Medical Verdicts

Was gastroschisis of late onset—or visible on sonograms?... and more


 

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Was gastroschisis of late onset—or visible on sonograms?

BECAUSE OF ADVANCED AGE and the presence of uterine fibroids, a woman underwent prenatal ultrasonography in the fifth, sixth, and seventh months of pregnancy. The sonograms were performed and interpreted by a specialist in maternal–fetal medicine. The baby was born with most of his intestines outside his abdomen and was transferred to another hospital, where surgery was performed nearly 4 hours after birth, revealing necrosis of a significant length of bowel. The child suffered short-gut syndrome and required intravenous catheter and tube feeding until the age of 5 years. His growth was stunted.

PATIENT’S CLAIM The sonograms showed gastroschisis. If this had been recognized at that time, the birth could have taken place in a hospital where surgical repair could be performed within 2 hours of birth. Because of the delay in surgery, necrosis of most of the small intestine occurred.

PHYSICIAN’S DEFENSE The child suffered late-onset gastroschisis, or ruptured umbilical hernia, which the sonograms did not show. No matter where the child was born, the outcome would have been the same.

VERDICT Illinois defense verdict for the specialist in maternal–fetal medicine. Prior to trial, the hospital and radiologist settled for $35,000 and $200,000, respectively.

Unsigned death certificate delays cremation of stillborn

FOLLOWING THE STILLBIRTH of their child, a couple waited 3 weeks for the death certificate to be signed. Only then were they given the body for cremation.

PLAINTIFFS’ CLAIM Dr. A, the attending physician, was negligent for not signing the baby’s death certificate in a timely manner, thus delaying the cremation and causing emotional distress. A death certificate should be signed within 1 day of determining the cause of death or knowing that there will be no further information about the cause.

PHYSICIAN’S DEFENSE According to Dr. A, his stated cause of death was rejected initially. While he was waiting for additional clinical information, Dr. B signed the certificate, giving only a general cause of death. Dr. A claimed his own actions caused no damages.

VERDICT $11,000 California verdict.

MDs find ovarian cyst, then, 7 months later, peritoneal cancer

A 49-YEAR-OLD WOMAN with an ovarian cyst underwent laparoscopy. Dr. C, the ObGyn who performed the surgery, found ovaries that were normal, but also the presence of endometriosis and adhesions. Dr. D and Dr. E provided follow-up care. When the patient visited Dr. E 5 months later complaining of bloating and gastrointestinal pain, ultrasonography was performed. She then followed up with her primary care physician and a gastroenterologist. Three months later, she underwent emergency surgery. Stage IIIC primary papillary serous carcinoma of the peritoneum was discovered in her pelvis and abdomen. Despite multiple surgeries and chemotherapy over the next year and a half, the patient died.

PLAINTIFF’S CLAIM Dr. C should have performed a biopsy during the original laparoscopy; this would have allowed an earlier diagnosis with a better prognosis.

PHYSICIAN’S DEFENSE A biopsy was not required initially; in fact, the cancer was probably either not present or microscopic at that time. Even with a diagnosis then, the odds of survival would have been much the same.

VERDICT Illinois defense verdict. The jury deadlocked, 11 to 1. The parties agreed to a less than unanimous verdict and a high/low agreement of $750,000/$100,000. Then the jury returned a defense verdict.

Still incontinent after undergoing retropubic urethropexy

A 43-YEAR-OLD WOMAN was experiencing urinary incontinence, gynecological pain, and bleeding. Her ObGyn diagnosed pelvic organ prolapse. A month later, the patient underwent a total abdominal hysterectomy with retropubic urethropexy. Following the surgery, the patient continued to be incontinent.

PATIENT’S CLAIM A sling procedure to correct the incontinence should have been performed.

PHYSICIAN’S DEFENSE The proper procedure and technique were used. As the patient was undergoing an abdominal hysterectomy, it was reasonable to perform a retropubic urethropexy at the same time.

VERDICT Texas defense verdict.

A $30.9 million verdict in the case of induced VBAC

ATTEMPTING A VAGINAL BIRTH after cesarean (VBAC), a woman arrived at the hospital for induced delivery of her child. During labor, the uterus ruptured and placental abruption occurred. For approximately 20 minutes, the fetus was deprived of oxygen. A cesarean delivery was performed, and the child was diagnosed with severe brain damage and cerebral palsy.

PATIENT’S CLAIM Uterine rupture was caused by hyperstimulation with oxytocin. After the loss of the fetal heart rate, the nurses delayed more than 15 minutes before notifying a physician.

PHYSICIAN’S DEFENSE The patient was informed of the increased risk of rupture when attempting VBAC. The nurses were following physician orders regarding use of oxytocin. Until the time of rupture and abruption, the uterus was not hyperstimulated and the heart rate was normal.

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