Pulmonary embolism, death 1 day after cesarean
<court>Bronx County (NY) Supreme Court</court>
A 31-year-old obese, diabetic woman presented to a hospital for delivery of her fourth child. The doctor was unable to induce labor, so the baby was delivered via cesarean.
Following the procedure, the doctor gave the patient a 24-hour “out-of-bed” order. The patient allegedly refused to rise until the following day. When she did leave the bed to take a shower, she suffered a pulmonary embolism and later died.
In suing, a relative of the woman argued that the doctor knew cesarean section carried an increased risk of pulmonary complications, particularly in an obese woman with diabetes. The relative claimed the doctor should have given the patient time to attempt natural delivery. In addition, she asserted that the woman should have been forced out of bed sooner, given antiembolic stockings, and administered small doses of heparin.
The doctor said a cesarean was performed because of the patient’s erratic blood-sugar control, fetal macrosomia measurements, and nonreactive stress testing with late decelerations on fetal monitoring. The doctor also argued that the 24-hour “out-of-bed” order was properly timed and that antiembolic stockings and heparin would not have prevented a pulmonary embolism. The doctor further noted that the patient’s physical examinations showed no signs of deep venous thrombosis, nor did her blood tests indicate that she was in a hypercoagulable state.
- The jury awarded the plaintiff $6.147 million. The case settled for $2.5 million following the verdict due to a $2.5 million/$350,000 high/low agreement. The hospital settled for $150,000.
The cases presented here were compiled by Lewis L. Laska, editor of Medical Malpractice Verdicts, Settlements & Experts (www.verdictslaska.com). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.