PATIENT'S CLAIM Knowing the mother’s history, the ObGyns were negligent in not diagnosing gestational diabetes. A cesarean delivery should have been performed because the fetus was known to be large; in fact, the mother requested cesarean delivery during labor—because she could tell the baby was larger than her first child—but the request was refused. Proper maneuvers were not used when shoulder dystocia occurred.
PHYSICIANS’ DEFENSE The prenatal charts were not sent to the hospital, so the results of the sonograms were unavailable. The fetus experienced intermittent hypoxia during delivery, resulting in a “floppy baby” more susceptible to injury during normal maneuvers. Shoulder dystocia was treated properly.
VERDICT A $1.6 million Ohio verdict was returned against the ObGyn group.
Midwife “pulled too hard”; child injured
A NURSE MIDWIFE ENCOUNTERED shoulder dystocia. Without calling for her back-up physician, she delivered the child. The baby suffers from a moderate brachial plexus injury.
PLAINTIFF’S CLAIM The midwife should have called in the physician when shoulder dystocia was encountered. The midwife pulled too hard on the child’s head, causing the injury.
DEFENDANT’S DEFENSE The midwife properly treated shoulder dystocia.
VERDICT A $950,000 North Carolina verdict was returned.
Would earlier cancer diagnosis have changed prognosis?
AFTER LAPAROSCOPIC ADHESIOLYSIS failed to resolve severe abdominal pain, a 52-year-old woman underwent removal of her ovaries and fallopian tubes in 2005. A pathologist reported that the tissue was a benign serous papillary tumor with psammoma bodies. Two years later, the woman’s abdominal pain returned, and, over the next 8 months, her primary physician sent her for several magnetic resonance imaging scans that revealed little change in the lower pelvis.
A diagnostic laparoscopy in 2008 found low-grade IIIC primary peritoneal carcinoma thought to have originated from her ovaries and fallopian tubes. The surgeon testified that there was cancer everywhere in the woman’s peritoneal cavity. After comparing pathology slides from the two procedures, the surgeon believed the tissue was virtually identical, and that the patient had been misdiagnosed in 2005.
PATIENT’S CLAIM The pathologist was at fault for not diagnosing cancer or borderline cancer in 2005. Had it been diagnosed then, the patient’s chances of survival would have been increased by almost 70%.
PHYSICIAN’S DEFENSE According to a gynecologic pathology expert who reviewed both tissue samples, the 2005 diagnosis was reasonable. An earlier diagnosis would not have changed the woman’s prognosis.
VERDICT A Washington defense verdict was returned.
Skull fracture and brain hemorrhage in infant
AFTER 11 HOURS OF LABOR, a mother developed fever. The fetal heart rate fluctuated until the baby was delivered 3 hours later. When the cervix was fully dilated, the mother’s pushing failed to result in fetal descent, and a cesarean delivery was performed. The child suffered seizures shortly after birth; magnetic resonance imaging and computed tomography scans revealed a linear skull fracture with subarachnoid hemorrhage. The discharge summary for the baby indicated hypotonia, birth depression, and acidosis.
PATIENT’S CLAIM During prenatal treatment, the ObGyn suggested the mother might require cesarean delivery because of her small stature (height, <5 ft). The injuries to the baby could have been avoided; when an arrest of labor occurred soon after the mother’s arrival at the hospital, a cesarean delivery should have been performed.
PHYSICIAN’S DEFENSE An arrest of labor did not occur; treatment provided was proper and timely
VERDICT A New York defense verdict was returned.