Medical Verdicts

Cesarean declined, stillbirth follows


 

Undisclosed venue (Va)

Two weeks past her due date and 12 hours before a scheduled induction, a woman with a prior cesarean presented to a hospital reporting decreased fetal movement.

On fetal monitoring, the child’s heart rate was nonreactive with decreased variability. When examination showed the woman’s cervix was closed, the obstetrician offered a cesarean section. The woman refused, opting for a trial of labor. A cervical ripening agent was administered via suppository.

When, 5 hours later, fetal monitoring showed 2 late decelerations but the cervix remained undilated, the physician once again offered a cesarean. The woman again declined.

An epidural was administered 2.5 hours later, after which the child’s heart rate dropped sharply. Sonography soon after revealed no fetal heart rate. An emergency cesarean was performed, but the child was stillborn.

The woman sued, claiming a cesarean should have been performed after the first signs of fetal distress. Had delivery occurred any time prior to the 2 late decelerations, she alleged, the child would have been born alive.

The defendant noted that the woman twice declined a cesarean section.

  • The case settled for $375,000.
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.

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