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Cesarean was delayed for elective procedure
On Thanksgiving Day, an Ob/Gyn performed an elective tubal ligation in the only operating room in the hospital’s labor and delivery suite. Prior to the procedure’s start, fetal monitoring on a laboring woman showed minimal variability and variable decelerations. This trend persisted for 2 hours and then worsened. Nurses later discovered a prolapsed umbilical cord.
It took hospital staff 20 minutes to secure an operating room and appropriate surgical staff. The child, born via emergency cesarean, suffered brain damage leading to cerebral palsy, spastic quadriparesis, and an inability to walk or talk.
The defense denied negligence, maintaining the child had a preexisting fetal inflammatory response syndrome.
- The Ob/Gyn settled for $1.5 million. The jury awarded the plaintiff $12.5 million against the hospital.
On Thanksgiving Day, an Ob/Gyn performed an elective tubal ligation in the only operating room in the hospital’s labor and delivery suite. Prior to the procedure’s start, fetal monitoring on a laboring woman showed minimal variability and variable decelerations. This trend persisted for 2 hours and then worsened. Nurses later discovered a prolapsed umbilical cord.
It took hospital staff 20 minutes to secure an operating room and appropriate surgical staff. The child, born via emergency cesarean, suffered brain damage leading to cerebral palsy, spastic quadriparesis, and an inability to walk or talk.
The defense denied negligence, maintaining the child had a preexisting fetal inflammatory response syndrome.
- The Ob/Gyn settled for $1.5 million. The jury awarded the plaintiff $12.5 million against the hospital.
On Thanksgiving Day, an Ob/Gyn performed an elective tubal ligation in the only operating room in the hospital’s labor and delivery suite. Prior to the procedure’s start, fetal monitoring on a laboring woman showed minimal variability and variable decelerations. This trend persisted for 2 hours and then worsened. Nurses later discovered a prolapsed umbilical cord.
It took hospital staff 20 minutes to secure an operating room and appropriate surgical staff. The child, born via emergency cesarean, suffered brain damage leading to cerebral palsy, spastic quadriparesis, and an inability to walk or talk.
The defense denied negligence, maintaining the child had a preexisting fetal inflammatory response syndrome.
- The Ob/Gyn settled for $1.5 million. The jury awarded the plaintiff $12.5 million against the hospital.
Was ectopic diagnosis wrong?
<court>Winnebago County (Ill) Circuit Court</court>
A 39-year-old woman with a history of pain from ovarian cysts experienced an acute increase in pain intensity, which persisted nearly a full day. Her physician diagnosed ectopic pregnancy and performed a laparoscopic salpingectomy.
The woman sued, claiming no ectopic pregnancy existed. Instead, she argued, her symptoms were due to an exacerbation of her cyst pain and salpingitis, as noted on pathology examination. She noted that her low levels of human chorionic gonadotropin made ectopic pregnancy unlikely.
She also alleged that endometriosis and adhesions caused by the procedure required additional surgery the following year.
The defendant maintained the woman’s symptoms were consistent with ectopic pregnancy and possible rupture, and thus the diagnosis and resultant surgery were appropriate.
- 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.
<court>Winnebago County (Ill) Circuit Court</court>
A 39-year-old woman with a history of pain from ovarian cysts experienced an acute increase in pain intensity, which persisted nearly a full day. Her physician diagnosed ectopic pregnancy and performed a laparoscopic salpingectomy.
The woman sued, claiming no ectopic pregnancy existed. Instead, she argued, her symptoms were due to an exacerbation of her cyst pain and salpingitis, as noted on pathology examination. She noted that her low levels of human chorionic gonadotropin made ectopic pregnancy unlikely.
She also alleged that endometriosis and adhesions caused by the procedure required additional surgery the following year.
The defendant maintained the woman’s symptoms were consistent with ectopic pregnancy and possible rupture, and thus the diagnosis and resultant surgery were appropriate.
- 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.
<court>Winnebago County (Ill) Circuit Court</court>
A 39-year-old woman with a history of pain from ovarian cysts experienced an acute increase in pain intensity, which persisted nearly a full day. Her physician diagnosed ectopic pregnancy and performed a laparoscopic salpingectomy.
The woman sued, claiming no ectopic pregnancy existed. Instead, she argued, her symptoms were due to an exacerbation of her cyst pain and salpingitis, as noted on pathology examination. She noted that her low levels of human chorionic gonadotropin made ectopic pregnancy unlikely.
She also alleged that endometriosis and adhesions caused by the procedure required additional surgery the following year.
The defendant maintained the woman’s symptoms were consistent with ectopic pregnancy and possible rupture, and thus the diagnosis and resultant surgery were appropriate.
- 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.
Woman dies after uterine atony
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.
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
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.
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
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.
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
Did cesarean delay cause hypoxic injury?
After a nonstress test at her obstetrician’s office was nonreassuring, a gravida was sent to a nearby medical center, where an emergency cesarean was ordered. An ultrasound examination conducted at a different hospital 2 days prior was also nonreassuring, but no action was taken at that time.
Following the order to perform an emergency cesarean, 1 hour and 20 minutes passed before anesthesia was ready. The child, delivered 40 minutes later, suffered hypoxic injury leading to severe cerebral palsy. Age 17 at the time of trial, he has no use of his limbs and suffers severe mental retardation.
The plaintiffs sued the hospital that conducted the ultrasound, alleging negligence. They also sued the obstetrician and the medical center where the cesarean was performed, claiming delivery was unacceptably delayed. Had the child been delivered in a timely manner, they argued, his cerebral palsy could have been avoided.
The physician and medical center claimed the child’s injury occurred well before delivery, and an earlier cesarean would not have changed the outcome.
- The hospital performing the ultrasound settled prior to trial. The jury awarded plaintiffs $30 million against the obstetrician and delivering medical center.
After a nonstress test at her obstetrician’s office was nonreassuring, a gravida was sent to a nearby medical center, where an emergency cesarean was ordered. An ultrasound examination conducted at a different hospital 2 days prior was also nonreassuring, but no action was taken at that time.
Following the order to perform an emergency cesarean, 1 hour and 20 minutes passed before anesthesia was ready. The child, delivered 40 minutes later, suffered hypoxic injury leading to severe cerebral palsy. Age 17 at the time of trial, he has no use of his limbs and suffers severe mental retardation.
The plaintiffs sued the hospital that conducted the ultrasound, alleging negligence. They also sued the obstetrician and the medical center where the cesarean was performed, claiming delivery was unacceptably delayed. Had the child been delivered in a timely manner, they argued, his cerebral palsy could have been avoided.
The physician and medical center claimed the child’s injury occurred well before delivery, and an earlier cesarean would not have changed the outcome.
- The hospital performing the ultrasound settled prior to trial. The jury awarded plaintiffs $30 million against the obstetrician and delivering medical center.
After a nonstress test at her obstetrician’s office was nonreassuring, a gravida was sent to a nearby medical center, where an emergency cesarean was ordered. An ultrasound examination conducted at a different hospital 2 days prior was also nonreassuring, but no action was taken at that time.
Following the order to perform an emergency cesarean, 1 hour and 20 minutes passed before anesthesia was ready. The child, delivered 40 minutes later, suffered hypoxic injury leading to severe cerebral palsy. Age 17 at the time of trial, he has no use of his limbs and suffers severe mental retardation.
The plaintiffs sued the hospital that conducted the ultrasound, alleging negligence. They also sued the obstetrician and the medical center where the cesarean was performed, claiming delivery was unacceptably delayed. Had the child been delivered in a timely manner, they argued, his cerebral palsy could have been avoided.
The physician and medical center claimed the child’s injury occurred well before delivery, and an earlier cesarean would not have changed the outcome.
- The hospital performing the ultrasound settled prior to trial. The jury awarded plaintiffs $30 million against the obstetrician and delivering medical center.
Nephrectomy required after ureter injury
<court>Rockland County (NY) Supreme Court</court>
Two days after a bilateral oophorectomy for ovarian cysts, a 72-year-old woman developed spiking fevers. The pathologists, in examining a mass removed at surgery, discovered a segment of the ureter.
After unsuccessful surgery to reattach the ureter—during which swelling in the abdominal cavity prevented the physician from locating the ureter’s distal end—the woman went into septic shock and required several days of ventilation. She was placed on a nephrostomy bag, which she wore for the next 3 months, before undergoing a successful nephrectomy plus insertion of a Greenfield filter.
In suing, the woman claimed the surgeon failed to identify and protect her ureter during surgery, and further failed to recognize the injury in a timely fashion, when successful repair was still possible.
The defendant maintained he took all appropriate precautions.
- The jury awarded the plaintiff $2.6 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). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.
<court>Rockland County (NY) Supreme Court</court>
Two days after a bilateral oophorectomy for ovarian cysts, a 72-year-old woman developed spiking fevers. The pathologists, in examining a mass removed at surgery, discovered a segment of the ureter.
After unsuccessful surgery to reattach the ureter—during which swelling in the abdominal cavity prevented the physician from locating the ureter’s distal end—the woman went into septic shock and required several days of ventilation. She was placed on a nephrostomy bag, which she wore for the next 3 months, before undergoing a successful nephrectomy plus insertion of a Greenfield filter.
In suing, the woman claimed the surgeon failed to identify and protect her ureter during surgery, and further failed to recognize the injury in a timely fashion, when successful repair was still possible.
The defendant maintained he took all appropriate precautions.
- The jury awarded the plaintiff $2.6 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). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.
<court>Rockland County (NY) Supreme Court</court>
Two days after a bilateral oophorectomy for ovarian cysts, a 72-year-old woman developed spiking fevers. The pathologists, in examining a mass removed at surgery, discovered a segment of the ureter.
After unsuccessful surgery to reattach the ureter—during which swelling in the abdominal cavity prevented the physician from locating the ureter’s distal end—the woman went into septic shock and required several days of ventilation. She was placed on a nephrostomy bag, which she wore for the next 3 months, before undergoing a successful nephrectomy plus insertion of a Greenfield filter.
In suing, the woman claimed the surgeon failed to identify and protect her ureter during surgery, and further failed to recognize the injury in a timely fashion, when successful repair was still possible.
The defendant maintained he took all appropriate precautions.
- The jury awarded the plaintiff $2.6 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). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.
Ectopic rupture death: Due to deficient care?
<court>Lucas County (Ohio) Court of Common Pleas</court>
A woman in her early 20s presented to her Ob/Gyn due to suspected pregnancy, which the physician confirmed. Six weeks later, the woman suffered a ruptured ectopic pregnancy and died due to blood loss.
The woman’s family claimed the doctor did not adequately counsel the patient on the risks of pregnancy, and failed to ensure she received proper follow-up care. They accused the defendant of altering the woman’s medical record.
The defendant maintained that the patient said she would seek an abortion, and denied tampering the woman’s records.
- 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.
<court>Lucas County (Ohio) Court of Common Pleas</court>
A woman in her early 20s presented to her Ob/Gyn due to suspected pregnancy, which the physician confirmed. Six weeks later, the woman suffered a ruptured ectopic pregnancy and died due to blood loss.
The woman’s family claimed the doctor did not adequately counsel the patient on the risks of pregnancy, and failed to ensure she received proper follow-up care. They accused the defendant of altering the woman’s medical record.
The defendant maintained that the patient said she would seek an abortion, and denied tampering the woman’s records.
- 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.
<court>Lucas County (Ohio) Court of Common Pleas</court>
A woman in her early 20s presented to her Ob/Gyn due to suspected pregnancy, which the physician confirmed. Six weeks later, the woman suffered a ruptured ectopic pregnancy and died due to blood loss.
The woman’s family claimed the doctor did not adequately counsel the patient on the risks of pregnancy, and failed to ensure she received proper follow-up care. They accused the defendant of altering the woman’s medical record.
The defendant maintained that the patient said she would seek an abortion, and denied tampering the woman’s records.
- 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.
Trichloroacetic acid used at colposcopy
During a colposcopy, a 24-year-old woman experienced a severely painful burning sensation, prompting the physician to halt the procedure. Investigation revealed the medical assistant had handed the physician trichloroacetic acid rather than acetic acid with which to swab the cervix.
This error, according to the plaintiff, led to vaginal burns, permanent injury to nerves inside the vaginal wall, and chronic painful spasms during intercourse.
The patient sued the gynecologist, citing negligence in not checking the bottle of solution prior to application; the medical assistant, for supplying the doctor with the wrong chemical; and the health plan that employed the assistant.
The physician argued it was the medical assistant’s responsibility to have proper materials ready for the procedure.
The assistant claimed that infection and other problems present prior to the colposcopy—not the trichloroacetic acid—caused the patients’ injuries.
- The jury returned a defense verdict for the obstetrician, and awarded the plaintiff $500,000 against the medical assistant and the health plan.
During a colposcopy, a 24-year-old woman experienced a severely painful burning sensation, prompting the physician to halt the procedure. Investigation revealed the medical assistant had handed the physician trichloroacetic acid rather than acetic acid with which to swab the cervix.
This error, according to the plaintiff, led to vaginal burns, permanent injury to nerves inside the vaginal wall, and chronic painful spasms during intercourse.
The patient sued the gynecologist, citing negligence in not checking the bottle of solution prior to application; the medical assistant, for supplying the doctor with the wrong chemical; and the health plan that employed the assistant.
The physician argued it was the medical assistant’s responsibility to have proper materials ready for the procedure.
The assistant claimed that infection and other problems present prior to the colposcopy—not the trichloroacetic acid—caused the patients’ injuries.
- The jury returned a defense verdict for the obstetrician, and awarded the plaintiff $500,000 against the medical assistant and the health plan.
During a colposcopy, a 24-year-old woman experienced a severely painful burning sensation, prompting the physician to halt the procedure. Investigation revealed the medical assistant had handed the physician trichloroacetic acid rather than acetic acid with which to swab the cervix.
This error, according to the plaintiff, led to vaginal burns, permanent injury to nerves inside the vaginal wall, and chronic painful spasms during intercourse.
The patient sued the gynecologist, citing negligence in not checking the bottle of solution prior to application; the medical assistant, for supplying the doctor with the wrong chemical; and the health plan that employed the assistant.
The physician argued it was the medical assistant’s responsibility to have proper materials ready for the procedure.
The assistant claimed that infection and other problems present prior to the colposcopy—not the trichloroacetic acid—caused the patients’ injuries.
- The jury returned a defense verdict for the obstetrician, and awarded the plaintiff $500,000 against the medical assistant and the health plan.
Nonstress test misread, call to Ob delayed
Following a nonstress test for fetal well-being, a 20-year-old woman at 37 weeks’ gestation was discharged from a hospital. She called 6 days later, noting decreased fetal movement, and returned to the hospital the following day; fetal monitoring revealed a nonreassuring heart rate tracing.
Rather than contact the physician on duty, a nurse called the defendant attending obstetrician, who arrived approximately 30 minutes later. Three hours passed before a cesarean delivery was ordered, and another 1 hour before the child was delivered. His Apgar scores at birth were 0 and 0; he now suffers developmental delay, as well as inability to walk or feed himself.
It was revealed at trial that the non-stress test at 37 weeks showed a sinusoidal pattern, which the plaintiffs claimed the nurse failed to recognize. The plaintiffs argued that the staff should have called an obstetrician immediately upon inspection of the fetal heart rate tracing.
The hospital claimed nurses acted appropriately, and charged that any negligence was that of the defendant physician.
- The plaintiff was awarded a $16 million default judgment against the obstetrician. The hospital settled for $1.4 million.
Following a nonstress test for fetal well-being, a 20-year-old woman at 37 weeks’ gestation was discharged from a hospital. She called 6 days later, noting decreased fetal movement, and returned to the hospital the following day; fetal monitoring revealed a nonreassuring heart rate tracing.
Rather than contact the physician on duty, a nurse called the defendant attending obstetrician, who arrived approximately 30 minutes later. Three hours passed before a cesarean delivery was ordered, and another 1 hour before the child was delivered. His Apgar scores at birth were 0 and 0; he now suffers developmental delay, as well as inability to walk or feed himself.
It was revealed at trial that the non-stress test at 37 weeks showed a sinusoidal pattern, which the plaintiffs claimed the nurse failed to recognize. The plaintiffs argued that the staff should have called an obstetrician immediately upon inspection of the fetal heart rate tracing.
The hospital claimed nurses acted appropriately, and charged that any negligence was that of the defendant physician.
- The plaintiff was awarded a $16 million default judgment against the obstetrician. The hospital settled for $1.4 million.
Following a nonstress test for fetal well-being, a 20-year-old woman at 37 weeks’ gestation was discharged from a hospital. She called 6 days later, noting decreased fetal movement, and returned to the hospital the following day; fetal monitoring revealed a nonreassuring heart rate tracing.
Rather than contact the physician on duty, a nurse called the defendant attending obstetrician, who arrived approximately 30 minutes later. Three hours passed before a cesarean delivery was ordered, and another 1 hour before the child was delivered. His Apgar scores at birth were 0 and 0; he now suffers developmental delay, as well as inability to walk or feed himself.
It was revealed at trial that the non-stress test at 37 weeks showed a sinusoidal pattern, which the plaintiffs claimed the nurse failed to recognize. The plaintiffs argued that the staff should have called an obstetrician immediately upon inspection of the fetal heart rate tracing.
The hospital claimed nurses acted appropriately, and charged that any negligence was that of the defendant physician.
- The plaintiff was awarded a $16 million default judgment against the obstetrician. The hospital settled for $1.4 million.
No Ob available for shoulder dystocia
By 37 weeks’ gestation, a woman who experienced shoulder dystocia and macrosomia with her first pregnancy had a 56-pound weight gain and an estimated fetal weight of greater than 8 pounds. Despite a request for cesarean delivery, she was scheduled for labor induction at 38 weeks.
Due to the complications with her first child, both a midwife and obstetrician were slated to be present for the delivery. At the time of the scheduled induction, however, the physician was investigating psychiatric care for his wife, and asked another obstetrician to cover. That physician, however, was available only for portions of the day in question. None of these changes were communicated to the mother.
Despite an awareness of the Ob scheduling problems, the midwife proceeded with the induction; delivery was complicated by shoulder dystocia. With no obstetrician available, the midwife performed the McRoberts and Wood’s maneuvers. The infant was born with Erb palsy and loss of function in her left arm.
The plaintiffs sued the scheduled obstetrician, claiming he did not arrange for adequate coverage. They also named the midwife, alleging she failed to ensure an obstetrician was present for delivery and that she used excessive force in attempting to dislodge the child’s shoulder.
- The jury awarded the plaintiffs $3.09 million.
By 37 weeks’ gestation, a woman who experienced shoulder dystocia and macrosomia with her first pregnancy had a 56-pound weight gain and an estimated fetal weight of greater than 8 pounds. Despite a request for cesarean delivery, she was scheduled for labor induction at 38 weeks.
Due to the complications with her first child, both a midwife and obstetrician were slated to be present for the delivery. At the time of the scheduled induction, however, the physician was investigating psychiatric care for his wife, and asked another obstetrician to cover. That physician, however, was available only for portions of the day in question. None of these changes were communicated to the mother.
Despite an awareness of the Ob scheduling problems, the midwife proceeded with the induction; delivery was complicated by shoulder dystocia. With no obstetrician available, the midwife performed the McRoberts and Wood’s maneuvers. The infant was born with Erb palsy and loss of function in her left arm.
The plaintiffs sued the scheduled obstetrician, claiming he did not arrange for adequate coverage. They also named the midwife, alleging she failed to ensure an obstetrician was present for delivery and that she used excessive force in attempting to dislodge the child’s shoulder.
- The jury awarded the plaintiffs $3.09 million.
By 37 weeks’ gestation, a woman who experienced shoulder dystocia and macrosomia with her first pregnancy had a 56-pound weight gain and an estimated fetal weight of greater than 8 pounds. Despite a request for cesarean delivery, she was scheduled for labor induction at 38 weeks.
Due to the complications with her first child, both a midwife and obstetrician were slated to be present for the delivery. At the time of the scheduled induction, however, the physician was investigating psychiatric care for his wife, and asked another obstetrician to cover. That physician, however, was available only for portions of the day in question. None of these changes were communicated to the mother.
Despite an awareness of the Ob scheduling problems, the midwife proceeded with the induction; delivery was complicated by shoulder dystocia. With no obstetrician available, the midwife performed the McRoberts and Wood’s maneuvers. The infant was born with Erb palsy and loss of function in her left arm.
The plaintiffs sued the scheduled obstetrician, claiming he did not arrange for adequate coverage. They also named the midwife, alleging she failed to ensure an obstetrician was present for delivery and that she used excessive force in attempting to dislodge the child’s shoulder.
- The jury awarded the plaintiffs $3.09 million.
Nurses question FHR tracing
<court>Hennepin County (Minn) District Court</court>
A 26-year-old woman at term presented to a hospital with ruptured membranes and clear amniotic fluid. The physician ordered oxytocin, but over the next 5 hours nurses twice halted its administration and contacted the obstetrician due to concerns regarding the fetal heart rate (FHR) tracing. Both times, oxytocin was resumed.
The physician reviewed the fetal monitoring strips after the second cessation, but when nurses called again approximately 1 hour later, opted not to review the strips and instructed the nursing staff to proceed as planned.
A vaginal exam 1 hour later revealed meconium, and fetal monitoring showed a 3-minute deceleration with a fetal heart rate in the 50s. The defendant ordered amnioinfusion and, following evidence of late variables, placed a scalp electrode.
Half an hour later the mother was fully dilated and began pushing, but dystocia was encountered, leading to 3 unsuccessful vacuum extraction attempts. Delivery was switched to cesarean. The child—born with Apgar scores of 1, 4, and 4—was diagnosed with hypoxic ischemic encephalopathy and is now in a vegetative state.
In suing, the plaintiff argued the physician should have halted oxytocin administration and delivered the child sooner.
The defendant claimed the child’s injuries stemmed from a sudden event immediately before delivery that could be neither predicted nor avoided.
- The case settled for $3.2 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). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.
<court>Hennepin County (Minn) District Court</court>
A 26-year-old woman at term presented to a hospital with ruptured membranes and clear amniotic fluid. The physician ordered oxytocin, but over the next 5 hours nurses twice halted its administration and contacted the obstetrician due to concerns regarding the fetal heart rate (FHR) tracing. Both times, oxytocin was resumed.
The physician reviewed the fetal monitoring strips after the second cessation, but when nurses called again approximately 1 hour later, opted not to review the strips and instructed the nursing staff to proceed as planned.
A vaginal exam 1 hour later revealed meconium, and fetal monitoring showed a 3-minute deceleration with a fetal heart rate in the 50s. The defendant ordered amnioinfusion and, following evidence of late variables, placed a scalp electrode.
Half an hour later the mother was fully dilated and began pushing, but dystocia was encountered, leading to 3 unsuccessful vacuum extraction attempts. Delivery was switched to cesarean. The child—born with Apgar scores of 1, 4, and 4—was diagnosed with hypoxic ischemic encephalopathy and is now in a vegetative state.
In suing, the plaintiff argued the physician should have halted oxytocin administration and delivered the child sooner.
The defendant claimed the child’s injuries stemmed from a sudden event immediately before delivery that could be neither predicted nor avoided.
- The case settled for $3.2 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). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.
<court>Hennepin County (Minn) District Court</court>
A 26-year-old woman at term presented to a hospital with ruptured membranes and clear amniotic fluid. The physician ordered oxytocin, but over the next 5 hours nurses twice halted its administration and contacted the obstetrician due to concerns regarding the fetal heart rate (FHR) tracing. Both times, oxytocin was resumed.
The physician reviewed the fetal monitoring strips after the second cessation, but when nurses called again approximately 1 hour later, opted not to review the strips and instructed the nursing staff to proceed as planned.
A vaginal exam 1 hour later revealed meconium, and fetal monitoring showed a 3-minute deceleration with a fetal heart rate in the 50s. The defendant ordered amnioinfusion and, following evidence of late variables, placed a scalp electrode.
Half an hour later the mother was fully dilated and began pushing, but dystocia was encountered, leading to 3 unsuccessful vacuum extraction attempts. Delivery was switched to cesarean. The child—born with Apgar scores of 1, 4, and 4—was diagnosed with hypoxic ischemic encephalopathy and is now in a vegetative state.
In suing, the plaintiff argued the physician should have halted oxytocin administration and delivered the child sooner.
The defendant claimed the child’s injuries stemmed from a sudden event immediately before delivery that could be neither predicted nor avoided.
- The case settled for $3.2 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). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.