Re: Why is there litigation for persistent nerve injury after
From: R. Daniel Braun, M.D. (rbraun@iunet.iupui.edu)
Mon Apr 27 14:32:11 1998
Read Dr. O'Leary's book on shoulder dystocia and you will see why.
-----Original Message-----
From: Geffrey H. Klein, MD <gklein@bcm.tmc.edu>
To: Multiple recipients of list <ob-gyn-l@talk.obgyn.net>
Date: Saturday, April 25, 1998 4:43 PM
Subject: OB: Why is there litigation for persistent nerve injury after
>Hi all.. I would like to get other opinions.
>
>Why is it that persistent brachial plexus injuries secondary to shoulder
>dystocia is such a common source of medical malpractice litigation against
>birth attendants? There is a large body of evidence to suggest that this
>condition is unpredictable. I consider litigation for this to be akin to
>suing a doctor because a patient has developed cancer, heart disease, or
>diabetes.
>
>The plaintiff in a medical malpractice case has the burden to demonstrate
>duty, deviation from standard medical practice, damages, and a causal link
>between the deviation and the damages.
>
>Some ob-gyn's rightfully fear the civil litigation that may result after a
>shoulder dystocia. This may lead to cesarean deliveries despite a large
>body of evidence that cesarean is not fully protective and that a large
>number of these operations are required to prevent one permanent brachial
>plexus injury. It seems more logical that an injury from one of these
>cesareans is more actionable than is one from a shoulder dystocia.
>
>Perhaps the litigation for these injuries results from a perception that
>the management of the condition was substandard and not that the attendant
>actually was responsible for the shoulder dystocia. Despite the fact that
>there are some risk factors for the development of shoulder dystocia (ie,
>macrosomia, diabetes, prior shoulder dystocia, excessive maternal weight
>gain, prolonged second stage, etc), many cases are a complete surprise.
>Even when the condition is anticipated and there is appropriate
>intervention, persisitent birth injury is possible. So why is it that
>there are so many of these cases accepted by plaintiff attorneys? Does
>anyone have any data on the outcomes of these cases?
>
>----------------------------------
>Geffrey H. Klein, MD
>----------------------------------
>gklein@bcm.tmc.edu
>----------------------------------
>List-owner OB-GYN-L
>
|
|
