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    Maternal death from intracranial hemorrhage

    Case hinges on family physician’s knowledge of obstetric conditions


    Failure to perform cesarean after attempted water birth

    An Oregon woman presented to the hospital, planning to deliver her infant under water. She claimed she was told she was an ideal candidate for a water birth and that it was just as safe as any other birthing technique. She was placed in the water, therefore the FHR was not continuously monitored. The patient was eventually taken out of the water bath and the baby was delivered vaginally. The infant was subsequently diagnosed with brain damage and is unable to walk or talk.

    The woman sued the midwives and hospital and alleged the child’s brain damage was from lack of oxygen and blood flow from the attempted underwater birth. She contended that she was told that the midwives would consult with an obstetrician during the water birth, but did not, and she claimed they were negligent in failing to immediately perform a cesarean when she was removed from the tub.

    The verdict: The case settled for $13 million.

    Ureter injured during robotic hysterectomy

    A 44-year-old Texas woman underwent a robotic hysterectomy to treat her fibroids, polyps, and heavy vaginal bleeding. During the operation one of the ureters sustained a thermal injury, but the patient was discharged home without the injury being diagnosed. She appeared to be fine at follow-up office visits.

    Next: Preventing ureteral injury at hysterectomy

    Nine days later she presented to the emergency room with symptoms of infection. She underwent a pelvic CT scan, which suggested leakage of fluid into the abdomen and a perforated ureter.

    In the lawsuit that was subsequently filed, the gynecologist was accused of negligence for allowing the thermal injury to occur and for not recognizing it at the time of surgery.

    The gynecologist denied any negligence and argued that the standard of care was met, that thermal injury to the ureter is a known complication of robotic hysterectomy, that this injury can occur without negligence, and that the perforation most likely occurred 9 days after the operation.

    The verdict: The jury returned a defense verdict.


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