Medical Verdicts

Conflicting accounts muddle case questioning placement of cerclage


Kings County (Ny) Supreme Court—On May 3, a gravida at 23 weeks’ gestation presented to a hospital clinic for a routine prenatal visit, at which time the obstetrician did not perform an internal exam. She presented again 8 days later, when it was determined that her cervix had dilated 2 cm and her membranes were bulging. Following admission, she was confined to bed and scheduled for the placement of a cerclage for an incompetent cervix. However, the procedure was delayed for 5 days, and on May 16, the woman vaginally delivered an infant, who subsequently suffers from spastic quadriplegia, blindness, and delayed mental development.

In suing, the mother claimed that the infant’s brain damage was the result of the obstetrician’s failure to place a cervical cerclage, which would have prevented preterm labor and delivery. She also asserted that there was no electronic fetal monitoring during labor; had there been, fetal distress would have been detected, allowing for a timely cesarean delivery to prevent hypoxia. Furthermore, the patient contended that an internal exam should have been performed during her visit on May 3, that a pediatrician should have been present during delivery, and that the physician didn’t intubate the infant in a timely manner. However, she did concede that most of the baby’s problems were due to his prematurity.

The defendant denied that the gravida presented to the hospital clinic on May 3. Citing the woman’s subsequent delivery of another healthy child, the physician argued that she didn’t have an incompetent cervix. Rather, the chorioamnionitis caused the preterm labor. He testified that a pediatrician was present at delivery.

The jury returned a defense verdict.

The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts. While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.

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