Failure to diagnose preeclampsia
A MOTHER CALLED HER OBGYN at 34 weeks’ gestation with complaints of a headache, swelling, and weight gain. The ObGyn prescribed Tylenol. The next morning, the mother was found unconscious on her kitchen floor. She was taken to the emergency department (ED), where she underwent a cesarean delivery and brain surgery. The child, born prematurely, suffered a stroke that resulted in brain damage and cerebral palsy (CP).
PARENTS’ CLAIM The ObGyn should have immediately evaluated the mother when she called with a headache. Failure to recognize eclampsia led to severe hypertension.
PHYSICIAN’S DEFENSE When the mother called the ObGyn, she reported a headache and diarrhea, and asked if it was all right to take Tylenol. The ObGyn claimed she asked the mother several questions and the mother’s answers included that the headache was not severe and that she’d had it for a few hours. The mother denied blurred vision, abdominal or uterine pain, and reported that she was not vomiting. The ObGyn believed that the mother had a virus and recommended Tylenol. The fetus’ stroke had occurred the day prior to the mother’s eclamptic episode.
VERDICT At first, a Pennsylvania defense verdict was returned. After an appeal, the second trial resulted in a $3.75 million verdict.
Spontaneous home birth goes badly awry
A WOMAN SPONTANEOUSLY DELIVERED her fourth baby at home. An ambulance transported the mother and child to the ED. Upon arrival, the child had depressed breathing. The pediatrician ordered a chest x-ray, which indicated a collapsed lung. A chest tube was inserted. The infant was monitored for the next 2 hours, when transfer to another hospital was arranged because her condition worsened. She sustained brain damage from the respiratory problems and died 2 days after birth.
PARENTS’ CLAIM The pediatrician failed to establish an airway and place a central line.
PHYSICIAN’S DEFENSE The newborn’s breathing difficulties were due to aspiration of meconium. The fetus suffered an in-utero hypoxic event due to a small placenta.
VERDICT A Kentucky defense verdict was returned.
NICU team not called early enough
AN INFANT’S HEART RATE was 100 bpm at birth. She was blue and not breathing, and suffered seizures in the first 24 hours of life. She was found to have brain damage, CP, and spastic quadriplegia. She requires a feeding tube and is unable to speak or walk.
PARENTS’ CLAIM The nurse should have called the NICU team before the baby’s birth because fetal distress was evident. The team arrived and began resuscitation 5 minutes after birth. The delay allowed for a lack of oxygen, which caused brain damage.
DEFENDANTS’ DEFENSE A placental infection caused the baby’s distress.
VERDICT A $8,583,000 Ohio verdict was returned against the hospital.
Woman not told cancer had spread to nodes
A 56-YEAR-OLD WOMAN underwent right breast mastectomy. The surgeon did not remove any lymph nodes despite radiologic evidence of possible nodal involvement. After the mastectomy, the surgeon advised the patient to see an oncologist.
The patient could not get an appointment with the oncologist for 6 months. During that visit, the oncologist told her that cancer had invaded lymph nodes that had not been removed. The cancer metastasized to a lung. Despite surgery, she was told that recurrence was inevitable.
PATIENT’S CLAIM Metastasis could have been avoided if the lymph nodes had been removed at mastectomy. The surgeon had not told her about lymph node involvement, which contributed to the delay in seeing the oncologist.
PHYSICIAN’S DEFENSE Removal of the lymph nodes was not necessary—immediate chemotherapy could have effectively addressed the cancer. The patient was told of the lymph node involvement and clearly advised that prompt chemotherapy was necessary.
VERDICT A $500,000 New York verdict was returned for past pain and suffering. Defense posttrial motions were denied. The judge granted the patient’s motion for future pain and suffering and awarded $500,000.
Brachial plexus injury after emergency surgery
A WOMAN WENT TO THE HOSPITAL FOR THE BIRTH of her eighth child. She had received no prenatal care, although she had a history of preeclampsia. Upon arrival at the ED, she had decreased blood pressure. Two on-call ObGyns delivered the baby. Shoulder dystocia was encountered, and after several unsuccessful attempts were made to dislodge the shoulder, a rescue cesarean delivery was performed. The child has a brachial plexus injury.
PARENTS’ CLAIM The ObGyns failed to perform a cesarean delivery in a timely manner, and used excessive force in attempting to free the baby’s shoulder.
PHYSICIAN’S DEFENSE All appropriate measures were taken in an effort to facilitate a prompt and injury-free delivery.
VERDICT A $1,250,000 Ohio verdict was returned.