Medical Verdicts

Shoulder dystocia: Fundal pressure used?


St. Louis (Mo) Circuit Court

When shoulder dystocia was encountered in the course of delivery, a clinician opted to use vacuum extraction, though the mother had pushed for just 16 minutes. The child was born with brachial plexus injury, which, despite subsequent surgery, left the affected arm 2 inches shorter than the uninjured arm, with partially limited function.

The plaintiff claimed vacuum extraction was used prematurely and contributed to the injury. She also argued that, per the delivery note, fundal pressure that was initiated prior to the dystocia was continued once the complication arose, when the clinician should have switched to suprapubic pressure.

The defense argued that a notation error was made in the delivery record, and that suprapubic pressure was indeed used.

  • The jury returned a defense verdict.
The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, of Nashville, Tenn ( While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.

Next Article: