Expert Commentary
Does tight control of hypertension in pregnancy produce better perinatal outcomes?
No.
Stroke during delivery: $35.4M verdict
During delivery, a 25-year-old woman had a hemorrhagic stroke that left her unable to care for herself or her child.
Patient’s claim The patient’s neurologist failed to advise the ObGyn that the patient had a history of brain aneurysm and a venous varix, which increased the risk for stroke during labor and delivery. The patient had shared her history with the ObGyn, and she requested that her neurologist contact the ObGyn.
Neurologist’s defense There was no negligence. The entire medical file had been delivered to the ObGyn. Any negligence was on the part of the ObGyn for failure to educate herself as to the patient’s condition.
Verdict A $35.4 million Massachusetts verdict was returned against the neurologist, including $12.9 million for past and future pain and suffering, $4 million for past medical care, $11 million for future medical care, $4.5 million for the husband’s loss of consortium, $1.5 million for lost wages, and $1.5 million for the child’s loss of consortium.
IUGR detected but not immediately treated: $15.5M settlement
During a prenatal visit at 38 weeks’ gestation, a mother’s ObGyn saw signs of intrauterine growth restriction (IUGR) but did not order ultrasono- graphy to confirm the diagnosis or induce labor. When born 15 days later, the baby had a low birth weight and low Apgar scores. The child has permanent brain injury due to hypoxia.
Parents’ claim The ObGyn should have confirmed the presence of IUGR and appropriately managed the mother’s prenatal care. The child’s injuries could have been prevented if an earlier delivery had occurred.
Physician’s defense The case was settled during the trial.
Verdict A $15.5 million Illinois settlement was reached.
Ureter injured during total abdominal hysterectomy
A 40-year-old woman with uterine fibroids, excessive bleeding, and pelvic pain underwent total abdominal hysterectomy performed by her ObGyn.
Postoperatively, the patient reported abdominal pain, but she was discharged from the hospital. Two days later, she returned to the emergency department reporting continued and increasing abdominal pain and urine leakage. The ObGyn referred her to a urologist who diagnosed stricture of the left ureter with a ureterovaginal fistula. A nephrostomy procedure was performed. Three months later, left ureter reimplantation surgery was completed.
Patient’s claim The ObGyn was negligent in injuring the ureter during hysterectomy, in not identifying the injury during surgery, and in not diagnosing and treating the injury in a timely manner, despite the patient’s reports of increasing pain.
Physician’s defense The case was settled during the trial.
Verdict A $350,000 Virginia settlement was reached.
Breech presentation but cesarean not performed
When her water broke, a mother was admitted to the hospital. The ObGyn ordered induction of labor but deferred vaginal examination to avoid infection. After labor was induced, a nurse noticed the presence of meconium. She performed a vaginal examination and found that the baby was in breech position; she did not immediately contact the ObGyn. After several hours of labor, the baby was born limp and not breathing with a heart rate of 50 bpm. The baby was resuscitated but sustained severe brain damage.
Parents’ claim The mother should have been examined before induction of labor. When it was determined that the baby was in breech position, a cesarean delivery should have been ordered. Communication between the nurse and ObGyn was poor.
Defendants' defense There was no negligence; labor was managed according to the standard of care.
Verdict A New Jersey defense verdict was returned.
