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Medical Verdicts

Postdelivery bleeding results in coma

November 2005 · Vol. 17, No. 11
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During cesarean delivery shortly before 9 PM, a 30-year-old woman lost about 500 mL of blood and had a blood pressure of 130/70 mm Hg. Upon transfer to recovery, her blood pressure was 110/70 with a pulse of 142. Her blood pressure was 90/60 at 10:00 PM, 80/40 at 10:10 PM, and 78/30 at 10:25 PM. The nurse notified the anesthesiologist, who arrived at 10:26 PM and called the obstetrician at home.

According to the obstetrician, he was told her pulse was in the 120–130 range and the blood pressure was 90/60. Results from blood drawn at 10:50 PM revealed a hemoglobin of 5.5 and a hematocrit of 15.8.

The obstetrician ordered 4 units of blood and came in for immediate surgery. At 11:10 PM the patient’s blood pressure was 60/30 with a heart rate of 130.

The patient arrested 5 minutes after surgery began at 11:40 PM. After 45 minutes of resuscitation, surgery continued. No source of bleeding was found, but a hysterectomy, gastrostomy, and tracheotomy were performed. Severe brain damage resulted due to a lack of oxygen; the woman remains semicomatose.

The obstetrician was faulted for failing to recognize signs of postoperative bleeding. He denied any deviation from the standard of care.

  • The case settled for $3.98 million: $980,000 from the obstetrician, $1 million from the anesthesiologist, and $2 million from the hospital.

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