Bowel perforation follows fetal demise, D&E
<court>Nassau County (NY) Supreme Court</court>
After contracting Parvovirus, a 36-year-old woman suffered fetal demise at 23 weeks’ gestation. Cervical ripening was begun in preparation for a dilation and evacuation (D&E) of the fetal remains. The physician intended to continue this ripening the following morning, but the woman developed a fever and returned to the hospital later that evening.
The physician opted to conduct the D&E that night, but in the course of surgery perforated the woman’s uterus and delivered the bowel vaginally. As a result, the patient underwent a 5-hour procedure consisting of a hysterectomy with unilateral salpingo-oophorectomy, bowel resection, and colostomy.
The woman sued, claiming the surgeon was negligent in injuring her bowel. She further alleged lack of informed consent and improper preparation of the cervix. She argued that in addition to sterility and vaginal scarring, she suffers urinary and bowel incontinence. She maintained that resultant psychological injuries, psychosexual dysfunction, and physiological difficulties have led to problems in her sexual relationship with her husband.
The defense noted that the injuries were known complications of the D&E procedure—a medically necessary intervention. They maintained that sound clinical judgment was exercised at all times.
- The jury returned a defense verdict.
The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, of Nashville, Tenn (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.