Page 33 - OB Risks - Delivering the Goods (Part Two)

SVMIC Obstetrics Risks: Delivering the Goods

prognosis in order to gain information on the injury. It is also

advised that you immediately notify the facility’s risk manager
and SVMIC’s claims department.

Litigation is almost certain where the infant is neurologically

impaired. Consider the following case study:

C A S E S T U DY

A 24-year-old gravida 2, para 0, had an uneventful prenatal

course and was admitted to the hospital at 38 weeks

gestation for induction of labor. At the onset of labor, the
patient was found to be at 2 cm dilation. A Pitocin drip was
started, and membranes were ruptured. An epidural was

placed, and labor progressed as expected. The second

stage of delivery was approximately one hour in length.
According to the medical record, at the time of delivery
of the baby’s head, shoulder dystocia was diagnosed and

maneuvers were administered. The infant suffered a left

Erb’s palsy. APGARS were 7 and 8 and the baby weighed
7 pounds, 6 ounces. It was confirmed by MRI that there
was an avulsion of the left C5 root. Subsequent surgery

to repair the injury was unsuccessful and a lawsuit was

filed. It was the plaintiff’s position that the injury was the
result of inappropriate and excessive forces and traction.

During their depositions, the obstetrician and each of the
labor and delivery nurses testified that various maneuvers

were performed including McRoberts, suprapubic
pressure, screw technique, and delivery of the posterior.

However, the medical record showed only that they
dystocia occurred and did not detail the maneuvers used

to achieve delivery, nor the level of ease or difficulty

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