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    OB ignores nursing supervisor, fractures infant’s skull

     

    Failure to recognize bladder perforation during hysterectomy

    A 32-year-old Arizona woman underwent an abdominal hysterectomy. She sued the gynecologist who performed the operation after a bladder perforation was discovered. She claimed the open procedure allowed all organs in the pelvis to be clearly seen, and alleged that the gynecologist failed to recognize and repair the 2-cm perforation in the back wall of the bladder. The patient required a second procedure to repair the bladder.

    The gynecologist argued that a bladder perforation was a known complication of the procedure and that his care was not below the standard.

    The verdict

    The jury returned a defense verdict.

     

    Delay in cesarean results in brain injury

    An Illinois woman presented to the hospital in 2004 at 40 weeks’ gestation with a complaint of decreased fetal movement. She was placed on an external FHR monitor, which showed a non-reassuring tracing. The obstetrician decided to try an induction of labor and attempt a vaginal delivery. About 10 hours later an internal FHR monitor was placed and showed decelerations necessitating an emergency cesarean delivery. The infant suffered a hypoxic brain injury, resulting in CP. Twelve years later he has cognitive and physical limitations that require 24-hour care.

    A lawsuit was filed against those involved with the delivery and alleged the physician should have performed a cesarean delivery immediately after FHR monitoring began.

    The gynecologist argued that while the tracings were consistently non-reassuring, they were stable and there were no repetitive FHR decelerations or other indicators of fetal compromise that would preclude allowing her to attempt to have the safer vaginal delivery. He argued that the brain injury did not occur around the time of labor and delivery, showing that the infant’s oxygen level was normal and metabolic acidosis was mild. He further contended that an infection in the amniotic sac was present and caused the brain injury before the patient presented to the hospital, so an earlier cesarean would not have changed the outcome.

    The verdict

    The jury awarded $53 million.

     

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