A Survival Guide to Obstetrical Malpractice for 2012 at the Mount Sinai Hospital

Avoiding Obstetrical Malpractice

I recently attended a day seminar presented by the obstetricians at the Mount Sinai Hospital. This is an annual event that has become a mecca of sorts for physicians, obstetrical nurses and medical malpractice lawyers who this year packed the hospital’s auditorium. This blog post shares its title with the seminar which is a misnomer. The seminar has very little to do with surviving an obstetrical malpractice case. Its focus is on emerging issues that health care professionals should be made aware of so that they will not find themselves subjected to medical malpractice cases. This year the presentations provided in depth coverage of a number of issues affecting the standard of practice in obstetrics.

Obstetrical Malpractice Issues

The screening, diagnosis and management of parvovirus infection was examined in detail. Congenital parvovirus infection in the pregnant mother can cause fetal anemia. It is at greater risk of contraction when it is in an endemic phase with nursery and other teachers as well as mothers with multiple children being at greater risk of infection than the general population. It is dangerous as it can lead to intrauterine fetal demise or to fetal hydrops.

Another discussion occurred concerning the use of magnesium sulphate for the neuroprotection of the fetus. The medical evidence suggests that magnesium sulphate (MgSO4) given before anticipated early preterm birth reduces the risk of cerebral palsy in surviving infants. it in fact it significantly increases the chances that the child will not need assistance with walking when he or she has reached the age of two. Its use increases the chance of a surviving child being free of gross motor dysfunction by almost 8 per cent. This could result in saving a lifetime care cost of a million dollars versus a cost of $65 for the treatment. There was some debate as to whether the failure to provide this treatment would attract liability to pay damages in a medical malpractice case as the chance of a materially better outcome did not approach 50 per cent.

There was also a very technical discussion on the screening and diagnostic testing of women at the greatest risk for placental dysfunction. This was a very technical discussion but quite important for the management of pregnancies of nulliparous women.

Timing of Delivery and Birth Asphxia: The Concerns of the Medical Malpractice Lawyers

A considerable amount of time was spent on these very important issues. There was a lively discussion by the doctors on the safety of vaginal birth after cesarean section delivery (VBAC) and the risk factors involved in intervention. Interestingly VBAC was a much more common choice for mothers in Canada as compared to the U.S. where physicians do not seem so keen to perform them. The presenting lawyers discussed the adequacy of the SOGC guidelines on birth asphxia and also reviewed recent obstetrical malpractice cases that had implications for the conduct of fetal heart rate monitoring.

If you have concerns over the management of your labour and delivery, you may have a case for medical negligence or medical malpractice. Contact our office the Obradovich Law firm for a free consultation using the case evaluation form or calling our toll free number. There is no fee or obligation for our case evaluation by an experienced Toronto medical malpractice lawyer.

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