Medicolegal Issues

Failure to find breast cancer; later diagnosed at Stage 3

Notable judgements and settlements


Failure to find breast cancer; later diagnosed at Stage 3
A 34-year-old woman with a history of breast cancer was referred to a breast surgeon after her primary care physician detected a lump in her left breast. The breast surgeon found the lump and ordered mammography and ultrasonography. The radiologist who read both tests found no evidence of malignancy.

After 6 months, the patient noticed a distinct change in the lump and had another mammography and ultrasound. A second radiologist also found no sign of malignancy.

One year later, the patient was sent for bilateral breast magnetic resonance imaging. Results were interpreted as Stage 3 cancer at the same spot in her left breast. She underwent a double mastectomy, reconstructive surgery, radiation, chemotherapy, and hormone therapy.

Patient’s claim The delay caused the cancer to develop to Stage 3 instead of being detected earlier when less drastic measures could have been taken.

Defendant’s defense A settlement was reached with the radiologists.

Verdict A $450,000 Massachusetts settlement was reached.

Fetal heart rate not properly monitored
A 14-year-old mother was given misoprostol to induce labor. The infant has spastic quadriplegia and cannot stand, walk, or eat without assistance.

Parents’ claim Misoprostol caused increasingly frequent contractions resulting in reduced blood flow to the baby. Although the fetal heart rate dropped to critically low levels, no counteracting drugs were administered. The attending physician was not present in the delivery room at several key junctures of labor and delivery.

Hospital’s defense The case was settled before the trial began.

Verdict A $3 million North Carolina settlement was reached.

Emergency cesarean performed too late: infant stillborn
A mother agreed to attempt vaginal birth after cesarean (VBAC) under the care of her ObGyn. When she arrived at the hospital, electronic fetal heart-rate monitoring was started.

As labor progressed, signs of fetal distress became apparent on monitor tracings. An hour after fetal distress was first noted, the ObGyn reviewed the monitor tracings from offsite and advised the patient to stop pushing.

About an hour later, nurses notified the ObGyn that monitor tracings were irregular; the ObGyn gave orders for the mother to start pushing again.

After an hour of pushing, the fetal heart rate increased and the ObGyn gave orders for the mother to stop pushing. He came to the hospital and performed emergency cesarean delivery. The infant was stillborn; attempts at resuscitation were unsuccessful.

Parents’ claim The ObGyn should have been at the mother’s bedside to more closely monitor the fetal heart rate. If he had ordered the cesarean delivery earlier, the baby would have survived.

Physician’s defense There was no negligence; proper review of monitor tracings was undertaken. The nurses frequently communicated with the ObGyn and a cesarean delivery was appropriately initiated.

Verdict A $1.5 million Virginia verdict was returned.

Ureter injury during vaginal hysterectomy missed for 8 days
A woman underwent total vaginal hysterectomy performed by her gynecologist. During the procedure, the left ureter was injured. The injury was not diagnosed for 8 days and, during that time, the patient was in intense pain. Eventually the injury was diagnosed and reconstructive surgery was performed by a urologist.

Patient’s claim The gynecologist was negligent in injuring the ureter during hysterectomy, in not identifying the injury during surgery, and in not diagnosing the injury in a timely manner, despite the patient’s reports of intense pain.

Physician’s defense The case was settled during the trial.

Verdict A $350,000 Virginia settlement was reached.

These cases were selected by the editors of 
OBG Management from Medical Malpractice Verdicts, Settlements, & Experts, with permission of the editor, Lewis Laska ( 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.
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