Postdelivery bleeding results in coma
<court>Unknown California venue</court>
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 (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.