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    Retained foreign object after gyn surgery

     

    Failure to timely treat preeclampsia

    A Florida woman presented to her obstetrician at 24 weeks’ gestation for a routine appointment. Testing showed that she had proteinuria and high blood pressure. The following day she underwent a 24-hour urine test and a blood pressure evaluation at the hospital. The results came back suspicious for preeclampsia. Over the next several days, the patient continued to experience high blood pressure and increased proteinuria, and restricted fetal growth was seen on ultrasound. She returned to the hospital, where she underwent an emergency cesarean section. Her child was born with periventricular leukomalacia.

    The patient sued the hospital and obstetrician both individually and on behalf of her daughter, and alleged the hospital and obstetrician failed to diagnose and treat her preeclampsia in a timely fashion to prevent the very premature delivery. The jury awarded $23.1 million, apportioning liability at 70% to the obstetrician and 30% to the hospital.

    Shoulder dystocia

    A California woman delivered her child in the hospital at term. During delivery a shoulder dystocia was encountered and the obstetrician released the impacted shoulder to accomplish the delivery. Unfortunately, the infant suffered a brachial plexus injury.  Despite nerve graft surgery, the infant was left with permanent paralysis of the right arm, shoulder, and hand.

    The parents sued the obstetrician and alleged a failure to properly manage the delivery. They claimed that a shoulder dystocia had been encountered in a previous delivery, and that the obstetrician failed to realize the need for cesarean delivery in future pregnancies.

    The obstetrician denied all liability, but the case settled for $950,000. 

    Perineal burns during hydrothermal ablation surgery

    A Texas woman in her 40s underwent a myomectomy followed by a hydrothermal ablation of the endometrium for treatment of heavy menstrual flow. During the hydrothermal ablation, the equipment was shut down immediately after an alarm sounded to indicate that it was leaking hot water. Unknown to gynecologist the patient sustained perineal burns from the leak. A week later, she returned to the clinic with perineal irritation and was seen by another gynecologist who diagnosed the burns.

    The patient sued the gynecologist and her practice and claimed that she sustained burns to both her external and internal genitalia. She alleged that the internal band of scar tissue makes sexual intercourse painful. The patient’s expert urogynecologist examined the patient at her attorneys' request and he opined that hydrothermal ablation was not indicated. The expert opined that the gynecologist failed to exercise reasonable care during the procedure.

    The gynecologist contended that the ablation procedure was indicated, that her decision to perform it was supported by the medical literature, and that perineum burns are a known risk of the procedure, and questioned whether the patient sustained any injury to her internal genitalia. She also noted that the procedure was otherwise successful. The defense noted that the plaintiff's expert did not perform hydrothermal ablation procedures. It was also argued that 2 days before her expert examined her, the patient had undergone an annual exam by her regular ob/gyn, who found nothing out of the ordinary. The gynecologist also noted that, based on the external burn pattern, the external injury was from just a few droplets and was therefore relatively minor. The jury returned a defense verdict, after deliberating for 4 hours at the conclusion of a 4-day trial. 

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