Medical Verdicts

External sphincter muscle damage undetected during delivery


District of Columbia (DC) Superior Court

The physician performed an episiotomy on a 24-year-old gravida delivering her first baby. According to the medical record, a fourth-degree laceration occurred, but no damage to the anal sphincter muscle was noted.

At an examination 4 weeks later, the patient indicated that she was experiencing urgency during bowel movements; her doctor detected no anatomical problems.

Dissatisfied with her physicians, the woman went to another doctor, who noted “thinness” in her external anal sphincter. During surgery to repair the injury, it was discovered that scar tissue had grown around one third of the anal sphincter, preventing proper repair. She now suffers chronic bowel urgency and leakage.

In suing, the woman said the doctor was negligent for failing to find and properly repair the external sphincter defect at the time of the tear. The doctor maintained that the patient suffered an occult tear. Hospital staff had no recollection of the incident.

  • The jury awarded the plaintiff $50 million.
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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