PHYSICIAN’S DEFENSE The ultrasonic scalpel had a product defect that caused the lower blade to dislodge. The application of pressure wasn’t a factor; the 6-hour procedure had caused the robotic arm to overheat, weakening the metal and causing the blade to separate. Dr. A followed appropriate procedures when searching for the blade. The perforation did not occur until 3 days after surgery; it was diagnosed and treated in a timely manner. The removal of adhesions from the sigmoid colon weakened the bowel wall, leading to the perforation; this was a known risk of the procedure.
VERDICT A California defense verdict was reached.
Stroke during in vitro fertilization
DURING IN VITRO FERTILIZATION, a woman suffered a stroke to the right side of her brain, which initially paralyzed the left side of her body. She partially regained movement, but walks with a limp and has diminished dexterity in her right hand and diminished strength.
PATIENT’S CLAIM The ObGyn ignored warning signs of ovarian hyperstimulation syndrome (OHSS), and continued therapy. OHSS caused enlargement of the ovaries and leakage of fluid from the patient’s blood vessels into her abdomen. This leakage increased the viscosity of her blood, and enhanced the danger of blood clots. The ObGyn administered intravenous fluids, but did not prescribe an anticoagulant.
PHYSICIAN’S DEFENSE Stroke is a known complication of the surgery.
VERDICT A $1.5 million Virginia verdict was returned.
Umbilical cord in cervix; premature delivery
A WOMAN HAD AN ABNORMAL PAP smear during pregnancy. She was sent to a university hospital and placed on bed rest due to cervical incompetence. Tests indicated that the fetus was healthy. A month later, the baby was born 3 months’ premature. He weighed less than 2 lb at birth, and had brain damage and cerebral palsy.
PATIENT’S CLAIM A sonogram performed on the morning of the delivery showed the umbilical cord in the cervix and a low amniotic fluid level. An emergency cesarean delivery should have been performed. Delivery did not occur for another 12 hours; this delay caused oxygen deprivation and brain damage.
DEFENDANTS’ DEFENSE The hospital and physicians denied negligence.
VERDICT A $4,100,000 Maryland defense verdict was returned, but was reduced by the statutory cap on noneconomic damages to a net verdict of $3,605,000.
No ObGyn available for emergency cesarean
A WOMAN IN LABOR went to a hospital. When the fetal heart monitor indicated abnormalities, the only ObGyn on duty was busy in a scheduled elective procedure. The on-call resident was assisting with another surgery. After attempting to find another physician, the labor and delivery nurse waited 40 minutes before she put out a code that delivery was imminent. The resident then delivered the child, who was limp and discolored at birth. The child suffered physical and mental impairment, is confined to a wheelchair, and is unable to speak or to care for herself.
PATIENT’S CLAIM An ObGyn should have been available to perform emergency cesarean delivery. The resident was not skilled enough to attempt a high-risk birth. The nurse should not have waited so long to find a physician.
PHYSICIAN’S DEFENSE This is a teaching hospital; the resident was trained to perform delivery. The nurse attempted to find a physician, but all were occupied elsewhere.
VERDICT A $6,015,000 New Jersey verdict was returned against the resident’s university employer ($15,000), and the hospital, ObGyn, and nurse ($6 million).
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.