Page 66 - OB Risks - Delivering the Goods (Part One)

SVMIC Obstetrics Risks: Delivering the Goods

C A S E S T U DY

A 32-year-old patient underwent a vaginal delivery of

a healthy baby followed by repair of a second-degree
episiotomy on January 24. The episiotomy was repaired

with three sutures, and her obstetrician took the necessary
precautions to verify that nothing was retained within the

uterus or vaginal vault after the episiotomy was performed.
The patient had an uneventful hospital stay following the

delivery and was discharged home on January 26 with
prescriptions for Percocet and ibuprofen to treat the pain

related to the episiotomy.

The patient called the office on February 3 complaining
of perineal pain and a foul odor and was informed by the

office staff that this was normal after an episiotomy. The
office staff did not document whether they consulted

with the provider or a clinical advice protocol before
giving the patient this advice. The patient called again

on February 7 with the same complaints but this time
requested an appointment to see the physician. Again,

without consulting a provider, the office person scheduled
the patient an appointment for 10 days later.

Ten days later, as scheduled, the patient appeared and
reported severe vaginal pain. She also reported she

stopped taking the Percocet because it was making the
baby sleepy. The obstetrician did a speculum exam and

did not see anything abnormal. The episiotomy was noted
to be healing well. The patient was told to try ibuprofen

for the pain and another appointment was scheduled for
two weeks later.

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