During her second pregnancy, a 37-year-old woman saw Dr. A, her ObGyn, for regular prenatal care. At 37 weeks’ gestation, the fundal height was not consistent with the fetus’ gestational age: the measurement was higher by 2 cm. No additional testing was scheduled.
At 39.5 weeks’ gestation, the mother reported decreased fetal movement. Because her regular ObGyn was on vacation, she was evaluated by another ObGyn (Dr. B). The fetal heart-rate monitor showed nonreactive results with minimal variability. Dr. B told the mother to drive herself to the emergency department (ED) for additional evaluation. At the hospital, when fetal heart-rate monitoring confirmed fetal distress, an emergency cesarean delivery was performed.
At birth, the baby was not breathing and resuscitation began. The infant was taken to a transitional care unit and then to the NICU, where he was intubated. Cord blood testing confirmed metabolic acidosis. The baby was later found to have dystonic cerebral palsy (CP). He is unable to speak, walk, eat, or care for himself, and he requires 24/7 nursing care.
Dr. A failed to order testing after the fundal height discrepancy was found. Testing could have led to an earlier delivery and avoided the injury. The pediatrician failed to ensure adequate oxygenation after delivery. The baby should have been transferred immediately to the NICU and intubated.
The fundal height discrepancy was explained by the baby’s position within the uterus. The pediatrician acted heroically to save the child’s life.
A $3.5 million Massachusetts settlement was reached.
At 13 weeks’ gestation, a 38-year-old woman saw a maternal-fetal medicine (MFM) specialist, who interpreted a nuchal translucency (NT) scan as normal. At 20 weeks’ gestation, an ObGyn performed a second screening that indicated the fetus was at high risk for Down syndrome. However, no further testing was ordered.
At 26.5 weeks’ gestation, amniocentesis was performed after ultrasonography and an echocardiogram revealed fetal abnormalities. A diagnosis of Down syndrome was made at 29 weeks’ gestation, too late for termination of pregnancy.
The MFM specialist misread the first NT scan. The ObGyn did not inform the mother of the results of the second screening. Proper interpretation and reporting would have initiated further testing and determination that the baby had Down syndrome before the deadline for termination of pregnancy.
The case was settled during trial.
A $3 million New Jersey settlement was reached, including $2 million from the medical center where the second test was performed, $940,000 from the ObGyn, and $60,000 from the MFM specialist.
At 38 weeks’ gestation, a mother was admitted to a hospital for induction of labor due to pregnancy-induced hypertension. The fetus was estimated to be large for its gestational age. A uterine rupture occurred during labor. The baby was stillborn.
The uterine rupture was not immediately recognized. The ObGyn failed to come to the mother’s bedside until after the fetus had receded up the birth canal, which indicated that a rupture was occurring. The ObGyn ordered oxytocin instead of performing an immediate cesarean delivery. Eleven minutes later, the cesarean was ordered, but the baby had died.
There was no negligence; proper protocols were followed. A uterine rupture cannot be predicted.
A $650,000 settlement was reached with the hospital before trial. Because the ObGyn was employed by a federally qualified clinic, the matter was filed in federal court. The Illinois court issued a bench decision awarding $1.5 million.
In september 2006, an ObGyn inserted an intrauterine device (IUD) in a patient. In February 2007, the patient had an ectopic pregnancy. The IUD was not found during dilation and curettage. The patient continued to report pain to the ObGyn. She sought treatment from another physician in November 2010 due to continuing pain. A CT scan revealed that the IUD had migrated to her abdomen. The IUD was surgically removed.
The ObGyn was unwilling to figure out why the patient had continuing pain, and told her to “just deal with it.” He should have found and removed the IUD after the ectopic pregnancy.
It was reasonable to assume that the IUD had been expelled, as 2 ultrasonographies performed after ectopic pregnancy revealed nothing. Since the IUD had not caused an abscess, infection, or inflammation, the patient suffered no injury.
A Virginia defense verdict was returned.
