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    Detecting abnormalities, documenting options

    Alleged failure to detect fetal abnormalities earlier in pregnancy, and other cases.



    Claim that episiotomy led to fistula

    A 31-year-old woman delivered her child at a New York hospital. During delivery of the head the obstetrician noticed the umbilical cord was wrapped around the neck. He performed an episiotomy and the infant was delivered safely. The next day the patient alleged she told the obstetrician that she noticed an odor from her vagina, and he told her it was a natural occurrence following delivery and would resolve. The woman soon became pregnant again and was examined by a midwife. The patient said she told the midwife about the odor, but there was no mention of it in the midwife’s notes. When she saw the same obstetrician from the previous delivery he determined she could delivery vaginally. After the delivery, the obstetrician then diagnosed a recto-vaginal fistula, which required 13 operations to repair.

    The woman sued the physician and hospital and alleged that the fistula was caused by the episiotomy from the first delivery. She claimed the episiotomy should not have been done and that the obstetrician should have diagnosed and treated the fistula earlier, which would have prevented the many procedures needed to repair it. She also alleged that the second delivery should have been a cesarean and that the obstetrician’s decision to allow a vaginal delivery exacerbated the fistula. She claimed the caregivers should have investigated her complaint of the odorous discharge earlier which would have allowed an easier repair prior to the second delivery.

    More: Using bilateral salpingectomy to reduce cancer risk

    The defense argued the patient’s medical records showed no indication of the complaint of odor until after the delivery of her second child so he could not have provided earlier treatment. He also contended that the patient’s fistula was due to a malformation, not the episiotomy. A $50 million verdict was returned including $10 million personal injury, past pain and suffering, and $40 million personal injury future pain and suffering.

    Alleged failure to timely diagnose breast cancer

    A 44-year-old Arizona woman sued her gynecologist and claimed the doctor failed to diagnose breast cancer for 2 years, so that she required a mastectomy rather than a lumpectomy as treatment. The patient’s expert opined that the delay resulted in a 70% survival rate as opposed to a 90% rate had there been a timely diagnosis.

    The gynecologist denied that the patient’s chance of survival had been reduced. The jury returned a defense verdict after deliberating a little over 5 hours following an 8-day trial.

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