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Medical Verdicts

Hospital unprepared for uterine rupture?

October 2004 · Vol. 16, No. 10

<court>Nueces County (Texas) District Court</court>

Having delivered her first child by cesarean and her second by vaginal birth after cesarean (VBAC), a 29-year-old woman entered a hospital for a trial of labor for her third child, at which time she received oxytocin.

The woman suffered a uterine rupture during labor. Her child, delivered by emergency cesarean, showed no signs of life at birth, with an Apgar score of 0 and a pH of 6.7. The child was revived, but suffers from cerebral palsy, mental retardation, and neurologic impairment.

The plaintiffs argued that the Ob/Gyn and nursing staff were negligent in not noting the signs of uterine rupture in a timely manner. They claimed that oxytocin was used improperly and that the hospital’s policies on how a VBAC patient on oxytocin should be monitored were insufficient.

They also alleged the nurses failed to notify the physician of changes in fetal monitoring strips and to make timely preparations for an emergency cesarean. Further, they claimed inadequate equipment and personnel were available to respond to the emergency.

  • The jury awarded the plaintiffs $9.7 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 ( While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.