the abdominal wall blood vessel and that the low transverse incision during the open surgery complicated the healing process.

The physician denied negligence and countered that the injury was a known potential complication of the laparoscopic procedure. The physician contended that the ectopic pregnancy was related instead to the woman’s history of pelvic inflammatory disease.

  • 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

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<court>Boyle County (Ky) Circuit Court</court>

During laparoscopic surgery to correct endometriosis in a 20-year-old woman, a blood vessel in the abdominal wall was nicked. The gynecologist switched to an open procedure with a transverse incision to repair the bleeding vessel. Patient recovery was prolonged, with slow healing of the incision. A year later, the woman had an ectopic pregnancy.

In suing, the woman claimed that the ectopic pregnancy was related to the open procedure. She asserted that the physician was negligent in nicking the abdominal wall blood vessel and that the low transverse incision during the open surgery complicated the healing process.

The physician denied negligence and countered that the injury was a known potential complication of the laparoscopic procedure. The physician contended that the ectopic pregnancy was related instead to the woman’s history of pelvic inflammatory disease.

  • 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

<court>Boyle County (Ky) Circuit Court</court>

During laparoscopic surgery to correct endometriosis in a 20-year-old woman, a blood vessel in the abdominal wall was nicked. The gynecologist switched to an open procedure with a transverse incision to repair the bleeding vessel. Patient recovery was prolonged, with slow healing of the incision. A year later, the woman had an ectopic pregnancy.

In suing, the woman claimed that the ectopic pregnancy was related to the open procedure. She asserted that the physician was negligent in nicking the abdominal wall blood vessel and that the low transverse incision during the open surgery complicated the healing process.

The physician denied negligence and countered that the injury was a known potential complication of the laparoscopic procedure. The physician contended that the ectopic pregnancy was related instead to the woman’s history of pelvic inflammatory disease.

  • 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

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Missed cancer leads to death

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Unknown County (NY) Supreme Court

For several years a woman had had routine Pap smears that were read as normal. She came in to her ObGyn the following year complaining of vaginal bleeding and pain; no Pap smear was done because she was menstruating. The Pap smear done 3 months later was also read as normal.

Further evaluation because of continued profuse vaginal bleeding revealed a grapefruit-sized tumor on the woman’s cervix. Despite a radical hysterectomy, chemotherapy, and radiation, the woman died from the cancer 3 years after diagnosis.

The suit claimed that the woman’s ObGyn was negligent in not palpating the cervix or performing a colposcopy, which may have led to earlier detection of the cancer when it could have been treated successfully. Later review of prior Pap smears showed the presence of abnormal cells. The plaintiff claimed the ObGyn negligently reported the woman’s condition when the Pap smears were sent for evaluation, and that a proper history would have led to the Pap smears being read as abnormal.

The physician contended that the cancer was aggressive and difficult to detect, and that the lab had misread the Pap smears.

  • The jury assessed damages at $11.8 million. The verdict found 55% fault against the physician and the remainder against the laboratory. Because the plaintiff made no claims against the laboratory, the award was expected to be reduced in proportion to the fault assessment.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Unknown County (NY) Supreme Court

For several years a woman had had routine Pap smears that were read as normal. She came in to her ObGyn the following year complaining of vaginal bleeding and pain; no Pap smear was done because she was menstruating. The Pap smear done 3 months later was also read as normal.

Further evaluation because of continued profuse vaginal bleeding revealed a grapefruit-sized tumor on the woman’s cervix. Despite a radical hysterectomy, chemotherapy, and radiation, the woman died from the cancer 3 years after diagnosis.

The suit claimed that the woman’s ObGyn was negligent in not palpating the cervix or performing a colposcopy, which may have led to earlier detection of the cancer when it could have been treated successfully. Later review of prior Pap smears showed the presence of abnormal cells. The plaintiff claimed the ObGyn negligently reported the woman’s condition when the Pap smears were sent for evaluation, and that a proper history would have led to the Pap smears being read as abnormal.

The physician contended that the cancer was aggressive and difficult to detect, and that the lab had misread the Pap smears.

  • The jury assessed damages at $11.8 million. The verdict found 55% fault against the physician and the remainder against the laboratory. Because the plaintiff made no claims against the laboratory, the award was expected to be reduced in proportion to the fault assessment.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

Unknown County (NY) Supreme Court

For several years a woman had had routine Pap smears that were read as normal. She came in to her ObGyn the following year complaining of vaginal bleeding and pain; no Pap smear was done because she was menstruating. The Pap smear done 3 months later was also read as normal.

Further evaluation because of continued profuse vaginal bleeding revealed a grapefruit-sized tumor on the woman’s cervix. Despite a radical hysterectomy, chemotherapy, and radiation, the woman died from the cancer 3 years after diagnosis.

The suit claimed that the woman’s ObGyn was negligent in not palpating the cervix or performing a colposcopy, which may have led to earlier detection of the cancer when it could have been treated successfully. Later review of prior Pap smears showed the presence of abnormal cells. The plaintiff claimed the ObGyn negligently reported the woman’s condition when the Pap smears were sent for evaluation, and that a proper history would have led to the Pap smears being read as abnormal.

The physician contended that the cancer was aggressive and difficult to detect, and that the lab had misread the Pap smears.

  • The jury assessed damages at $11.8 million. The verdict found 55% fault against the physician and the remainder against the laboratory. Because the plaintiff made no claims against the laboratory, the award was expected to be reduced in proportion to the fault assessment.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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D&C did not avert endometrial cancer

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Ocean County (NJ) Superior Court

A 64-year-old woman diagnosed with postmenopausal bleeding underwent a dilation and curettage (D&C) after several ultrasounds. (Results of the D&C were not reported.) Despite continued bleeding, no follow-up testing was done at 3 months.

At a return visit 14 months later, the woman was still bleeding. Tests revealed she had advanced endometrial cancer that had metastasized to her lungs and bones. She died 3 months later.

The claim was that the physician had removed an inadequate amount of tissue during the D&C.

  • The case settled for $400,000.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Ocean County (NJ) Superior Court

A 64-year-old woman diagnosed with postmenopausal bleeding underwent a dilation and curettage (D&C) after several ultrasounds. (Results of the D&C were not reported.) Despite continued bleeding, no follow-up testing was done at 3 months.

At a return visit 14 months later, the woman was still bleeding. Tests revealed she had advanced endometrial cancer that had metastasized to her lungs and bones. She died 3 months later.

The claim was that the physician had removed an inadequate amount of tissue during the D&C.

  • The case settled for $400,000.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

Ocean County (NJ) Superior Court

A 64-year-old woman diagnosed with postmenopausal bleeding underwent a dilation and curettage (D&C) after several ultrasounds. (Results of the D&C were not reported.) Despite continued bleeding, no follow-up testing was done at 3 months.

At a return visit 14 months later, the woman was still bleeding. Tests revealed she had advanced endometrial cancer that had metastasized to her lungs and bones. She died 3 months later.

The claim was that the physician had removed an inadequate amount of tissue during the D&C.

  • The case settled for $400,000.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Brain damage follows group B strep infection

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Unknown Massachusetts venue

A 31-year-old woman was admitted for delivery of her first child 26 hours after her water broke. A rapid test to determine the presence of group B strep was negative. During the next shift the woman had no signs of infection and the fetal heart rate remained normal.

Shortly after the infant was born that night, the woman developed a fever. A second rapid test was positive for group B strep infection.

In the nursery the infant began having respiratory distress requiring resuscitation. The infant was eventually diagnosed with group B strep infection and was placed on a heart-lung machine. During the heart-lung treatment the infant had a cerebral hemorrhage, resulting in irreversible brain damage. Now 9 years old, the child has permanent neurological deficits and delayed cognitive development.

In suing, the mother asserted the defense failed to test for, recognize, and treat group B strep infection, claiming her prolonged rupture of membranes is one of the universally recognized risk factors for bacteria transmission. She contended her temperature was not taken within 4 hours before delivery. Moreover, she claimed the rapid tests for group B strep infection are inherently unreliable and that she should have been given prophylactic antibiotics when she passed 18 hours of labor.

  • The case went to arbitration with the agreement that any award would be increased by 50%. The arbitrator ruled against 2 of the 3 physicians, awarding $3.4 million to the minor, $350,000 to the mother, and $175,000 to the father, bringing the entire award to more than $6 million.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Unknown Massachusetts venue

A 31-year-old woman was admitted for delivery of her first child 26 hours after her water broke. A rapid test to determine the presence of group B strep was negative. During the next shift the woman had no signs of infection and the fetal heart rate remained normal.

Shortly after the infant was born that night, the woman developed a fever. A second rapid test was positive for group B strep infection.

In the nursery the infant began having respiratory distress requiring resuscitation. The infant was eventually diagnosed with group B strep infection and was placed on a heart-lung machine. During the heart-lung treatment the infant had a cerebral hemorrhage, resulting in irreversible brain damage. Now 9 years old, the child has permanent neurological deficits and delayed cognitive development.

In suing, the mother asserted the defense failed to test for, recognize, and treat group B strep infection, claiming her prolonged rupture of membranes is one of the universally recognized risk factors for bacteria transmission. She contended her temperature was not taken within 4 hours before delivery. Moreover, she claimed the rapid tests for group B strep infection are inherently unreliable and that she should have been given prophylactic antibiotics when she passed 18 hours of labor.

  • The case went to arbitration with the agreement that any award would be increased by 50%. The arbitrator ruled against 2 of the 3 physicians, awarding $3.4 million to the minor, $350,000 to the mother, and $175,000 to the father, bringing the entire award to more than $6 million.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

Unknown Massachusetts venue

A 31-year-old woman was admitted for delivery of her first child 26 hours after her water broke. A rapid test to determine the presence of group B strep was negative. During the next shift the woman had no signs of infection and the fetal heart rate remained normal.

Shortly after the infant was born that night, the woman developed a fever. A second rapid test was positive for group B strep infection.

In the nursery the infant began having respiratory distress requiring resuscitation. The infant was eventually diagnosed with group B strep infection and was placed on a heart-lung machine. During the heart-lung treatment the infant had a cerebral hemorrhage, resulting in irreversible brain damage. Now 9 years old, the child has permanent neurological deficits and delayed cognitive development.

In suing, the mother asserted the defense failed to test for, recognize, and treat group B strep infection, claiming her prolonged rupture of membranes is one of the universally recognized risk factors for bacteria transmission. She contended her temperature was not taken within 4 hours before delivery. Moreover, she claimed the rapid tests for group B strep infection are inherently unreliable and that she should have been given prophylactic antibiotics when she passed 18 hours of labor.

  • The case went to arbitration with the agreement that any award would be increased by 50%. The arbitrator ruled against 2 of the 3 physicians, awarding $3.4 million to the minor, $350,000 to the mother, and $175,000 to the father, bringing the entire award to more than $6 million.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Discordant fetal growth not noted

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Discordant fetal growth not noted

Unknown Massachusetts venue

On the day of delivery of twins at 35 weeks’ gestation, a woman went to her doctor’s office, where the nurse midwife administered a nonstress test. Because one twin’s heart pattern was nonreactive, the mother was sent for evaluation of premature labor.

It was revealed that the cover letter to a report from an ultrasound at 29 weeks reported concordant fetal growth, but numbers within the report differed from data in the cover letter and suggested discordant fetal growth.

Upon hospital admission, the woman’s cervix was 1.5 cm dilated and 100% effaced, with the presenting fetus at +1 station. The membranes were intact. The nursing notes indicated that the woman had been evaluated for labor in the morning and that the covering Ob was present, but did not mention that one fetus was nonreactive. After rupture of membranes and placement of an internal scalp lead on twin A (the presenting fetus), the covering Ob left the area and had to be called several times over the next 1.5 hours in response to late decelerations in twin A’s fetal heart rate. Scalp blood sampling on twin A revealed severe acidosis.

Delivered by emergency cesarean section, twin A was floppy, blue, and without respiratory effort. (Twin B was healthy.) Five days after birth a head ultrasound revealed a left germinal matrix hemorrhage in twin A, consistent with hypoxic ischemia. He remained in the NICU for a month. He now has cerebral palsy, visual and speech difficulties, and requires a walker and braces.

  • The case settled for $2.9 million.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Unknown Massachusetts venue

On the day of delivery of twins at 35 weeks’ gestation, a woman went to her doctor’s office, where the nurse midwife administered a nonstress test. Because one twin’s heart pattern was nonreactive, the mother was sent for evaluation of premature labor.

It was revealed that the cover letter to a report from an ultrasound at 29 weeks reported concordant fetal growth, but numbers within the report differed from data in the cover letter and suggested discordant fetal growth.

Upon hospital admission, the woman’s cervix was 1.5 cm dilated and 100% effaced, with the presenting fetus at +1 station. The membranes were intact. The nursing notes indicated that the woman had been evaluated for labor in the morning and that the covering Ob was present, but did not mention that one fetus was nonreactive. After rupture of membranes and placement of an internal scalp lead on twin A (the presenting fetus), the covering Ob left the area and had to be called several times over the next 1.5 hours in response to late decelerations in twin A’s fetal heart rate. Scalp blood sampling on twin A revealed severe acidosis.

Delivered by emergency cesarean section, twin A was floppy, blue, and without respiratory effort. (Twin B was healthy.) Five days after birth a head ultrasound revealed a left germinal matrix hemorrhage in twin A, consistent with hypoxic ischemia. He remained in the NICU for a month. He now has cerebral palsy, visual and speech difficulties, and requires a walker and braces.

  • The case settled for $2.9 million.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

Unknown Massachusetts venue

On the day of delivery of twins at 35 weeks’ gestation, a woman went to her doctor’s office, where the nurse midwife administered a nonstress test. Because one twin’s heart pattern was nonreactive, the mother was sent for evaluation of premature labor.

It was revealed that the cover letter to a report from an ultrasound at 29 weeks reported concordant fetal growth, but numbers within the report differed from data in the cover letter and suggested discordant fetal growth.

Upon hospital admission, the woman’s cervix was 1.5 cm dilated and 100% effaced, with the presenting fetus at +1 station. The membranes were intact. The nursing notes indicated that the woman had been evaluated for labor in the morning and that the covering Ob was present, but did not mention that one fetus was nonreactive. After rupture of membranes and placement of an internal scalp lead on twin A (the presenting fetus), the covering Ob left the area and had to be called several times over the next 1.5 hours in response to late decelerations in twin A’s fetal heart rate. Scalp blood sampling on twin A revealed severe acidosis.

Delivered by emergency cesarean section, twin A was floppy, blue, and without respiratory effort. (Twin B was healthy.) Five days after birth a head ultrasound revealed a left germinal matrix hemorrhage in twin A, consistent with hypoxic ischemia. He remained in the NICU for a month. He now has cerebral palsy, visual and speech difficulties, and requires a walker and braces.

  • The case settled for $2.9 million.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Delayed cesarean blamed for injuries

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Essex County (Mass) Superior Court

Two weeks past her due date, a woman underwent artificial rupture of membranes in the morning; scant amniotic fluid was noted. Oxytocin was administered and late decelerations were noted.

Labor progressed slowly and the possibility of cephalopelvic disproportion was entertained.

Later that night the fetal heart rate demonstrated tachycardia. The plaintiff alleged that the nurses failed to make detailed notes in the patient’s record or question the obstetrician’s decision to continue with labor induction in the presence of a nonreassuring tracing. In the second stage, a vacuum-assisted vaginal delivery was attempted due to a prolonged deceleration of the fetal heart rate. Nine vacuum extractions were attempted and were unsuccessful.

The infant was delivered by emergency cesarean section with no heart rate, respirations, muscle tone, or reflex irritation. After resuscitation, the infant was transferred to another hospital, where seizures developed and cerebral palsy was diagnosed.

The woman sued both the obstetricians and the nurses. The defendants contended the fetal monitoring strips showed little, if any, signs of nonreassuring patterns. They also claimed the infant’s injuries had other causes.

  • The case settled for $4 million.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Essex County (Mass) Superior Court

Two weeks past her due date, a woman underwent artificial rupture of membranes in the morning; scant amniotic fluid was noted. Oxytocin was administered and late decelerations were noted.

Labor progressed slowly and the possibility of cephalopelvic disproportion was entertained.

Later that night the fetal heart rate demonstrated tachycardia. The plaintiff alleged that the nurses failed to make detailed notes in the patient’s record or question the obstetrician’s decision to continue with labor induction in the presence of a nonreassuring tracing. In the second stage, a vacuum-assisted vaginal delivery was attempted due to a prolonged deceleration of the fetal heart rate. Nine vacuum extractions were attempted and were unsuccessful.

The infant was delivered by emergency cesarean section with no heart rate, respirations, muscle tone, or reflex irritation. After resuscitation, the infant was transferred to another hospital, where seizures developed and cerebral palsy was diagnosed.

The woman sued both the obstetricians and the nurses. The defendants contended the fetal monitoring strips showed little, if any, signs of nonreassuring patterns. They also claimed the infant’s injuries had other causes.

  • The case settled for $4 million.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

Essex County (Mass) Superior Court

Two weeks past her due date, a woman underwent artificial rupture of membranes in the morning; scant amniotic fluid was noted. Oxytocin was administered and late decelerations were noted.

Labor progressed slowly and the possibility of cephalopelvic disproportion was entertained.

Later that night the fetal heart rate demonstrated tachycardia. The plaintiff alleged that the nurses failed to make detailed notes in the patient’s record or question the obstetrician’s decision to continue with labor induction in the presence of a nonreassuring tracing. In the second stage, a vacuum-assisted vaginal delivery was attempted due to a prolonged deceleration of the fetal heart rate. Nine vacuum extractions were attempted and were unsuccessful.

The infant was delivered by emergency cesarean section with no heart rate, respirations, muscle tone, or reflex irritation. After resuscitation, the infant was transferred to another hospital, where seizures developed and cerebral palsy was diagnosed.

The woman sued both the obstetricians and the nurses. The defendants contended the fetal monitoring strips showed little, if any, signs of nonreassuring patterns. They also claimed the infant’s injuries had other causes.

  • The case settled for $4 million.
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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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What caused fecal incontinence?

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Fulton County (Ga) State Court

A 37-year-old woman delivered a healthy infant after normal labor and vaginal delivery. After birth the woman had total fecal incontinence, and could no longer work or perform many activities. A sphincteroplasty to repair an anal sphincter tear was unsuccessful.

In suing, the woman asserted her physician failed to recognize, treat, or repair the tear during delivery.

Her physician countered that a history of hemorrhoidectomy and fistulotomy from 15 years before the birth should have been revealed in the medical history forms completed by the patient. The physician asserted that had he known about this medical history, he would have suggested a cesarean section. He also contended that some types of muscle tears are unrecognizable.

  • After 2 mistrials, 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Fulton County (Ga) State Court

A 37-year-old woman delivered a healthy infant after normal labor and vaginal delivery. After birth the woman had total fecal incontinence, and could no longer work or perform many activities. A sphincteroplasty to repair an anal sphincter tear was unsuccessful.

In suing, the woman asserted her physician failed to recognize, treat, or repair the tear during delivery.

Her physician countered that a history of hemorrhoidectomy and fistulotomy from 15 years before the birth should have been revealed in the medical history forms completed by the patient. The physician asserted that had he known about this medical history, he would have suggested a cesarean section. He also contended that some types of muscle tears are unrecognizable.

  • After 2 mistrials, 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

Fulton County (Ga) State Court

A 37-year-old woman delivered a healthy infant after normal labor and vaginal delivery. After birth the woman had total fecal incontinence, and could no longer work or perform many activities. A sphincteroplasty to repair an anal sphincter tear was unsuccessful.

In suing, the woman asserted her physician failed to recognize, treat, or repair the tear during delivery.

Her physician countered that a history of hemorrhoidectomy and fistulotomy from 15 years before the birth should have been revealed in the medical history forms completed by the patient. The physician asserted that had he known about this medical history, he would have suggested a cesarean section. He also contended that some types of muscle tears are unrecognizable.

  • After 2 mistrials, 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Was force excessive?

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Cook County (III) Circuit Court

At 36.5 weeks, a woman was admitted for labor induction. Delivery of the head was followed by shoulder dystocia. The infant was born with a severe left brachial plexus injury and left torticollis. Despite 4 reparative surgeries, the left arm and hand have little useful function.

In suing, the woman asserted the physician used inappropriate and excessive force to complete the delivery, a claim the defense denied.

  • The hospital settled for $400,000 before the case went to trial. 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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Cook County (III) Circuit Court

At 36.5 weeks, a woman was admitted for labor induction. Delivery of the head was followed by shoulder dystocia. The infant was born with a severe left brachial plexus injury and left torticollis. Despite 4 reparative surgeries, the left arm and hand have little useful function.

In suing, the woman asserted the physician used inappropriate and excessive force to complete the delivery, a claim the defense denied.

  • The hospital settled for $400,000 before the case went to trial. 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.

Cook County (III) Circuit Court

At 36.5 weeks, a woman was admitted for labor induction. Delivery of the head was followed by shoulder dystocia. The infant was born with a severe left brachial plexus injury and left torticollis. Despite 4 reparative surgeries, the left arm and hand have little useful function.

In suing, the woman asserted the physician used inappropriate and excessive force to complete the delivery, a claim the defense denied.

  • The hospital settled for $400,000 before the case went to trial. 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). The available information about the cases presented here is sometimes incomplete; thus, pertinent details of a given situation may be unavailable. Moreover, the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations that typically result in litigation and are meant to illustrate nationwide variation in jury verdicts and awards.
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