Page 67 - OB Risks - Delivering the Goods (Part One)

SVMIC Obstetrics Risks: Delivering the Goods

On March 7, the patient returned to the office and reported
continued pain. Another vaginal exam was performed,

and the physician found “vaginal tape” gauze used during

the episiotomy repair which had been overlooked in the
previous exams. The gauze was removed without difficulty,
and the patient was given prescriptions for Doxycycline

and Percocet. Her symptoms rapidly improved after the

removal of the gauze.

This claim is another example of the difficulty a defendant faces
when medical judgment issues are called into question and

when systems issues create a “piling-on” effect. A key allegation
for this patient was that the obstetrician failed to perform an

appropriate exam on February 17, requiring her return on March
7 for removal of the surgical gauze. The patient also alleged the

inappropriate prescribing of Percocet and Doxycycline while she
was nursing. Either of these complaints standing alone might

have been defensible provided the failed systems issues had not
also contributed to the development of the situation.

The importance of ensuring a careful count of the gauze,
sponge, or other foreign bodies used during a procedure

cannot be overemphasized. Regardless of the number of staff

participating in the oversight of the supplies, the physician is
ultimately responsible and should participate in monitoring the
number used. The failure of this system gives the appearance of

a poorly organized and careless obstetrician.

Additionally, the intraoffice phone-handling process failed. The
office did not employ use of a scheduling protocol requiring

consultation with the provider when a request for an immediate

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