Sutures in sciatic nerve cause multiple problems

A GYNECOLOGIC ONCOLOGIST recommended and repaired a cystocele that was causing urinary incontinence in a patient. Immediately following the surgery, the patient experienced severe pain radiating from her right buttock to her right knee and developed numbness in her right toes. Two days later, after consultation with a neurologist, she underwent further surgery. After it was found that the first physician had placed sutures in the right sciatic nerve, they were removed. The nerve sustained permanent injury, and the patient continues to have chronic pain, paresthesia, weakness, fatigue, and an altered gait.

PATIENT’S CLAIM The physician was negligent for placing the sutures in the sciatic nerve.

PHYSICIAN’S DEFENSE The physician denied any negligence.

VERDICT $700,000 Indiana verdict, which included $25,000 for loss of consortium for the patient’s husband.

Was retained sponge from C-section—or later surgery?

A 16-YEAR-OLD PATIENT delivered a baby by C-section, which proceeded uneventfully. Eight months later, because of abdominal pain, the patient underwent an exploratory laparotomy performed by Dr. A, a surgeon. She continued to experience abdominal pain, the origin of which could not be found. After another 8 months, in exploratory surgery performed by Dr. B, a retained lap sponge was found and removed. At this time, the patient was 5 months pregnant. Two months later, the baby was delivered prematurely and lived for 12 days.

PATIENT’S CLAIM The retained lap sponge was left there during the laparotomy surgery performed by Dr. A, and it should have been found sooner.

PHYSICIAN’S DEFENSE The retained sponge was left during the C-section. Also, the death of the second child was unrelated to the retained sponge.

VERDICT Kentucky defense verdict. An appeal was pending.

$22 million award follows preeclamptic mother’s death

A 29-YEAR-OLD WOMAN who was 9 months pregnant presented at the hospital with a severe headache. She was admitted to labor and delivery, where she was examined by an experienced nurse and a 2nd year resident. A diagnosis of preeclampsia and HELLP syndrome, as indicated by lab tests, was given. The patient was administered three 10-mg doses of labetalol—despite hospital policy of administering the drug every 10 minutes in increasing doses until the blood pressure returns to a safe level. When labor was induced, her blood pressure rose dangerously and she became unresponsive. The baby was delivered successfully by emergency C-section. A CT scan indicated that the mother had suffered a massive brain hemorrhage. She was placed on a ventilator for 4 days, and died when it was disconnected.

PLAINTIFF’S CLAIM Labetalol was not administered properly and according to hospital policy.

PHYSICIAN’S DEFENSE The patient would likely not have survived because the preeclampsia and HELLP syndrome were so severe.

VERDICT $22 million Illinois verdict.

Woman conceives after undergoing tubal ligation

A 29-YEAR-OLD WOMAN underwent a tubal ligation. But 9 to 10 months later, she became pregnant. A subsequent ligation indicated a “normal appearing” right fallopian tube.

PATIENT’S CLAIM The physician failed to ligate the proper structure.

PHYSICIAN’S DEFENSE The right fallopian tube had recanalized and appeared normal. However, there was no negligence in performing the tubal ligation.

VERDICT District of Columbia defense verdict.

Placental fragment, aggressive D&C—failed pregnancy

A WEEK AFTER DELIVERING a healthy baby, a woman underwent an emergency dilation and curettage (D&C) because of severe, life-threatening bleeding. Two years later, she suffered a miscarriage, and 7 months after that an ectopic pregnancy.

PATIENT’S CLAIM The obstetrician negligent for failing to examine the placenta after the birth, leading to a retained placental fragment that caused the bleeding. An aggressively performed D&C resulted in Asherman’s syndrome, which caused the miscarriage and ectopic pregnancy.

PHYSICIAN’S DEFENSE At the time of delivery, the placenta was inspected properly. There was nothing to indicate a retained placental fragment, which is a recognized complication of delivery. The D&C was performed properly; uterine scarring is a recognized complication of the procedure.

VERDICT Illinois defense verdict.

Gallbladder disease during pregnancy is not properly treated

FOR A MONTH BEFORE DELIVERY of her child, a woman suffered severe abdominal pain and vomiting, for which she took over-the-counter calcium carbonate antacids. Two days before giving birth, she was admitted to the hospital dehydrated and with life-threatening elevated calcium in her blood. She was transferred to another hospital, where she gave birth to a child with cerebral palsy at 28 weeks’ gestation. She then underwent removal of her gallbladder.

PATIENT’S CLAIM The plaintiff child claimed the treating ObGyn failed to properly treat the mother’s gallbladder disease and pancreatitis.

PHYSICIAN’S DEFENSE The mother’s problems were mainly due to ingestion of an off-label dosage of over-the-counter calcium carbonate antacids.

VERDICT Nebraska defense verdict. The plaintiff appealed the case on the basis of exclusion of some expert testimony. The case was affirmed on appeal.

Medical Verdicts