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Medical Verdicts

Woman dies after uterine atony

January 2005 · Vol. 17, No. 1
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<court>Danville (Va) Circuit Court</court>

Following the delivery of her third child, a 37-year-old woman suffered uterine atony leading to intermittent bleeding. Over the next several hours, the patient:

  • received bimanual compressions with fundal massage, oxytocin, methylergonovine, and carboprost;
  • underwent an emergency dilatation and curettage, after tests revealed disseminated intravascular coagulation and her vital signs began deteriorating;
  • received further fundal massage, misoprostol, packed red blood cells, normal saline, Ringer’s lactate, and hetastarch;
  • underwent an emergency hysterectomy.

Bleeding persisted following removal of the uterus, but neither the defendant nor an additional Ob/Gyn could find its source. A general surgeon was, for 1 hour, also unable to determine the source, though it was eventually located.

Though stable after surgery, the woman developed a cardiac arrhythmia and died due to a myocardial infarction.

In suing, plaintiffs claimed the defendant was negligent for his failure to consult a hematologist, follow up on lab results, and transfuse a sufficient amount of clotting factors before starting the hysterectomy.

The doctor claimed these actions would not have altered the outcome, noting that the woman’s blood volume was replaced nearly 7 times during the events.

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

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Vaginal hysterectomy 
with basic instrumentation