Botched C-Section Leads to Hysterectomy

Case Overview

The patient was previously using an IUD as a form of contraceptive but decided on having a second child. The patient had originally attempted to have her baby via a natural vaginal delivery, however, multiple complications arose during labor which made a c-section necessary. Due to the irregular positioning of the patient’s uterus, the surgeon was not able to use the traditional techniques used in performing a c-section and had to use an unorthodox procedure in order to deliver the baby. Following the procedure, both the patient and baby were judged healthy and allowed to leave the hospital. Several days later the patient returned to the hospital emergency room with severe vaginal bleeding. A hysterectomy was performed due to a significant infection in the patient’s uterus around the c-section incision, and the woman’s doctors worried that her significant blood loss indicated an amniotic fluid embolism. The patient lost a large quantity of blood and nearly died before the hysterectomy was performed. An expert in obstetrics and fertility was retained for this issue.

Questions to the Gynecology expert and their responses

What is the standard of care for a patient with failure to progress?

The standard of care for a patient with failure to progress is to perform an emergency C-section or vacuum or forceps delivery under some circumstances.

Should the patient have been discharged with elevated white cell count?

The elevated white cell count is only one of many factors to consider when discharging a patient. I would have to review the hospital events and notes in more detail to see where the white count fits in, however it is fairly apparent that there was a significant infection that could have been avoided.

About the expert

This actively practicing, board-certified expert is an experienced OB/GYN with over 25 years of clinical practice experience. He received his B.S. and M.S. at the Massachusetts Institute of Technology and his M.D. from the State University of New York at Buffalo. He has worked in OBGYN in a private practice, HMOs, and in the hospital clinic environment. He is a fellow of the American College of Obstetrics and Gynecology. Currently, this expert is an assistant professor at a top medical school as well as an attending OB/GYN at a major university affiliated medical center.

E-000874

Specialties:

Gynecology