Missed cornual pregnancy blamed for subtotal hysterectomy, infertility
<court>Kings County (NY) Supreme Court</court>
Following a fertility workup, a 43-year-old woman was administered clomiphene citrate along with human chorionic gonadotropin to stimulate ovulation. About 17 months later, she became pregnant. However, the patient had a fetal demise at 14 weeks’ gestation.
The woman underwent dilatation and curettage to clear the fetal remains. Shortly thereafter, she returned to the doctor with complaints of abdominal pain and light vaginal bleeding. An examination revealed tenderness in the fundal area. The physician diagnosed incomplete abortion and referred her to the hospital for an additional dilatation and curettage. This was performed the following day, along with an exploratory laparotomy.
During the procedure, it was determined that the patient had a second undiagnosed pregnancy in her cornua that had ruptured. She required a subtotal hysterectomy, losing 50% of her uterus and retaining 1 fallopian tube and ovary.
The patient sued, arguing that she did indeed exhibit signs of a cornual pregnancy. She maintained that if the physician had detected her condition in a timely fashion, a cornual resection could have been performed. This procedure would have saved 90% of her uterus, she claimed, thereby increasing her chances of achieving pregnancy and carrying a fetus to term.
The doctor contended that the woman’s symptoms did not warrant hospitalization or a differential diagnosis of cornual pregnancy. He also claimed that the patient failed to undergo a fertility workup following her subtotal hysterectomy, despite his specific recommendation.
- The jury awarded the plaintiff $1.25 million.
The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts. While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.