“HT caused my breast cancer” … and more
PLAINTIFF’S CLAIM The radiation oncologist was negligent for recommending and administering radiotherapy because of its limited value in ESS. Hormonal therapy should have been used instead.
PHYSICIAN’S DEFENSE Radiotherapy was necessary because of the patient’s history and disease type. Morcellation during vaginal hysterectomy increased the risk of microscopic cancer cells remaining in the pelvis, supported by the finding of residual cancer cells during the second procedure. Radiotherapy was necessary to treat the residual cancer cells.
VERDICT A defense verdict was returned.
No response to alarm when fetal heart tones are lost
A WOMAN ATTEMPTED VAGINAL BIRTH after having one vaginal birth and one cesarean delivery in the past. Labor progressed slowly with inadequate contractions and lack of descent. After the mother pushed five or six times without progress, the OB left to deliver another baby. Because of lack of progression, the mother requested cesarean delivery, and the husband conveyed their concerns to the nursing staff. The nurses assured them that all was well but did not discuss the parents’ concerns with the OB or other hospital personnel. One hour later, the mother’s uterus ruptured, fetal heart tones were lost from the external fetal monitor, and an alarm sounded.
PLAINTIFF’S CLAIM The nursing staff failed to respond to the alarm immediately; when a response did come, a nurse allegedly stated with excitement that she was amazed that no one had responded. This statement was confirmed by the OB. After 9 minutes of signal loss, a fetal heartbeat of 60 was found, but it was severely bradycardic. The mother was rushed to the OR and the baby was delivered expeditiously. The child was born limp and without respiratory effort, and sustained hypoxic ischemic encephalopathy. At age 5, he had no purposeful movement of his extremities, could not communicate, and was wheelchair-bound, although he was not cognitively impaired.
DEFENDANTS’ DEFENSE The OB offered full policy limits before trial. The hospital claimed that the 9-minute delay in detecting the loss of fetal heart tone and seeking the OB’s intervention was not the proximate cause of the child’s handicaps.
VERDICT A $4.9 million Michigan verdict was reached.
Untreated postpartum infection necessitated hysterectomy
AN 18-YEAR-OLD WOMAN was discharged from the hospital two days after the vaginal birth of her healthy child, although she claimed to not feel well. When a hospital-employed nurse visited her the next day, the patient reported abdominal pain and cramping. Five days later, she returned to the hospital in extreme pain. She was diagnosed with severe Streptococcus A infection, air-lifted to another hospital, and treated with antibiotics for 5 days. A hysterectomy was later performed.
PLAINTIFF’S CLAIM The physician, visiting nurse, and hospital failed to diagnose and treat the infection in a timely manner, resulting in a hysterectomy. Laboratory tests taken before the patient’s hospital discharge showed an elevated white blood cell (WBC) count; the patient should have been prescribed antibiotics before leaving the hospital. The visiting nurse did not react appropriately when the patient reported pain. The hospital was responsible because the results of the WBC test were not entered into the patient’s chart.
DEFENDANTS’ DEFENSE The physician claimed that the elevated WBC count was not recorded in the patient’s medical chart with other lab values. The hospital claimed that a high WBC count is common after childbirth; the test is rarely performed at that time. The only reason it was performed was that the technology automatically recorded WBC when it evaluated hemoglobin and hemocrit. Abdominal cramping reported to the visiting nurse is normal 3 days after childbirth. The patient did not have an infection at discharge or at the time of the nurse’s visit.
VERDICT Suit against the physician was dismissed prior to jury deliberations. A $2.3 million verdict was returned against the hospital.
Did retained sponges lead to PID and gallbladder disease?
A 6-INCH VAGINAL LACERATION was discovered after a woman delivered a healthy baby. The ObGyn, who was covering for the patient’s regular ObGyn because of a snowstorm, could not repair the laceration in the delivery room. He packed the patient’s vagina with gauze sponges, and took her to the OR where he repaired the laceration. The next day, he removed sponges placed after surgery. The patient was discharged with instructions to follow-up with her regular ObGyn. Eight days after delivery, the patient complained to her ObGyn of severe abdominal pain and a foul odor. Antibiotics were prescribed, but she refused a vaginal examination because of the pain. Six weeks after delivery, four gauze sponges were removed from the patient’s vagina.
