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    IUD blamed for multiple miscarriages

    Was caregiver negligence the proximate cause of the deaths?

    An ob/gyn implanted an intrauterine device (IUD) in a Missouri woman in 2005. A month later, the device could not be located on ultrasound and the ob/gyn believed it had been expelled from the patient’s body. The woman suffered 3 miscarriages between 2009 and 2011 and asked her gynecologist if the missing IUD, which she never observed exiting her body, could be contributing to the miscarriages. She was reportedly told that the device was not present. The IUD was eventually seen on an abdominal x-ray in 2013 after the patient switched doctors. After the IUD was removed the patient had a successful pregnancy.

    The woman sued the original ob/gyn and the clinic for personal injury and wrongful death of the unborn fetuses. Her experts testified that the time line of the miscarriages was consistent with their causation theory and it was below the standard of care to not perform an abdominal x-ray when the IUD position could not be found.

    Related: Using ultrasound to zero in on IUD issues

    The gynecologist argued that the American College of Obstetricians and Gynecologists guidelines at the time did not specify that an x-ray was required, although such a guideline was added later. They claimed that the IUD did not cause the miscarriages and instead that the fetal tissue showed abnormalities not attributable to the IUD.

    Analysis

    In general, for successful prosecution of a wrongful death case, the caregiver’s negligence must be shown to be the proximate cause of the death. In this case, the defense introduced evidence showing that the pathology report on the remains of 2 of the 3 miscarriages showed trisomic abnormalities. The patient’s attorney objected to presentation of the test results, contending that the tissues were sent for testing without the patient’s consent and that the test requisition forms conveyed misinformation. The defense countered that the testing forms had the patient’s signed consent and nothing was misrepresented on the forms. The jurors found for the defense on the wrongful death claims.

    NEXT: Failure to diagnose breast cancer

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