Medical Verdicts

PATIENT’S CLAIM The tumor was not diagnosed in a timely manner. Her complaints should have been investigated during her pregnancy or before discharge from the hospital following delivery.

DOCTOR’S DEFENSE Not reported.

VERDICT A jury awarded $7.7 million. Fault was distributed as follows: the group, 60%; physician 1, 25%; physician 2, 15%.

Urinary leakage, fistula blamed on cystotomy

A 40-year-old woman was diagnosed with uterine prolapse and underwent a vaginal hysterectomy. Dense adhesions found during surgery made the separation and removal of the cervix and uterus from the bladder difficult. An intentional cystotomy was performed and then repaired, but the patient developed a vesicovaginal fistula.

PATIENT’S CLAIM The hysterectomy was not performed properly because the cystotomy was contraindicated and resulted in a vesicovaginal fistula, and the incision for the cystotomy was not properly repaired. The patient also claimed that she suffered occasional urinary leakage during laughing, coughing, straining, and sexual activity.

DOCTOR’S DEFENSE The hysterectomy was performed properly, and the cystotomy helped prevent more serious damage to the urinary tract and bladder. The patient’s urinary leakage was due to overactive bladder, smoking, and age.

VERDICT Defense verdict.

Did the emergency excuse the retained sponge?

A 40-year-old woman underwent an emergency hysterectomy and oophorectomy, during which a surgical sponge was left in her pelvic cavity. The retained sponge, which was not diagnosed on a postoperative x-ray, was discovered when the patient was later admitted to the hospital for chest pain. The sponge and a large mass of purulent material were removed from her pelvic cavity, as was her remaining ovary due to adhesions.

PATIENT’S CLAIM The ObGyn was negligent for leaving a sponge in her pelvic cavity and then for not diagnosing it on postoperative x-ray. The defendant should have consulted the radiologist because the x-ray indicated a vague area of radiopacity. The patient also claimed early-onset menopause due to removal of the ovary.

DOCTOR’S DEFENSE The emergency circumstances of the initial surgery accounted for the retained sponge, and the radiologist never verbally informed him of the questionable x-ray finding.

VERDICT A pretrial settlement was reached with the hospital and assistant surgeon for an undisclosed amount.

Claim: Crash C-section team was tardy

A 21-year-old woman presented to the hospital after experiencing rupture of membranes, and was started on oxytocin. The OB found that labor progress and fetal monitoring strips were normal.

Five hours later, nurses noted signs of prolonged deceleration and began to prepare for an emergency cesarean section.

The anesthesiologist and OB were unavailable at that time, and it took about 34 minutes for a team to be assembled to deliver the infant.

Within 2 minutes, the child was delivered, but his Apgars were 0 at 1, 5, and 10 minutes and 1 at 15 minutes, and he suffered severe brain damage. Cord blood was not analyzed for blood gases.

PATIENT’S CLAIM The defendants were negligent for not anticipating or recognizing developing problems, which were evident as much as 1 hour before the OB’s visit and included hyperstimulation of the uterus and slow progress of labor.

DOCTOR’S DEFENSE The OB would have come in and probably delivered the child if he had been called earlier.

There was no indication of hypoxia or cause for concern until very late in the process, and the brain damage to the child was the result of an unanticipatable event that occurred 30 minutes before delivery.

VERDICT A $3.5 million present-value settlement was reached during trial.

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, Nashville, Tenn (www.verdictslaska.com). The available information about the cases is sometimes incomplete; pertinent details may be unavailable. Moreover, the cases may or may not have merit. Still, these cases represent types of clinical situations that may result in litigation and are meant to illustrate variation in verdicts and awards. Any illustrations are generic and do not represent a specific legal case.