Medicolegal Issues

Signs of chorioamnionitis ignored? $3.5M settlement

Notable judgments and settlements

In this Article

  • Surgical approach questioned
  • Macrosomic baby and mother both injured during delivery
  • Surgical table folds during hysterectomy: $5.3M verdict


 

Signs of chorioamnionitis ignored? $3.5M settlement
At 31 weeks’ gestation, a mother at risk for preterm labor was admitted to the hospital for 2 days. Examination and test results showed evidence of infection. She was given antenatal corticosteroids for fetal lung development in case of premature delivery. At discharge, bed rest was ordered and she complied. At 32 weeks’ gestation, she returned to the hospital with worsening symptoms, was prescribed antibiotics to treat a urinary tract infection, and was discharged. She went to the hospital a third time at almost 33 weeks’ gestation, experiencing contractions and leaking fluid. She was admitted with a plan to deliver the baby if any signs or symptoms of intra-amniotic infection (clinical chorioamnionitis) were present. Four days later, a cesarean delivery was ordered due to fetal tachycardia and decreased fetal heart rate. Imaging results performed in the neonatal intensive care unit showed that the baby received a brain injury. The child has physical and mental impairments including cerebral palsy, cortical blindness, and epilepsy.

Parents’ claim Hospital health care providers failed to communicate with each other or to obtain records from prior admissions, although the mother told them that she had been to the hospital twice within the past 2 weeks. Medical records from all 3 admissions showed clear signs and symptoms of a vaginal/cervical infection that had progressed to clinical chorioamnionitis 2 days before delivery. Examination of the placenta by a pathologist confirmed that the infection had spread to the umbilical cord, injuring the child.

Defendant’s defense The standard of care was met. There was no indication that an earlier delivery was needed.

Verdict A $3.5 million Michigan settlement was reached by the hospital during the trial.

Surgical approach questioned
A woman went to her ObGyn for tubal ligation and ventral hernia repair. The patient was concerned about infection and scarring. She agreed to a laparoscopic procedure, knowing that the procedure might have to be altered to laparotomy.

Patient’s claim The patient consented to laparoscopic surgery. However, surgery did not begin as laparoscopy but as an open procedure. The patient has a 6-inch scar on her abdomen. She accused both the ObGyn and the hospital of lack of informed consent for laparotomy.

Defendant’s defense The hospital claimed that their nurses’ role was to read the consent form signed by the patient in the ObGyn’s office. The ObGyn claimed that the patient signed a general consent form that permitted him to do what was reasonable. He had determined after surgery began that a laparoscopic procedure would have been more dangerous.

Verdict A $150,000 Louisiana verdict was returned against the ObGyn; the hospital was acquitted.

Macrosomic baby and mother both injured during delivery
Delivery of a mother’s fourth child was managed by a hospital-employed family physician (FP). Shoulder dystocia was encountered, and the FP made a 4th-degree extension of the episiotomy. The baby weighed 10 lb 14 oz at birth. The mother has fecal and urinary incontinence and pain as a result of the large episiotomy. The child has a right-sided brachial plexus injury.

Parents’ claim Failure to perform cesarean delivery caused injury to the mother and child. The FP should have recognized from the mother’s history of delivering 3 macrosomic babies and the progress of this pregnancy, that the baby was large.

Defendant’s defense The case was settled during trial.

Verdict A $1.5 million Minnesota settlement was reached that included $1.2 million for the child and $300,000 for the mother.

Surgical table folds during hysterectomy: $5.3M verdict
While a woman was undergoing a hysterectomy, the surgical table she was lying on folded up into a “U” position, causing the inserted speculum to tear the patient from vagina to rectum. The fall also caused a back injury usually attributed to falls from great distances. The patient has permanent pain, recurring diarrhea, and depression as a result of the injuries.

Patient’s claim The injuries occurred because of the defendants’ failure to read, understand, and follow the warning labels on the surgical table.

Defendant’s defense The case was settled before trial.

Verdict A $5.3 million settlement was reached with the hospital.

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.

Share your thoughts! Send your Letter to the Editor to rbarbieri@frontlinemedcom.com. Please include your name and the city and state in which you practice.

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