Gynecologist Causes Severe Infection After C-Section

ByJason Cohn

Updated on

Gynecologist Causes Severe Infection After C-Section

Case Overview

This case involves a thirty-two-year-old female who developed septic pelvic thrombophlebitis shortly after being induced for labor at a local hospital. The woman was thirty eight weeks gestation at the time of induction. During the days leading up to her induction, the patient claimed that she was never examined by a physician. On the second day of labor, her amniotic sac ruptured. Within the next twenty-four hours, the patient was never seen by a physician. She was then scheduled for a Caesarean section due to failed progression of normal vaginal labor. The patient stated that she was abruptly taken to the operating room where adequate sterile technique and surgical prepping was not followed. While in recovery, the patient developed severe burning during urination. Her physician advised her that she had a bladder infection and was discharged with penicillin the next day. A week later, the patient experienced pelvic pain and urinary symptoms which included increased frequency of urination and pain during urination. The patient was taken to the emergency room where she was diagnosed with septic pelvic thrombophlebitis, which required a month long hospitalization. Additionally, this patient had a pre-existing heart valve condition from childhood. As a result of her infection, her heart valve became severely damaged requiring corrective surgery.

Questions to the Infectious Disease and Communicable Disease expert and their responses

Q1

What measures could have been put in place to reduce the risk of the complications seen in this patient?

There were deviations from the standard of care in this case. Primarily, proper measures were not taken to ensure a proper sterile environment for her Caesarean section. Additionally, she wasn’t properly worked up for her infection. By assuming she had a bladder infection, the gynecologist missed the diagnosis of a severe pelvic infection. The majority of patients will have leukocytosis (an elevated white blood cell count), indicating infection. Once the diagnosis is established, proper treatment must be initiated. However, this woman’s infection required the administration of broad-spectrum antibiotics. The correct combination antibiotics for this patient should have included ampicillin-sulbactam, piperacillin-tazobactam, or ticarcillin-clavulanate, plus ceftriaxone or metronidazole. In addition to antibiotics, this patient should have also been initiated on anticoagulants, such as heparin.

About the expert

This board certified infectious disease doctor has practiced general infectious disease in an academic setting for over 20 years, and has consulted on and co-manged many joint and prosthetic joint infection medical cases. He has previously served in such high ranking positions as Chief of the department of infectious diseases, as well as major academic appointments at top medical schools.

Expert headshot

E-002754

About the author

Jason Cohn

Jason Cohn

Jason is a 4th year medical student pursuing a career in Otolaryngology/Facial Plastic Surgery. His Interest include sports, fitness, chemistry, otolaryngology, plastic surgery, allergy/immunology, surgical oncology, human genetics, public health, preventative medicine, and rheumatology.

Find an expert witness near you

What State is your case in?

What party are you representing?

background image

Subscribe to our newsletter

Join our newsletter to stay up to date on legal news, insights and product updates from Expert Institute.