Page 64 - OB Risks - Delivering the Goods (Part One)

SVMIC Obstetrics Risks: Delivering the Goods

Three days later, the patient presented to labor and
delivery at 8:30 pm complaining of ruptured membranes

which occurred at about 5:00 pm. The patient was

admitted by the covering physician for the group, and
this physician was unaware of the positive Strep B test
result. The patient’s regular physician was not available

for consult and the prenatal records had not yet been sent

to the hospital by the office staff. The admitting physician
wrote an order to “initiate Group B Strep prophylaxis if
the status is unknown or positive”. No follow-up was done

to ensure that the antibiotics were administered, labor

progressed, and the following morning, a viable baby boy
was delivered at 10:11 am with APGARS of nine and nine.

Within hours, the infant was grunting, and the obstetrician
went to the office to access the prenatal chart and found

the positive Strep B result. The physician then called to the
hospital so that the infant could be treated immediately.

Although the obstetrician’s office had the complete

Group B Strep results in the patient’s record, no one had
reported the results to the patient at the time that she
was seen for the follow-up appointment. In addition to

failing to notify the mother of the positive test results, the

office did not send the prenatal records to the hospital
so that this information could be available to the labor
and delivery staff and the delivering physician when the

mother presented in early labor. In spite of phone orders

from the obstetrician to administer antibiotics if the
Group B Strep status was unknown, neither the hospital
staff nor the physician followed up to verify that the

prophylactic antibiotics were initiated. Ultimately, it is the

Page 64