Cutting the medicolegal risk of shoulder dystocia

What’s the best way to reduce legal risks? A physician expert and clinical riskmanagement team developed practice recommendations based on actual cases.

Dr. Zylstra is assistant professor, obstetrics and gynecology, University of Massachusetts, Worcester, Mass. Ms. Greenwald, Ms. Halloran, Ms. Kaltsounis, and Ms. Mondor are members of the ProMutual Group Risk Management Department,  Boston, Mass.

Clip-and-save shoulder dystocia documentation form
Practice recommendations

Among the intrapartum events that constitute bona fide emergencies, shoulder dystocia stands out. This obstetric emergency is the focus of an increasing number of medical liability cases. Most lawsuits involving shoulder dystocia allege negligence as the cause of the brachial plexus injury, fractured clavicle or humerus, or other injury. The defendant physicians named in these suits are often accused of inappropriately managing the prenatal or intrapartum course or the dystocia itself—or of inadequately documenting the steps taken to resolve the emergency.