Page 41 - OB Risks - Delivering the Goods (Part One)

SVMIC Obstetrics Risks: Delivering the Goods

C A S E S T U DY

A 37-year-old gravida 3, para 1, female with a history of

multiple miscarriages, cardiac issues, and gestational
diabetes was seen by her obstetrician. At her first prenatal

visit, the patient’s blood glucose was 148 with 4+ glucose
in her urine. At 13 weeks gestation, her blood glucose was

239, and she was referred to a maternal fetal specialist
who started the patient on insulin and began diabetic

education. Throughout her pregnancy, the patient had
three normal ultrasounds and weekly fetal non-stress tests

performed. Midway through her pregnancy, her insurance
coverage lapsed. Seven days before her due date, the

patient presented to the emergency department with
increased blood pressure, swelling, and heart palpitations.

After admission, she was referred to a cardiologist who
found no acute etiology for her symptoms. Nurses’ notes

indicated that fetal heart tones were detected at each
shift. No non-stress test, fetal evaluation, or evaluation

for preeclampsia was performed. Her obstetrician simply
instructed her to come back to his office three days later

to assess for induction.

When she arrived at the obstetrician’s office at the

appointed date and time, the receptionist told the patient
that without verifiable insurance, she would be required

to make a substantial payment before being seen by the
obstetrician. Because she did not have the money, the

patient left the office without being seen. No physician or
clinical staff was notified. Four days later, the patient

delivered a stillborn male infant weighing 10 pounds, 4
ounces.

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