Page 35 - OB Risks - Delivering the Goods (Part One)

SVMIC Obstetrics Risks: Delivering the Goods

uterine rupture with the infant partially extruding into the
abdomen. The infant survived but was severely impaired

and diagnosed with hypoxic ischemic encephalopathy,
cerebral palsy, and seizures.

A lawsuit was filed alleging the patient requested a
C-section on admission to the hospital but was forced

into the trial of labor by the resident. It further alleged
that the physician who provided prenatal care and knew

of the patient’s election to have a C-section should have
communicated that information to the physician in the

labor and delivery department, either through direct verbal
conversation or by ensuring the prenatal records with the

information about the decision would be available at the
time of the patient admission.

The obstetrician’s office failed to send the prenatal medical

records to the hospital, so the information from the
discussion in the office was not available to the admitting

resident. Additionally, the resident documented that the
patient elected to have a trial of labor but failed to include

documentation of any discussion about repeat C-section
as an option. This allowed the plaintiff to argue that she

was not given the repeat C-section as an alternative. The
faculty attending residents were also not aware of the

agreed-upon plan for a C-section, nor were they aware
the resident had changed the plan to a trial of labor.

The communication failures were compounded as the
resident did not communicate with an attending physician

regarding the patient’s status until the fetal heart rate
dropped, resulting in the emergency C-section after the

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