User login
Cesarean denied for macrosomic baby
A woman in her fourth pregnancy presented to a physician. Her first pregnancy, 18 years prior, was notable for 36-hour labor followed by delivery of a 9-lb infant; the next 2 pregnancies resulted in miscarriage.
The doctor deemed the patient a high-risk pregnancy and ordered sonograms every 2 weeks. When sonography in her sixth month indicated a fetal weight over 7 lb, the woman requested a cesarean delivery. A sonogram performed in her ninth month suggested a fetal weight over 10 lb, but the physician doubted the accuracy of these calculations and scheduled an induction to take place in 2 days.
Following a vaginal delivery complicated by shoulder dystocia and aided by episiotomy, the woman gave birth to a 9-lb, 13-oz child. The child suffered from Erb’s palsy, but the condition resolved. The mother, however, sustained a 3rd-degree laceration, postpartum hemorrhaging, and injury to the pelvic joints and vaginal area.
In suing, she claimed the physician did not properly evaluate the child’s birth weight, and was negligent in not granting her request for a cesarean.
- The doctor settled for $27,000 with the mother and $5,000 with the child.
A woman in her fourth pregnancy presented to a physician. Her first pregnancy, 18 years prior, was notable for 36-hour labor followed by delivery of a 9-lb infant; the next 2 pregnancies resulted in miscarriage.
The doctor deemed the patient a high-risk pregnancy and ordered sonograms every 2 weeks. When sonography in her sixth month indicated a fetal weight over 7 lb, the woman requested a cesarean delivery. A sonogram performed in her ninth month suggested a fetal weight over 10 lb, but the physician doubted the accuracy of these calculations and scheduled an induction to take place in 2 days.
Following a vaginal delivery complicated by shoulder dystocia and aided by episiotomy, the woman gave birth to a 9-lb, 13-oz child. The child suffered from Erb’s palsy, but the condition resolved. The mother, however, sustained a 3rd-degree laceration, postpartum hemorrhaging, and injury to the pelvic joints and vaginal area.
In suing, she claimed the physician did not properly evaluate the child’s birth weight, and was negligent in not granting her request for a cesarean.
- The doctor settled for $27,000 with the mother and $5,000 with the child.
A woman in her fourth pregnancy presented to a physician. Her first pregnancy, 18 years prior, was notable for 36-hour labor followed by delivery of a 9-lb infant; the next 2 pregnancies resulted in miscarriage.
The doctor deemed the patient a high-risk pregnancy and ordered sonograms every 2 weeks. When sonography in her sixth month indicated a fetal weight over 7 lb, the woman requested a cesarean delivery. A sonogram performed in her ninth month suggested a fetal weight over 10 lb, but the physician doubted the accuracy of these calculations and scheduled an induction to take place in 2 days.
Following a vaginal delivery complicated by shoulder dystocia and aided by episiotomy, the woman gave birth to a 9-lb, 13-oz child. The child suffered from Erb’s palsy, but the condition resolved. The mother, however, sustained a 3rd-degree laceration, postpartum hemorrhaging, and injury to the pelvic joints and vaginal area.
In suing, she claimed the physician did not properly evaluate the child’s birth weight, and was negligent in not granting her request for a cesarean.
- The doctor settled for $27,000 with the mother and $5,000 with the child.
Shoulder dystocia: Fundal pressure used?
When shoulder dystocia was encountered in the course of delivery, a clinician opted to use vacuum extraction, though the mother had pushed for just 16 minutes. The child was born with brachial plexus injury, which, despite subsequent surgery, left the affected arm 2 inches shorter than the uninjured arm, with partially limited function.
The plaintiff claimed vacuum extraction was used prematurely and contributed to the injury. She also argued that, per the delivery note, fundal pressure that was initiated prior to the dystocia was continued once the complication arose, when the clinician should have switched to suprapubic pressure.
The defense argued that a notation error was made in the delivery record, and that suprapubic pressure was indeed used.
- The jury returned a defense verdict.
When shoulder dystocia was encountered in the course of delivery, a clinician opted to use vacuum extraction, though the mother had pushed for just 16 minutes. The child was born with brachial plexus injury, which, despite subsequent surgery, left the affected arm 2 inches shorter than the uninjured arm, with partially limited function.
The plaintiff claimed vacuum extraction was used prematurely and contributed to the injury. She also argued that, per the delivery note, fundal pressure that was initiated prior to the dystocia was continued once the complication arose, when the clinician should have switched to suprapubic pressure.
The defense argued that a notation error was made in the delivery record, and that suprapubic pressure was indeed used.
- The jury returned a defense verdict.
When shoulder dystocia was encountered in the course of delivery, a clinician opted to use vacuum extraction, though the mother had pushed for just 16 minutes. The child was born with brachial plexus injury, which, despite subsequent surgery, left the affected arm 2 inches shorter than the uninjured arm, with partially limited function.
The plaintiff claimed vacuum extraction was used prematurely and contributed to the injury. She also argued that, per the delivery note, fundal pressure that was initiated prior to the dystocia was continued once the complication arose, when the clinician should have switched to suprapubic pressure.
The defense argued that a notation error was made in the delivery record, and that suprapubic pressure was indeed used.
- The jury returned a defense verdict.
Ureter injury follows unneeded hysterectomy
<court>Orange County (NY) Supreme Court</court>
With complaints of menorrhagia and dyspareunia, a 23-year-old woman with a previous tubal ligation presented to her Ob/Gyn. A course of oral contraceptives proved unsuccessful.
Ultrasound examination revealed an enlarged uterus. The physician informed the woman she had uterine fibroids and recommended a hysterectomy. At surgery, however, no fibroids were discovered. In the course of the procedure, the woman’s right ureter was severed. She developed a ureterovaginal fistula. Despite several corrective procedures, she claims to still suffer from urinary incontinence.
In suing, the plaintiff argued that the physician was negligent in not offering an alternative to hysterectomy, such as dilation and curettage.
The defendants maintained that the patient was fully informed, and argued that the hysterectomy was appropriate. Further, they noted that ureter injury is a known complication of the procedure, and alleged that the woman’s symptoms had resolved.
- The jury awarded the plaintiff $600,000.
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). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.
<court>Orange County (NY) Supreme Court</court>
With complaints of menorrhagia and dyspareunia, a 23-year-old woman with a previous tubal ligation presented to her Ob/Gyn. A course of oral contraceptives proved unsuccessful.
Ultrasound examination revealed an enlarged uterus. The physician informed the woman she had uterine fibroids and recommended a hysterectomy. At surgery, however, no fibroids were discovered. In the course of the procedure, the woman’s right ureter was severed. She developed a ureterovaginal fistula. Despite several corrective procedures, she claims to still suffer from urinary incontinence.
In suing, the plaintiff argued that the physician was negligent in not offering an alternative to hysterectomy, such as dilation and curettage.
The defendants maintained that the patient was fully informed, and argued that the hysterectomy was appropriate. Further, they noted that ureter injury is a known complication of the procedure, and alleged that the woman’s symptoms had resolved.
- The jury awarded the plaintiff $600,000.
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). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.
<court>Orange County (NY) Supreme Court</court>
With complaints of menorrhagia and dyspareunia, a 23-year-old woman with a previous tubal ligation presented to her Ob/Gyn. A course of oral contraceptives proved unsuccessful.
Ultrasound examination revealed an enlarged uterus. The physician informed the woman she had uterine fibroids and recommended a hysterectomy. At surgery, however, no fibroids were discovered. In the course of the procedure, the woman’s right ureter was severed. She developed a ureterovaginal fistula. Despite several corrective procedures, she claims to still suffer from urinary incontinence.
In suing, the plaintiff argued that the physician was negligent in not offering an alternative to hysterectomy, such as dilation and curettage.
The defendants maintained that the patient was fully informed, and argued that the hysterectomy was appropriate. Further, they noted that ureter injury is a known complication of the procedure, and alleged that the woman’s symptoms had resolved.
- The jury awarded the plaintiff $600,000.
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). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.
Was infant’s death “no serious harm”?
A gravida with a high-risk pregnancy presented to a hospital with preterm premature rupture of membranes (PPROM), but was discharged home without delivery of her child.
She returned a few days later still leaking amniotic fluid, but was not examined by the defendant physician. Though fetal monitor records had been lost by the time of trial, a nurse’s notes indicate a problematic fetal heart rate—but also state that the defendant was not informed of this development.
The child, born with brain damage, died 1 week after birth.
In suing, the plaintiff alleged negligence in the delayed delivery of her child.
The defendant, who did not have liability insurance, chose not to defend the liability suit, leading to a default judgment. She did defend the damages claim, however, arguing that the plaintiff did not suffer serious harm, as she already had another child.
- The jury awarded the plaintiff $5 million for pain and suffering.
A gravida with a high-risk pregnancy presented to a hospital with preterm premature rupture of membranes (PPROM), but was discharged home without delivery of her child.
She returned a few days later still leaking amniotic fluid, but was not examined by the defendant physician. Though fetal monitor records had been lost by the time of trial, a nurse’s notes indicate a problematic fetal heart rate—but also state that the defendant was not informed of this development.
The child, born with brain damage, died 1 week after birth.
In suing, the plaintiff alleged negligence in the delayed delivery of her child.
The defendant, who did not have liability insurance, chose not to defend the liability suit, leading to a default judgment. She did defend the damages claim, however, arguing that the plaintiff did not suffer serious harm, as she already had another child.
- The jury awarded the plaintiff $5 million for pain and suffering.
A gravida with a high-risk pregnancy presented to a hospital with preterm premature rupture of membranes (PPROM), but was discharged home without delivery of her child.
She returned a few days later still leaking amniotic fluid, but was not examined by the defendant physician. Though fetal monitor records had been lost by the time of trial, a nurse’s notes indicate a problematic fetal heart rate—but also state that the defendant was not informed of this development.
The child, born with brain damage, died 1 week after birth.
In suing, the plaintiff alleged negligence in the delayed delivery of her child.
The defendant, who did not have liability insurance, chose not to defend the liability suit, leading to a default judgment. She did defend the damages claim, however, arguing that the plaintiff did not suffer serious harm, as she already had another child.
- The jury awarded the plaintiff $5 million for pain and suffering.
Was fetal presentation compound?
Shortly after discharge following delivery and tubal ligation, a woman brought her newborn infant to a pediatrician. The physician suggested she take the child to an orthopedic surgeon, who diagnosed brachial plexus injury and Erb’s palsy. Surgery was required to repair the child’s cosmetic deformities, but full range of motion could not be recovered.
In suing, the plaintiff claimed the Ob/Gyn failed to recognize a compound presentation—which was noted by a delivery nurse—and applied excessive traction to the head and brachial plexus. She claimed the physician was further negligent in failing to recognize the injury.
The mother noted that, due to her tubal ligation procedure, she saw the infant very little prior to discharge, and only when the child was wrapped in a blanket. Thus, she did not notice any abnormalities before her release.
The obstetrician denied a compound presentation, maintained delivery was uncomplicated, and contended the child was in good condition at discharge.
- The jury returned a defense verdict.
Shortly after discharge following delivery and tubal ligation, a woman brought her newborn infant to a pediatrician. The physician suggested she take the child to an orthopedic surgeon, who diagnosed brachial plexus injury and Erb’s palsy. Surgery was required to repair the child’s cosmetic deformities, but full range of motion could not be recovered.
In suing, the plaintiff claimed the Ob/Gyn failed to recognize a compound presentation—which was noted by a delivery nurse—and applied excessive traction to the head and brachial plexus. She claimed the physician was further negligent in failing to recognize the injury.
The mother noted that, due to her tubal ligation procedure, she saw the infant very little prior to discharge, and only when the child was wrapped in a blanket. Thus, she did not notice any abnormalities before her release.
The obstetrician denied a compound presentation, maintained delivery was uncomplicated, and contended the child was in good condition at discharge.
- The jury returned a defense verdict.
Shortly after discharge following delivery and tubal ligation, a woman brought her newborn infant to a pediatrician. The physician suggested she take the child to an orthopedic surgeon, who diagnosed brachial plexus injury and Erb’s palsy. Surgery was required to repair the child’s cosmetic deformities, but full range of motion could not be recovered.
In suing, the plaintiff claimed the Ob/Gyn failed to recognize a compound presentation—which was noted by a delivery nurse—and applied excessive traction to the head and brachial plexus. She claimed the physician was further negligent in failing to recognize the injury.
The mother noted that, due to her tubal ligation procedure, she saw the infant very little prior to discharge, and only when the child was wrapped in a blanket. Thus, she did not notice any abnormalities before her release.
The obstetrician denied a compound presentation, maintained delivery was uncomplicated, and contended the child was in good condition at discharge.
- The jury returned a defense verdict.
Fetus expelled to floor after D&C
A 28-year-old woman in her first trimester learned that her fetus had no cardiac activity. A dilation and curettage (D&C) was performed.
At home following the procedure, the woman experienced abdominal pain. While in the bathroom, she expelled the fetus onto the floor. The patient required a second D&C procedure. When the woman and her husband requested the fetus for burial, they learned that it was sent to pathology, where it was destroyed.
In suing, the plaintiffs noted that medical records showed that, at the first D&C, only 50 cc of blood and minimal products of conception were collected. They alleged this should have prompted an ultrasound examination to ensure the fetus was completely removed.
The defendants denied negligence, noting that incomplete removal of the fetus is a known risk of the procedure.
- The parties settled for $225,000 at arbitration.
A 28-year-old woman in her first trimester learned that her fetus had no cardiac activity. A dilation and curettage (D&C) was performed.
At home following the procedure, the woman experienced abdominal pain. While in the bathroom, she expelled the fetus onto the floor. The patient required a second D&C procedure. When the woman and her husband requested the fetus for burial, they learned that it was sent to pathology, where it was destroyed.
In suing, the plaintiffs noted that medical records showed that, at the first D&C, only 50 cc of blood and minimal products of conception were collected. They alleged this should have prompted an ultrasound examination to ensure the fetus was completely removed.
The defendants denied negligence, noting that incomplete removal of the fetus is a known risk of the procedure.
- The parties settled for $225,000 at arbitration.
A 28-year-old woman in her first trimester learned that her fetus had no cardiac activity. A dilation and curettage (D&C) was performed.
At home following the procedure, the woman experienced abdominal pain. While in the bathroom, she expelled the fetus onto the floor. The patient required a second D&C procedure. When the woman and her husband requested the fetus for burial, they learned that it was sent to pathology, where it was destroyed.
In suing, the plaintiffs noted that medical records showed that, at the first D&C, only 50 cc of blood and minimal products of conception were collected. They alleged this should have prompted an ultrasound examination to ensure the fetus was completely removed.
The defendants denied negligence, noting that incomplete removal of the fetus is a known risk of the procedure.
- The parties settled for $225,000 at arbitration.
Nurses urge Ob/Gyn to perform cesarean
After passing 41 weeks’ gestation, a 30-year-old woman was admitted to the hospital and given oxytocin to induce labor. The fetal heart rate tracing was not reassuring and there was a deceleration to 45 beats per minute, which prompted nursing staff to urge the Ob/Gyn to conduct a cesarean section.
When the physician chose not to proceed with a cesarean, the nurses contacted a supervisor, who also recommended cesarean delivery. The doctor ordered an immediate cesarean, but changed the order from “stat” to “ASAP” when the child’s heart rate improved.
At delivery a nuchal cord was discovered. The infant, born with brain damage, was never able to walk, talk, or blink. He died of pneumonia at age 2.
The family claimed the doctor was negligent in not initiating cesarean sooner.
The defendant argued that the child suffered chronic hypoxia throughout pregnancy, and noted that placental pathology revealed significant abnormalities, including profound chorangiosis.
- The jury awarded the plaintiffs $2.4 million.
After passing 41 weeks’ gestation, a 30-year-old woman was admitted to the hospital and given oxytocin to induce labor. The fetal heart rate tracing was not reassuring and there was a deceleration to 45 beats per minute, which prompted nursing staff to urge the Ob/Gyn to conduct a cesarean section.
When the physician chose not to proceed with a cesarean, the nurses contacted a supervisor, who also recommended cesarean delivery. The doctor ordered an immediate cesarean, but changed the order from “stat” to “ASAP” when the child’s heart rate improved.
At delivery a nuchal cord was discovered. The infant, born with brain damage, was never able to walk, talk, or blink. He died of pneumonia at age 2.
The family claimed the doctor was negligent in not initiating cesarean sooner.
The defendant argued that the child suffered chronic hypoxia throughout pregnancy, and noted that placental pathology revealed significant abnormalities, including profound chorangiosis.
- The jury awarded the plaintiffs $2.4 million.
After passing 41 weeks’ gestation, a 30-year-old woman was admitted to the hospital and given oxytocin to induce labor. The fetal heart rate tracing was not reassuring and there was a deceleration to 45 beats per minute, which prompted nursing staff to urge the Ob/Gyn to conduct a cesarean section.
When the physician chose not to proceed with a cesarean, the nurses contacted a supervisor, who also recommended cesarean delivery. The doctor ordered an immediate cesarean, but changed the order from “stat” to “ASAP” when the child’s heart rate improved.
At delivery a nuchal cord was discovered. The infant, born with brain damage, was never able to walk, talk, or blink. He died of pneumonia at age 2.
The family claimed the doctor was negligent in not initiating cesarean sooner.
The defendant argued that the child suffered chronic hypoxia throughout pregnancy, and noted that placental pathology revealed significant abnormalities, including profound chorangiosis.
- The jury awarded the plaintiffs $2.4 million.
New mother dies after normal delivery
A few hours after an uncomplicated vaginal delivery, a 36-year-old woman began experiencing abdominal discomfort and back pain, which was diagnosed as a distended bladder and musculoskeletal pain. She received analgesics, but subsequently experienced pain in her abdomen and right shoulder so severe that she could not move.
Approximately an hour later, the woman suffered 2 seizures. Nursing staff identified these as eclamptic seizures and called the attending physician at home. Soon after, the woman’s blood pressure began to fall and she was brought to intensive care, where she was intubated and received blood due to low hemoglobin.
Though a surgical team was assembled, the woman could not be stabilized for surgery. She died soon after. Autopsy revealed the cause of death to be intraabdominal hemorrhage due a ruptured pancreatic cyst.
The woman’s family sued the hospital, alleging that if nursing staff had contacted the physician sooner, blood administration would have begun earlier, allowing the woman to get to the operating room for surgery.
The defense argued that the woman hemorrhaged too quickly for an effective intervention to occur. Further, it maintained that the nurses’ assessment of eclamptic seizures was reasonable.
- The jury awarded the plaintiff $12.4 million.
A few hours after an uncomplicated vaginal delivery, a 36-year-old woman began experiencing abdominal discomfort and back pain, which was diagnosed as a distended bladder and musculoskeletal pain. She received analgesics, but subsequently experienced pain in her abdomen and right shoulder so severe that she could not move.
Approximately an hour later, the woman suffered 2 seizures. Nursing staff identified these as eclamptic seizures and called the attending physician at home. Soon after, the woman’s blood pressure began to fall and she was brought to intensive care, where she was intubated and received blood due to low hemoglobin.
Though a surgical team was assembled, the woman could not be stabilized for surgery. She died soon after. Autopsy revealed the cause of death to be intraabdominal hemorrhage due a ruptured pancreatic cyst.
The woman’s family sued the hospital, alleging that if nursing staff had contacted the physician sooner, blood administration would have begun earlier, allowing the woman to get to the operating room for surgery.
The defense argued that the woman hemorrhaged too quickly for an effective intervention to occur. Further, it maintained that the nurses’ assessment of eclamptic seizures was reasonable.
- The jury awarded the plaintiff $12.4 million.
A few hours after an uncomplicated vaginal delivery, a 36-year-old woman began experiencing abdominal discomfort and back pain, which was diagnosed as a distended bladder and musculoskeletal pain. She received analgesics, but subsequently experienced pain in her abdomen and right shoulder so severe that she could not move.
Approximately an hour later, the woman suffered 2 seizures. Nursing staff identified these as eclamptic seizures and called the attending physician at home. Soon after, the woman’s blood pressure began to fall and she was brought to intensive care, where she was intubated and received blood due to low hemoglobin.
Though a surgical team was assembled, the woman could not be stabilized for surgery. She died soon after. Autopsy revealed the cause of death to be intraabdominal hemorrhage due a ruptured pancreatic cyst.
The woman’s family sued the hospital, alleging that if nursing staff had contacted the physician sooner, blood administration would have begun earlier, allowing the woman to get to the operating room for surgery.
The defense argued that the woman hemorrhaged too quickly for an effective intervention to occur. Further, it maintained that the nurses’ assessment of eclamptic seizures was reasonable.
- The jury awarded the plaintiff $12.4 million.
Was ovary removed without consent?
<court>Buchanan County (Mo) Circuit Court</court>
A 33-year-old woman presented to a hospital with severe pain in her lower right quadrant. She had had a hysterectomy 11 years earlier due to painful adhesions; a painful right ovarian cyst 7 years prior was treated with analgesics and oral contraceptives.
An ultrasound revealed a simple cyst on the right ovary. The consulting Ob/Gyn ordered a 5-week regimen of analgesics and oral contraceptives. Symptoms persisted after the regimen’s completion, however, so the physician recommended surgery.
The following day the woman had a bilateral oophorectomy. Five days after discharge she returned to the hospital with lower abdominal pain. Testing revealed injury to her left ureter, which was leaking urine resulting in urinoma. A nephrostomy tube was inserted; she wore this with a collecting bag for the following 2 months, after which the ureter was repaired.
In suing, the woman claimed to have consented to removal of her right ovary only—not both. She noted all pain following her hysterectomy had been on her right side. Further, she claimed the physician was negligent for injuring her ureter at the time of surgery, most likely by use of a clamp.
The defendant maintained the patient wanted a bilateral oophorectomy to prevent future pain. He argued that the left ovary was diseased, and noted that at surgery it was scarred and attached to the pelvic sidewall. He denied using a clamp.
- The first trial resulted in a hung jury. The jury in the second trial 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.
<court>Buchanan County (Mo) Circuit Court</court>
A 33-year-old woman presented to a hospital with severe pain in her lower right quadrant. She had had a hysterectomy 11 years earlier due to painful adhesions; a painful right ovarian cyst 7 years prior was treated with analgesics and oral contraceptives.
An ultrasound revealed a simple cyst on the right ovary. The consulting Ob/Gyn ordered a 5-week regimen of analgesics and oral contraceptives. Symptoms persisted after the regimen’s completion, however, so the physician recommended surgery.
The following day the woman had a bilateral oophorectomy. Five days after discharge she returned to the hospital with lower abdominal pain. Testing revealed injury to her left ureter, which was leaking urine resulting in urinoma. A nephrostomy tube was inserted; she wore this with a collecting bag for the following 2 months, after which the ureter was repaired.
In suing, the woman claimed to have consented to removal of her right ovary only—not both. She noted all pain following her hysterectomy had been on her right side. Further, she claimed the physician was negligent for injuring her ureter at the time of surgery, most likely by use of a clamp.
The defendant maintained the patient wanted a bilateral oophorectomy to prevent future pain. He argued that the left ovary was diseased, and noted that at surgery it was scarred and attached to the pelvic sidewall. He denied using a clamp.
- The first trial resulted in a hung jury. The jury in the second trial 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.
<court>Buchanan County (Mo) Circuit Court</court>
A 33-year-old woman presented to a hospital with severe pain in her lower right quadrant. She had had a hysterectomy 11 years earlier due to painful adhesions; a painful right ovarian cyst 7 years prior was treated with analgesics and oral contraceptives.
An ultrasound revealed a simple cyst on the right ovary. The consulting Ob/Gyn ordered a 5-week regimen of analgesics and oral contraceptives. Symptoms persisted after the regimen’s completion, however, so the physician recommended surgery.
The following day the woman had a bilateral oophorectomy. Five days after discharge she returned to the hospital with lower abdominal pain. Testing revealed injury to her left ureter, which was leaking urine resulting in urinoma. A nephrostomy tube was inserted; she wore this with a collecting bag for the following 2 months, after which the ureter was repaired.
In suing, the woman claimed to have consented to removal of her right ovary only—not both. She noted all pain following her hysterectomy had been on her right side. Further, she claimed the physician was negligent for injuring her ureter at the time of surgery, most likely by use of a clamp.
The defendant maintained the patient wanted a bilateral oophorectomy to prevent future pain. He argued that the left ovary was diseased, and noted that at surgery it was scarred and attached to the pelvic sidewall. He denied using a clamp.
- The first trial resulted in a hung jury. The jury in the second trial 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.
Could preterm twins have been saved?
Within in 48 hours of birth, twin boys born at 24 weeks’ gestation died due to respiratory distress syndrome.
The mother claimed negligence, alleging that the obstetrician should have:
- performed a urinalysis and urine culture at her first prenatal visit,
- ordered a urinalysis and therapy for asymptomatic bacteria detected on urine dipstick testing,
- assessed her for preterm labor during an office visit, and
- provided medical therapy to prevent preterm birth.
- The jury awarded the plaintiff $225,000.
Within in 48 hours of birth, twin boys born at 24 weeks’ gestation died due to respiratory distress syndrome.
The mother claimed negligence, alleging that the obstetrician should have:
- performed a urinalysis and urine culture at her first prenatal visit,
- ordered a urinalysis and therapy for asymptomatic bacteria detected on urine dipstick testing,
- assessed her for preterm labor during an office visit, and
- provided medical therapy to prevent preterm birth.
- The jury awarded the plaintiff $225,000.
Within in 48 hours of birth, twin boys born at 24 weeks’ gestation died due to respiratory distress syndrome.
The mother claimed negligence, alleging that the obstetrician should have:
- performed a urinalysis and urine culture at her first prenatal visit,
- ordered a urinalysis and therapy for asymptomatic bacteria detected on urine dipstick testing,
- assessed her for preterm labor during an office visit, and
- provided medical therapy to prevent preterm birth.
- The jury awarded the plaintiff $225,000.