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    OB ignores nursing supervisor, fractures infant’s skull


    Failure to diagnose macrosomia

    A lawsuit was filed in Illinois following the delivery of an infant who suffered a brachial plexus injury. The suit alleged that the obstetrician failed to read an ultrasound report from 5 days prior to delivery that showed the comparison of the fetal head and abdominal circumferences, which would have led him to be suspicious for macrosomia. Instead, it was alleged, he relied solely on the estimated fetal weight of under 8 lb when he decided to proceed with a vaginal delivery. A vacuum extractor was used to deliver the head and a shoulder dystocia occurred. The shoulder was successfully delivered but the infant sustained a permanent brachial plexus injury. The infant weighed 10 lb, 8 oz.

    The patient contended that the obstetrician caused the injury by failing to diagnose macrosomia and allowing the dystocia to occur, then improperly using a vacuum extractor, which is contraindicated for macrosomia.

    The obstetrician denied any responsibility for causing the injury and asserted that his reliance on the estimated fetal weight by ultrasound was within the standard of care.

    The verdict

    A defense verdict was returned.


    Misdiagnosis of ectopic pregnancy

    A Kentucky woman was 6 weeks pregnant when she called her obstetrician with complaints of lower abdominal pain. She went to the office and was seen by a partner of her obstetrician, who was off that day. The obstetrician in the office performed an ultrasound and could not find a fetus in utero. The patient’s β-HCG levels were suggestive of an ectopic pregnancy. The following day the obstetrician performed a laparoscopy but found no evidence of an ectopic pregnancy. She did remove the patient’s appendix. The obstetrician continued to be concerned about the possibility of an ectopic pregnancy and the following day recommended termination and prescribed methotrexate. A week later, an ultrasound revealed a gestational sac in the uterus and a heartbeat. Because of the methotrexate use and the possibility of birth defects the obstetrician again suggested terminating the pregnancy, which the patient did 1 month later.

    The patient sued the obstetrician involved and alleged she rushed to advise the patient to terminate the pregnancy, and was negligent in not waiting for the pathology from the appendix and not repeating the ultrasound to assess the normally implanted pregnancy.

    The obstetrician argued that she acted reasonably based on the patient’s symptoms.

    The verdict

    A defense verdict was returned.



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