Clinical Review
Optimal obstetric care for women aged 40 and older
As the trend toward delayed childbearing continues, ObGyns will encounter more pregnancies among patients of advanced maternal age. Here, a guide...
Estate’s claim The hospital staff was negligent for failing to inform the patient of the signs and symptoms of continuing preeclampsia and for not prescribing antihypertensive medication at discharge. Her follow-up appointment should have been scheduled for 1 week.
Defendant’s defense The patient was given oral instructions regarding postpartum preeclampsia. The case was settled during trial.
Verdict A $50,000 North Carolina settlement was reached.
Was delivery properly managed?
When a 16-year-old woman was found to have preeclampsia, she was admitted and labor was induced using oxytocin. An external fetal heart-rate monitor was placed.
Three hours later, her ObGyn took over her care from the attending physician. He saw the patient once in the evening, then left to deliver a baby at another hospital. He maintained telephone contact with labor and delivery nurses, who told him that the mother’s labor was progressing as planned. Early the next morning, the nurse called the ObGyn to report that the mother was fully dilated and ready to deliver. The ObGyn was at the patient’s bedside within 30 minutes. After the mother pushed once, the ObGyn determined that a cesarean delivery was necessary.
After birth, the child suffered seizures in the NICU and was transferred to another facility. With CP and microcephaly, he cannot speak, is incontinent, has motor difficulties, and will require 24-hour care for life.
Parent’s claim Labor was not properly monitored. Oxytocin doses were too large and continued for too long.
Defendants’ defense The mother’s treatment was appropriate and timely. There was no negligence.
Verdict A confidential Kansas settlement was reached with another defendant during the trial. A defense verdict was returned for the ObGyn.
Evidence of CMV on ultrasonography
During her pregnancy in 2012, a woman contracted congenital cytomegalovirus (CMV), although she did not have any symptoms. The child has CP, a hearing deficiency, and other complications caused by the virus.
Parents’ claim The ObGyn failed to identify CMV, despite ultrasound evidence that the virus was affecting the fetus. Studies available at the time of the pregnancy show considerable success in treating the condition in utero with hyperimmune globulin antiviral agents.
Defendant’s defense The case was settled during trial.
Verdict A confidential Idaho settlement was reached.
These cases were selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements, & Experts, with permission of the editor, Lewis Laska (www.verdictslaska.com). The information available to the editors about the cases presented here is sometimes incomplete. 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.
Share your thoughts! Send your Letter to the Editor to rbarbieri@frontlinemedcom.com. Please include your name and the city and state in which you practice.
As the trend toward delayed childbearing continues, ObGyns will encounter more pregnancies among patients of advanced maternal age. Here, a guide...
Successful delivery of the posterior arm may require finding and firmly grasping the fetal hand, wrist, and/or distal forearm
IT’S UNCLEAR. Although the authors of this retrospective analysis claim to have found evidence that electronic fetal heart rate monitoring lowers...
…and do something instead to improve fetal status!