Patient alleges she was not advised of likelihood of Down Syndrome

A MARYLAND WOMAN was seen by her obstetrician during her pregnancy in 2006. She underwent a blood test that indicated that the fetus had an increased risk of Down Syndrome. The infant was born with Down Syndrome and the woman sued the obstetrician, claiming she was not informed of the risk during her pregnancy. She claimed that if she had been told of the test results and the increased risk, she would have terminated the pregnancy. A defense verdict was returned.

LEGAL PERSPECTIVE In malpractice cases brought on behalf of the child, where he or she is born with an abnormality that could have been detected in utero, the parent most often claims and must show that had she known of the abnormality, she would have terminated the pregnancy. The usual damages are then the "cost" of the child living with the abnormality calculated over the course of his or her lifetime. This lawsuit was filed and went all the way through the litigation process to trial, although the patient's chart contained documentation that she had been informed multiple times of the increased risk of Down Syndrome. The chart also reflected that an amniocentesis had been recommended to her, but she did not obtain one. The obstetrician relied on the patient's prenatal records, and the suit was successfully defended.

Failure to timely deliver infant results in neonatal death

The physician argued that the timing of the cesarean delivery was appropriate and within the standard of care. He maintained that the fetal heart monitor strips did not indicate fetal distress for more than 5 minutes before the procedure was ordered.

LEGAL PERSPECTIVE This suit was brought on behalf of the deceased child's estate. It alleged negligence by both the obstetrician and the hospital. The case eventually proceeded to trial against the physician only and was successfully defended: The jury returned a verdict in favor of the doctor. However, the hospital had settled before trial with the representative of the child's estate for $1,625,000.

Colon perforation during hysteroscopic surgery

A 44-YEAR-OLD NEW YORK WOMAN underwent hysteroscopic surgery in 2006. The procedure, involving removal of polyps and a fibroid tumor, was performed by her gynecologist. During the procedure a loop ligature device was inserted into the uterus. Two days later it was determined that her colon had been perforated and she developed peritonitis. She required a resection of a portion of the colon and a temporary colostomy The woman sued her gynecologist, claiming that the injury was due to the physician pushing the loop ligature device through the uterus, burning a hole in the uterus and the colon. She claimed that the doctor should have performed a more extensive check to ensure that no perforations had been created.

The physician claimed that the perforation was a delayed thermal effect that did not occur until 2 days after the procedure and denied any negligence. A $1.55 million verdict was returned.

Alleged misdiagnosis of missed abortion

A GEORGIA WOMAN was seen by a physician in 2006 after a positive home pregnancy test. A blood test confirmed her pregnancy, but an ultrasound found no intrauterine gestational sac, although a small amount of fluid was seen in the uterus and was deemed to be an early intrauterine pregnancy. Eleven days later she went to the emergency department with painless vaginal bleeding and a transvaginal ultrasound was performed. A gestational sac and yolk sac were found in the uterus. The woman reported no further bleeding or pain, but 3 days later her obstetrician noted falling quantitative beta human chorionic gonadotrophin levels and made a diagnosis of missed abortion. The gynecologist prescribed misoprostol and the patient was instructed to return in 2 weeks for a D&C; however, she moved to Washington state and did not return to her original obstetrician.

A few months later, she was seen by a Washington obstetrician and was found to be 19 weeks pregnant and leaking amniotic fluid. She was placed on bed rest for almost 3 months and then delivered an infant by cesarean section. The fetus had continued oligohydramnios, which resulted in limb injuries and underdeveloped lungs. She required intubation shortly after delivery, was diagnosed with pulmonary hypoplasia, and required extensive treatment in the neonatal intensive care unit. She also was diagnosed with deficits in cognitive ability, fine motor skills, and speech. The child had 2 hip surgeries as an infant and was expected to require hip replacements over her lifetime. A lawsuit was filed alleging negligence by the original physician in the failure to perform further testing and examination and confirm a viable pregnancy. The defense maintained that the diagnosis of missed abortion was not negligence; however, a $4.5 million settlement was reached.