OB blames disability on mother’s language
A woman diagnosed with group B strep at 32 weeks’ gestation had spontaneous rupture of membranes at 36 to 37 weeks and developed a fever during labor and delivery. Several hours into labor, severe variable decelerations were noted and the infant was delivered by cesarean section. Within hours, the infant developed sepsis. The child survived, but suffers from learning disabilities.
PATIENT’S CLAIM The mother should have been given antibiotics before labor.
DOCTOR’S DEFENSE The physicians never received the lab report showing the test result. The child’s learning disability was not caused by any birth event, but by the mother’s use of her native Farsi at home.
VERDICT After mediation, the parties reached a $962,000 settlement.
Did doctors miss signs of chorioamnionitis?
A 30-year-old woman presented to the emergency room at 25 weeks’ gestation, complaining of abdominal pain. After examining her, doctors decided hospitalization was unnecessary. Nine days later, she returned to the hospital and reported vomiting and vaginal spotting. Immediate cesarean section was performed. The child was later diagnosed with mental and physical disabilities, including developmental delays and spastic quadriplegia.
PATIENT’S CLAIM The disabilities and premature birth were caused by an undiagnosed antepartum infection, and the chorioamnionitis should have been detected at the first emergency room visit. Prompt diagnosis and treatment would have prevented the adverse outcome.
DOCTOR’S DEFENSE The child’s injuries were unavoidable.
VERDICT $1.2 million settlement.
“Postop gas, constipation led to divorce”
A 34-year-old woman underwent laparoscopic tubal ligation. After the surgery, she developed a hernia, which was repaired via laparotomy.
PATIENT’S CLAIM The original surgery caused chronic constipation and gas and contributed to the patient’s divorce. The physician caused the hernia by failing to stitch the fascia closed.
DOCTOR’S DEFENSE It was not necessary to suture the fascia closed. The hernia occurred through an adhesion and below the fascia, so a stitch would not have prevented it. The patient’s marriage was in peril before the tubal ligation was performed.
VERDICT Defense verdict.
Missed tubo-ovarian abscess leads to death
A 42-year-old woman with anemia and complaints of generalized abdominal pain and heavy bleeding was referred to an ObGyn, who performed an endometrial biopsy and concluded that her pain and bleeding were caused by fibroids. A hysterectomy was scheduled, and pain medication was prescribed. When ultrasound imaging revealed a cyst, more pain medicine was prescribed, and the date for the hysterectomy was moved up. Blood tests showed extremely elevated white blood cell levels, indicative of infection, but the doctor did not receive results for several days.
The day after the patient visited the ObGyn, she collapsed at home and was taken to a hospital, where she died a few hours later. An autopsy revealed the death was due to sepsis from a right tubo-ovarian abscess. No fibroids were present.
PATIENT’S CLAIM The ObGyn was negligent in failing to examine the patient the day before her death, despite her report of severe pain. Furthermore, the physician caused the tubo-ovarian abscess at the time of the endometrial biopsy.
DOCTOR’S DEFENSE The diagnoses of uterine fibroids, possible ovarian cyst, and urinary tract infection explained all the patient’s symptoms, none of which were consistent with tubo-ovarian abscess.
VERDICT The jury ruled for the defense.
$12 million verdict despite counseling
A woman delivered an infant with spina bifida, who requires lifelong treatment.
PATIENT’S CLAIM The mother was not informed of the need for alpha-fetoprotein testing to detect neural tube defects and Down’s syndrome, and a nurse telephoned her to say the test was unnecessary because the woman was not at risk. As a result, the parents were denied the opportunity to have the pregnancy terminated.
DOCTOR’S DEFENSE The practice group’s records noted that test information was provided during a visit the previous year. The child’s problems were genetic and could not have been avoided.
VERDICT $12 million verdict.
5 operations needed after prolapse repair
A 51-year-old woman suffering from vaginal prolapse underwent pelvic reconstruction in January and continued under the surgeon’s care until May, when she was advised to return to the referring ObGyn. In June, she was found to have grossly distorted vaginal anatomy and infection, necessitating 5 additional operations.
PATIENT’S CLAIM The surgeon was negligent, failed to obtain informed consent, misrepresented the success rate of the procedure, and concealed the true condition of the vagina at the time of discharge. In addition, a mesh used to reinforce the anterior, apical, and posterior compartments of the vagina became infected, causing the distortion. The patient should have been treated with intravenous antibiotics and/or removal of the mesh.