Delayed ectopic diagnosis results in tubal rupture
<court>Ingham County (Mich) Circuit Court</court>
A 31-year-old woman presented to an obstetrician for prenatal care. An ultrasound was reported to demonstrate a gestational sac in the uterus but no fetal pole or yolk sac. The doctor ruled out a nonviable fetus and diagnosed her with early pregnancy.
The following day, the patient called the doctor complaining of sudden pain in her left lower stomach. She was referred to a radiologist for an ultrasound, which revealed a small amount of intrauterine fluid with no visible yolk sac or fetal pole, and no free fluid in the pelvis. Later that evening, the woman presented to a hospital with continued pain and vaginal bleeding. She was diagnosed with a threatened abortion and discharged.
The next morning, the woman returned to the obstetrician for another ultrasound; this revealed free fluid in the pelvic cavity, suggesting a ruptured ectopic pregnancy. The patient was immediately admitted to the hospital. She was diagnosed with a ruptured fallopian tube, which was subsequently removed.
The woman sued, arguing that the ectopic pregnancy would have been discovered prior to the rupture had the doctor performed an examination. She also claimed the fallopian tube could have been repaired before the rupture.
The doctor argued that the standard of care did not necessitate an examination the day before the rupture, and maintained that tube removal would have been necessary even if the patient had been seen.
- The jury returned a defense verdict.
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.