Mother dies following cesarean for fetal demise
<court>San Bernardino County (Calif) Superior Court</court>
Complaining of decreased fetal movement and cramping, a 36-year-old gravida with a prior cesarean presented to a hospital with a fever. A sonogram revealed fetal demise. Labor induction was scheduled for 5 days later, and the patient was sent home.
Two days later, the woman returned to the hospital with pain and bleeding, but was sent home and instructed to return for the scheduled induction. That same night, however, she once again presented, demanding the fetus be delivered. Blood tests revealed a white blood cell count of 9,900 with 88.7% neutrophils.
The physician attempted to deliver the child vaginally, but the mother insisted on a cesarean section. When the fetus was delivered by cesarean the following morning, placenta previa and placenta accreta were discovered.
Postoperatively, the woman suffered heavy vaginal bleeding. Despite the administration of packed red blood cells, she was later found in septic shock. She died that night. Autopsy revealed placental remains in the uterus.
In suing, the woman’s family alleged that the physician was negligent in not initiating cesarean delivery sooner. Had the fetus been delivered 2 days earlier, they claimed, the mother would have survived.
The defendant physician argued that the patient died not of sepsis, but of bleeding due to the placenta accreta—a condition the doctor was powerless to treat. She maintained that the scheduled delivery date was appropriate given the woman’s symptoms.
- The jury awarded the plaintiff $4 million
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.