Hospital discharge is followed by stillbirth
A 38-year-old woman’s pregnancy was proceeding uneventfully. After about 7 months of prenatal care, she presented to her physician with persistent vaginal bleeding and abdominal and back pain. One hour of monitoring at the hospital indicated that she was not in labor and the signs of fetal well-being were reassuring. Despite continued bleeding and abdominal pain, the woman was discharged. She returned to her physician’s office in early afternoon with increased bleeding and pain, and was sent to the hospital for delivery. On the way there, she suffered massive hemorrhaging due to placental abruption. Before an emergency cesarean section could be performed, the child was stillborn. The mother received transfusions for disseminated intravascular coagulation and blood loss.
Patient’s claim She was discharged without a proper workup for the bleeding and abdominal pain. A sonogram should have been ordered, and she should not have been discharged.
Doctor’s defense The mother’s condition had improved and delivery was not imminent, so the discharge was proper. The sudden massive placental abruption could not have been predicted.
Verdict $1,651,166 Illinois verdict.
Did MD cause kidney loss by injuring ureter?
A 36-year-old woman underwent a total hysterectomy performed by her ObGyn. A week later, she still complained about right flank pain. Additional surgery indicated an atrophied right kidney and an injured ureter, and a nephrectomy was performed.
Patient’s claim The physician injured the ureter during the hysterectomy, and this caused the loss of the kidney. He should have protected the ureter during the surgery—and identified the injury once it occurred.
Doctor’s defense The ureter was not injured during the surgery; rather, the patient had a slow-developing ureteral blockage.
Verdict $974,683 Kentucky verdict. Posttrial motions were pending.
$57 million verdict after admission of fault
A 39-year-old woman was in labor for 8 hours under the care of an ObGyn, an anesthesiologist, and a nurse midwife. When the child was eventually delivered by cesarean section, he was limp and pale, with no heart rate. He was diagnosed later as quadriplegic with cerebral palsy. He has global developmental delay and both bladder and bowel incontinence, and will never walk or live on his own.
Patient’s claim Despite significant abnormalities on the fetal heart monitor, labor was allowed to continue. A cesarean section should have been performed sooner. Also, it was negligent to not have specialists present at delivery; 11 minutes elapsed before a neonatologist arrived to resuscitate the infant.
Doctor’s defense Before the start of the trial, all defendants conceded liability.
Verdict $57,623,113 Pennsylvania verdict, which was reduced to $23,000,000 under a high-low agreement.
Was hysterectomy overly invasive?
Following laparoscopic surgery, a 33-year-old woman reported vaginal bleeding to her ObGyn. Three weeks later, he performed a total hysterectomy.
Patient’s claim The ObGyn made an improper diagnosis. Less invasive methods were available to address the vaginal bleeding.
Doctor’s defense Treatment with less invasive procedures was unsuccessful. Also, the patient was informed of the risks before the surgery.
Verdict Kentucky defense verdict.
Undetected injury leads to extensive surgery
A woman underwent endometrial ablation, performed by an ObGyn. During the procedure, the uterus was perforated. The physician did not recognize the perforation. The ablation device was acti vated, and a thermal injury to the bowel occurred. Ten days later, the patient returned to the hospital with extreme abdominal pain. She was diagnosed with peritonitis and taken to surgery, where the removal of 32 cm of small intestine and repair of the colon and uterus were performed. She returned to the hospital 2 weeks after this and was hospitalized for another 2 weeks for peritonitis.
Patient’s claim The physician was negligent for failing to recognize and treat the uterine perforation.
Doctor’s defense Not reported.
Verdict $245,000 Minnesota settlement was reached in mediation.
Mom blames injury on lack of cerclage
A woman who had already experienced preterm delivery was pregnant with twins and was being seen by both her ObGyn and a perinatologist. At 23 weeks’ gestation, she was admitted to a hospital for bed rest. A month later, due to signs of immediate delivery, she was transferred to a hospital with a better neonatal intensive care unit. She gave birth the following day to both a healthy twin and a twin suffering an intraventricular brain bleed, leading to diplegia, microcephaly, cognitive defects, and visual problems.
Patient’s claim She required cerclage for an incompetent cervix. If cerclage had been performed, the baby’s injuries would have been avoided. She disputed the defendants’ claim.
Doctor’s defense A cerclage had been offered, but the mother declined.