An area of medicine that we often get consulted about has to do with those kinds of cases having to do with pregnancy, labor and delivery. Of those kinds of cases are involving ectopic pregnancy which have been coming to the fore recently.
Specifically, an ectopic pregnancy means a pregnancy that’s outside the uterus and if there is a pregnancy outside the uterus, the vast majority of times that there is just a pregnancy will be in one of the fallopian tubes. The fallopian tubes are very thin, they’re very small and so if the products of conception or a fetus were to lodge there or start to grow there, there is a great risk that there will ultimately be a rupture, hemorrhage and possibly death. So, no Physician wants that on their conscience and as part of their responsibility. So sometimes there is an overcompensation to make sure that that doesn’t happen and this can lead to other kinds of cases that happen as a result.
Early in pregnancy, the developing fetus, the products of conception are so small. It’s hard to see them on an imaging study such as a sonogram. So if a woman comes to an emergency room and has complaints of pain, and the Physicians finds out that she’s pregnant, that’s gonna be something they want to investigate with an imaging study, like a sonogram. If they do a sonogram and they don’t see anything in the tube, but they don’t see anything in the uterus; they now have to make a decision. They realize it’s an early pregnancy and so therefore, it might be in the uterus. If they don’t see it in the tube, but they’re afraid it might be, they use other criteria to make the determination to enhance their decision making as to whether it may or it may not be in the fallopian tube.
The problem happens when the Physicians “rush to judgment” and make the decision that to terminate the pregnancy. Now the real problem comes when they talk to the plaintiff about it and give her an informed consent. They rarely if ever say look, we really don’t have any idea if it is in the tube or not. Instead, it’s presented to the woman as being you have a tubal pregnancy. You’ve got to terminate; and so they will give her a drug called methotrexate which is a chemotherapy drug used to treat cancer because it stops cell replication, highly desirable when you’re talking about tumors but obviously a problem if you’re talking about a developing fetus. And so methotrexate is an abortifant, it causes the abortion of the baby.
The cases that I’ve been talking to you about are cases where on multiple occasions unfortunately, the erroneous decision was made that the woman had an ectopic pregnancy when in fact shortly thereafter, sometimes as little as a few hours, a subsequent sonogram is either red or taken to show that the pregnancy was in the uterus all along. However, once the methotrexate is given, it’s just too late; and so each of the women who I’ve had the privilege to represent lost their pregnancy. These kinds of ectopic pregnancy cases are also similar to the failure to diagnose cases where there’s no responsive action taken.
Pregnancy, labor, delivery; these are complicated areas of medicine and as you can see they also involve the overlay of some of these other disciplines; reading a sonogram, taking an imaging study and properly conveying the results, informed consent; all of them come together. If you have a case involving ectopic pregnancy, and labor and delivery, and you’d like to discuss it with us, please give us a call.
Check out our Medical Malpractice Education Series for free!