Medicolegal Issues

Failure to convert to laparotomy: $6.25M settlement

Notable judgements and settlements

Additional Medical Verdicts
• Circumcision requires revision
• Mother with CP has child with CP
• Fallopian tubes grow back, pregnancy
• Challenges in managing labor
• Brachial plexus injury during delivery
• HPV-positive Pap tests results never reported


Failure to convert to laparotomy: $6.25M settlement

A 67-year-old woman with urinary incontinence underwent robot-assisted laparoscopic prolapse surgery and hysterectomy. Complications arose, including an injury to the transverse colon. Postoperatively, the patient developed sepsis and had multiple surgeries. At the time of trial, she used a colostomy bag and had a malabsorption syndrome that required frequent intravenous treatment for dehydration.

Patient's claim:

The gynecologist deviated from the standard of care by failing to convert from a laparoscopic procedure to an open procedure when complications developed.

Defendants' defense:

The procedure was properly performed.


A $6.25 million New Jersey settlement was reached, paid jointly by the gynecologist and the medical center.

Circumcision requires revision

A day after birth, a baby underwent circumcision performed by the mother’s ObGyn. Revision surgery was performed 2.5 years later. When the boy was age 7 years, urethral stricture developed and was treated.

Parents' claim:

Circumcision was improperly performed. Once the child was able to talk, he said that his penis constantly hurt. Pain was only relieved by revision surgery.

Physician's defense:

There was no negligence. Redundant foreskin is often left following a circumcision.


A Michigan defense verdict was returned.

Mother with CP has child with CP
A pregnant woman with cerebral palsy (CP) reported a prior preterm delivery at 24 weeks’ gestation to a high-risk prenatal clinic. At that time, she was offered synthetic progesterone (170HP) injections, but she declined because of the cost. She declined 170HP several times. Nine weeks after her initial visit, she declined 170HP despite ultrasonography (US) showing a shortened cervical length (25 mm) for the gestational age. In 2 weeks, when the cervical length measured 9 mm, she was hospitalized to rule out preterm labor but, before tests began, she left the hospital. Five days later, when her cervical length was 11 mm, she received the first 170HP injection. In the next month she received 4 injections, but she failed to show for the fifth injection and US. The next day, she went to the hospital with cramping. She was given steroids and medication to stop labor. US results indicated that the baby was in breech position. The mother consented to cesarean delivery, but the baby was born vaginally an hour later. The child has mild brain damage, CP, developmental delays, and learning disabilities.

Parents' claim: The mother should have been offered vaginal progesterone, which is cheaper. Given the high risk of preterm birth, steroids administered earlier would have improved fetal development. Cesarean delivery should have been performed.

Defendants' defense: Vaginal progesterone was not available at the time. Starting steroids earlier would not have improved fetal outcome. A cesarean delivery was not possible because the baby was in the birth canal.

Verdict: A $3,500,000 Michigan settlement was reached.

Fallopian tubes grow back, pregnancy

A couple decided they did not want more children and sought counseling from the woman’s ObGyn, who recommended laparoscopic tubal ligation. Several months after surgery, the patient became pregnant and gave birth to a son.

Parents' claim:

The additional child placed an economic hardship on the family, now raising 4 children. The youngest child has language delays and learning disabilities.

Physician's defense:

Regrowth of the fallopian tubes resulting in unwanted pregnancy is a known complication of tubal ligation.


A $397,000 Maryland verdict was returned, including funds for the cost of raising the fourth child and to cope with the child’s special needs.


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