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Medicalverdicts Medical Verdicts Notable judgmeNts aNd settlemeNts times she refused consent; her fam- Wrongful birth claim: Child has ily could not be contacted without her a chromosomal disorder authorization. Proper actions were A woman’S husband and an interpreter came to taken when consent was obtained. her first prenatal appointment at 10 weeks’ gesta- } VERDICT An Illinois defense verdict tion, as she spoke only Mandarin and the father’s was returned. English was limited. The ObGyn offered maternal serum sequential screening. At subsequent visits, Epidural pump stolen— with the husband and interpreter present, the mother saw a geneticist, genetic counselor, and nurse practitioner. At no time was additional while in use genetic testing offered. At the 23-week visit, the husband was present, but the interpreter had not yet arrived; the ObGyn attempted to communi- A WOMAN WAS GIVEN AN EPIDURAL cate through the husband. during labor. While she slept, a newly The baby was born at term with cri-du-chat syndrome. The child is hired physician assistant (PA) entered severely physically and mentally handicapped, and will require constant her room, disconnected the epidural medical and attendant care for life. pump, and stole it. The woman awoke but the PA assured her that every- } patient’S CLAIM The ObGyn did not offer amniocentesis or chorionic thing was fine. Soon, she experienced villus sampling (CVS), and failed to inform the parents that the chance significant labor pains and called the of a 37-year-old woman having a child with a chromosomal aberration nurses, who paged an anesthesiologist was 1.5%. The ObGyn did not obtain the woman’s signature waiving the to administer another epidural. Secu- presence of an interpreter at the 23-week visit. If the physician offered rity personnel questioned the woman. amniocentesis then, the parents did not understand. She would have She gave birth to a healthy child. terminated the pregnancy if she had been told the fetus had a severe chromosomal defect. } patient’S CLAIM The hospital failed } PHySICIAN’S DEfENSE The ObGyn claimed to have offered amniocentesis at to provide adequate security. Secu- the 23-week visit, but it was declined. Proper care and treatment was provided. rity personnel unduly questioned the } VERDICT A $7 million Massachusetts settlement was reached. woman before the second epidural was administered, delaying the pro- cedure and increasing the length of An ICU resident and nurse sub- time she was in pain. Hematoma after sequently obtained consent from the } defendants’ DEfENSE The hospi- biopsy; death woman’s family. The surgeon was not tal claimed no responsibility for the told this for 4 hours, at which time theft; the PA’s actions were outside A 77-year-old woman underwent the woman was taken immediately the scope of his employment, and his percutaneous biopsy of three right to the operating room. The surgeon criminal behavior was unforeseeable. axillary lymph nodes. She developed a repaired a severed axillary vein and } VERDICT A Connecticut defense hematoma. She was sent to the hospi- punctured axillary artery. verdict was returned for the hospital. tal from the physician’s office because The woman suffered two epi- (The PA pleaded guilty to stealing the of the increasing size of the hema- sodes of asystole during surgery. She epidural pump, received 3 years’ pro- toma, low blood pressure, and pain, later died of multiple organ failure. bation, and lost his license.) then admitted to the ICU for monitor- ing. She declined exploratory surgery } ESTATE’S CLAIM The surgeon These cases were selected by the editors of to discover and repair the bleeding failed to take adequate mea- OBG Management from Medical Malpractice Ver- dicts, Settlements & Experts, with permission of the source. When her blood pressure and sures to obtain surgical consent to editor, Lewis Laska (www.verdictslaska.com). The hemoglobin level dropped overnight, repair the hematoma, and failed information available to the editors about the cases presented here is sometimes incomplete. Moreover, the physician again tried to persuade to perform surgery in a timely the cases may or may not have merit. Nevertheless, these cases represent the types of clinical situations hutterstock the woman to have surgery; she manner once consent was given. s that typically result in litigation and are meant to } PHySICIAN’S DEfENSE refused. The physician then under- The woman illustrate nationwide variation in jury verdicts took surgery on another patient. was awake, alert, and oriented both and awards. Photo: 56a OBG management | october 2011 | Vol. 23 No. 10 obgmanagement.com Medical Verdicts Notable judgmeNts aNd settlemeNts because they expected him to look at, Ectopic pregnancy Uterine laceration review, and interpret the monitor. The didn’t miscarry during cesarean physicians claimed that the arrest and despite methotrexate death were due to an amniotic fluid A woman began to bleed exces- embolism or amniotic fluid syndrome thinking she was pregnant, a sively in the recovery room after a that was sudden, unpredictable, and woman saw her ObGyn, Dr. A, who nonemergent cesarean delivery. difficult to treat. found no evidence of pregnancy, Blood pressure and blood oxygen } VERDICT A $1,350,000 Virginia and suspected that she had miscar- saturation decreased, heart rate settlement was reached. ried. The next day, Dr. A’s office called increased, and she passed large clots. the woman to return because of an The recovery room nurse notified the elevated hCG level. A sonogram per- woman’s ObGyn, who ordered medi- Was she discharged formed at the second visit did not cation to constrict the uterus and too early? reveal any signs of pregnancy. diminish blood flow, but treatment Eleven days later, she went to the was unsuccessful. an ObGyN performed total trans- emergency department (ED) in excru- She was returned to the operat- vaginal hysterectomy on a 54-year-old ciating pain. A sonogram revealed an ing room, where the ObGyn repaired patient, and discharged her the next ectopic pregnancy. Methotrexate was a low-segment uterine laceration. day. Several hours later, she began to administered to terminate the preg- Blood was administered with addi- have severe abdominal pain, and was nancy. The woman was advised to tional uterotonics. After surgery, the readmitted. The ObGyn prescribed IV follow up with her ObGyn. Ten days woman was sent to the labor and antibiotics and ordered fluid manage- later, blood tests continued to show an delivery recovery room. When tests ment. When she continued to deterio- elevated hCG level, but Dr. A did not indicated that her hematocrit and rate, she was transferred to the ICU. order further testing or follow up. hemoglobin level had decreased and The next day, the ICU physician Two weeks later, the woman she showed signs of a clotting diffi- ordered diagnostic laparoscopy. A went to Dr. B, a different ObGyn, who culty, the ObGyn ordered additional perforation of the sigmoid colon was ordered blood work to monitor her blood products and fundal massage. found and repaired, but the woman hCG. The next day, she went to the Two hours later, the woman suffered continued to deteriorate. Nine days ED in great pain. The ED physician cardiac arrest and was revived, but later, she was transferred to another contacted Dr. B, who advised that suffered significant brain damage. hospital, where she died. the woman should be discharged After six months, mechanical ventila- with instructions to follow up with tion was withdrawn and she died. } ESTATE’S CLAIM The ObGyn failed him. Nine days later, the woman saw to find the perforation during hys- Dr. B, who diagnosed and surgically } ESTATE’S CLAIM The patient’s vital terectomy. He did not properly removed a ruptured fallopian tube. signs never returned to normal after follow-up with the patient after sur- uterine repair surgery. The ObGyn gery, and improperly discharged } patient’S CLAIM Neither physician and anesthesiologist did not stabi- her despite abnormal blood work properly monitored the patient after lize the patient, and failed to per- and vital signs; elevated tempera- administration of methotrexate. form a hysterectomy to save her life. ture and pulse rate; and an increase The ectopic pregnancy continued, The nurses did not notify the ObGyn in her white blood cell count. Both and caused rupture of the fallopian and anesthesiologist of unstable physicians failed to diagnose and tube. Dr. B failed to respond prop- vital signs that signaled blood loss. treat the perforation in a timely man- erly to the call from the ED physician. } defendants’ DEfENSE The anesthe- ner. Delay in diagnosis and treat- } PHySICIANS’ DEfENSE Dr. A admit- siologist found the patient’s vital signs ment led to the woman’s death. ted that the patient had not been normal after repair of the laceration } PHySICIANS’ DEfENSE The physi- properly monitored, but claimed and left the woman in the care of the cians denied negligence. that the lack of monitoring caused no nursing staff and ObGyn. The ObGyn } VERDICT A $7 million North Caro- harm. Dr. B denied any negligence. was not notified of unstable vital lina verdict was returned against } VERDICT A Georgia defense verdict signs. The nurses asserted that they the ObGyn. A defense verdict was was returned for both physicians. did not tell the ObGyn of the changes returned for the ICU physician. obgmanagement.com Vol. 23 No. 10 | october 2011 | OBG management 56b.
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