Ectopic pregnancy missed: Salpingectomy required
<court>Queens County (NY) Supreme Court</court>
A 21-year-old woman presented with complaints of severe abdominal pain and fainting. Hospital residents determined she was 5 weeks pregnant. After informing the clinicians she had received a birth-control shot 5 to 6 weeks earlier, she was admitted for additional testing. During this time her beta-human chorionic gonadotropin (β-HCG) was noted as rising.
Following a dilation and curettage procedure conducted 2 days after admission, physicians concluded the patient had miscarried. A pathology report issued 4 days later, however, noted no pregnancy tissue in the woman’s uterus. No additional studies were ordered and the woman was released.
Four days later, the woman presented to another hospital with a fallopian tube ruptured beyond repair, and underwent a salpingectomy.
In suing, the plaintiff claimed that information obtained during her hospital stay clearly pointed to an ectopic pregnancy—specifically, the slowness with which her β-HCG levels were rising and the absence of pregnancy tissue in her uterus. Had the ectopic pregnancy been diagnosed, she argued, the injury to her fallopian tube would have been discovered earlier, when it could have been repaired laparoscopically, protecting her fertility.
Further, the woman contended that during her stay she suffered undiagnosed internal bleeding that may have caused damage to her remaining fallopian tube, thus cutting her chances of achieving pregnancy naturally by more than half.
One of the 2 defendant attending physicians claimed she was not in any way involved with the admission or care of the patient; as a result, action against her was subsequently dropped. The second physician maintained she was never informed of the pathology results.
- The case settled for $500,000, split between the defendant hospital and physician.
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.