Page 38 - OB Risks - Delivering the Goods (Part One)

SVMIC Obstetrics Risks: Delivering the Goods

encountered. The placenta was down to the cervical OS,
and scarring was found when dissection was done. A

viable female infant was delivered with vacuum extraction

and taken to the nursery with no complications prior to
her discharge four days later.

After the baby was delivered, the surgeon attempted
to remove the placenta and fragments from the lower

uterine segment but encountered significant bleeding.
The patient’s blood pressure dropped to 70/30

necessitating a hysterectomy. After a discussion with
the patient, who was awake for the delivery, the patient

verbally consented. The bleeding continued while
preparations for the hysterectomy were underway and a

transfusion was started 30 minutes after her deterioration.
Unfortunately, the patient’s blood pressure continued to

drop. Multiple physicians were called and medications
to aid in the resuscitation efforts were administered, but

the resuscitation efforts were unsuccessful. The patient
expired less than two hours after the initial drop in the

blood pressure.

The devastating outcome resulted in a lawsuit claiming a

long and significant list of allegations on the part of the

patient’s surviving husband and five children. The issues,
which created significant obstacles to defensibility,
included the failure to implement a thorough plan for

addressing the potential complications that the known

placenta previa and history of multiple C-sections posed.
In the face of a complicated delivery, requesting assistance
from an additional obstetrician or even a urologist or

anesthesiologist, would have been reasonable. Experts

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