Blocked intestine after cesarean—a nonsurgical cause?…and more

PATIENT’S CLAIM The child suffered a hypoxic event caused by meconium aspiration, resulting in encephalopathy and cerebral palsy. The finding of stained amniotic fluid should have prompted the ObGyn to perform an emergency cesarean delivery.

PHYSICIAN’S DEFENSE Electronic fetal monitoring never indicated fetal distress. Amnioinfusion cleared the amniotic fluid, making a cesarean delivery unnecessary. The child’s condition resulted from preexisting neurological problems and/or a genetic condition that also caused microcephaly, a heart defect, and polydactylism.

VERDICT A New York defense verdict was returned.

Bowel is perforated: “Now I can’t conceive”

A WOMAN WAS GIVEN A DIAGNOSIS of endometriosis. During laparoscopic surgery to treat the condition, the gynecologist used a unipolar laparoscopic coagulator wand.

Eighteen days later, the patient went to the emergency department with severe lower abdominal pain. Peritonitis, caused by bowel perforation, was diagnosed, and she underwent surgery. A portion of bowel was removed. A colostomy was created, which was later reversed.

She developed adhesions from the peritonitis and required additional surgeries that, she alleged, caused subsequent fertility treatments to be unsuccessful.

PATIENT’S CLAIM The coagulator wand perforated the bowel. The gynecologist was negligent in his use of the wand; the wand manufacturer and the electrosurgical generator manufacturer were negligent in the equipment’s design; and the hospital was negligent in its maintenance of the equipment.

DEFENDANTS’ DEFENSE The instrument manufacturer denied any design defect and argued that the injury was not a burn but was caused by the coagulator wand making contact with another surgical instrument. The physician, generator manufacturer, and hospital denied negligence.

VERDICT The claim against the gynecologist was dismissed by summary judgment. The hospital and the generator manufacturer settled for an undisclosed amount. A $2.2 million California verdict was reached against the wand manufacturer.

Child has spina bifida despite evaluation

ULTRASONOGRAPHY RESULTS indicated normal fetal growth during a woman’s pregnancy. However, the child was born with spina bifida and required back and brain surgery shortly after birth. She wears ankle and foot orthotics and is incontinent.

PATIENT’S CLAIM The ObGyn failed to perform a prenatal alpha-fetoprotein test. The radiologist misinterpreted the sonogram.

PHYSICIANS’ DEFENSE The ObGyn believes that most spina bifida conditions are detectable by ultrasonography, and the radiologist’s report did not indicate spina bifida.

VERDICT The radiologist settled for $1 million before the trial. A $2.5 million New Jersey verdict was returned against the ObGyn.