Medical Verdicts

Patient’s claim The physician failed to visualize the ureter during the surgery and was negligent in placing a staple in it, thus causing the injury.

Doctor’s defense He had visualized the ureter and properly placed the staples. The stricture was due to scar tissue.

Verdict Three Virginia trials resulted in a hung jury, a mistrial, and finally a defense verdict.

Bladder injury during tubal ligation

A 25-year-old woman pregnant with her first child made plans with a family physician to undergo a tubal ligation the day after delivery. During the procedure, performed under general anesthesia, the woman’s bladder was lacerated and a sudden gush of fluid contaminated the surgical site. A urologist was called immediately and repaired the damage successfully. After 2 days, the patient was discharged, but she returned 5 hours later with intense abdominal pain, the result of a ruptured bladder. Another repair was followed by further complications and more hospital visits.

Patient’s claim Because of a lack of bladder control, she requires ongoing treatment, including the use of catheters to drain her bladder.

Doctor’s defense A lacerated bladder is a known complication of tubal ligation. Because the patient did not urinate before the surgery as he instructed her, the bladder was distended and discharged an unexpected gush of fluid when it was lacerated. Her ongoing problems, however, are not a result of the laceration or repair.

Verdict Indiana defense verdict.

Sex impossible after too much surgery?

A 52-year-old woman underwent a hysterectomy, bladder neck suspension to repair a cystocele, and implantation of a synthetic suburethral sling, all performed by an ObGyn. Following surgery, the patient suffered erosion of the sling into the vagina, causing a chronic infection with discharge and pain. After undergoing further procedures, including debridement and resection of the vagina, she has vaginal scar tissue, muscle myalgia, chronic vaginal pain or irritation and discharge, and the loss of her vagina due to scarring and foreshortening. She and her husband can no longer have sexual intercourse.

Patient’s claim The sling procedure was unnecessary. Also the physician mishandled the postoperative complications resulting from the sling, and he did not refer her to a specialist in a timely manner.

Doctor’s defense The patient had complained of stress urinary incontinence, and the sling procedure was indicated because of a hypermobile urethra. Also the complications were handled properly.

Verdict $5 million Illinois verdict, including $1 million for the woman’s husband for loss of consortium.

IUD in place while pregnant with twins

A month after giving birth to her first child, a 19-year-old woman underwent a Pap smear and had an IUD inserted for birth control. After reviewing the Pap results, the physician asked the patient to return for a cervical biopsy. During the colposcopy, the physician removed the IUD because it was partially expelled from her cervix. A week later he inserted a new IUD, but neither he nor the patient knew she was 2 weeks pregnant. When she suffered severe bleeding and cramping 2 months later, a pregnancy test indicated she was pregnant, and a sonogram revealed twins with the IUD in place. The string was not visible, so the IUD could not be removed. The patient was put on bed rest to avoid a threatened miscarriage. At a second facility, it was confirmed that the IUD could not be removed. The patient was diagnosed with an incompetent cervix and, following placement of a cervical cerclage, was told to remain on rest. Within a month, she miscarried.

Patient’s claim The physician was negligent for inserting an IUD without determining if she was pregnant, and the IUD caused the miscarriage.

Doctor’s defense A pregnancy test prior to insertion of an IUD is not the standard of care, especially when the patient reports regular periods. Also, the miscarriage was not related to the IUD.

Verdict Missouri defense verdict.

Was mother’s brain damage avoidable?

A 27-year-old pregnant woman at full term presented at the hospital for labor augmentation. Her OB was Dr. A. Dr. B, the anesthesiologist, was called a few hours later to place an epidural. Later, the patient began vomiting and experiencing seizures and became unresponsive. Neither Dr. A nor Dr. B was present. Fetal bradycardia was diagnosed and an emergency cesarean section was performed. During the delivery, the mother experienced cardiac arrest, uterine atony, and disseminated intravascular coagulation. She was resuscitated, but suffered severe brain damage. She must use a wheelchair because of cognitive and neurological impairments.

Patient’s claim Three things should have been done: earlier cesarean section, suctioning after the vomiting, and intubation.