He said, she said: Consent for postpartum sterilization contested

April 1, 2012

The 34-year-old patient was admitted to the defendant hospital for a repeat c?sarean delivery at 39 weeks' gestation. She has no significant past medical or surgery history. According to a perinatal admission form, she had 2 daughters: a 13-year-old, born at a nonparty hospital by cesarean delivery following breech presentation and a 7-year-old, born at the defendant hospital after a failed vaginal birth after prior cesarean,. The preanesthesia evaluation noted that she had also had 2 prior ectopic pregnancies.

THE FACTS

She was taken to the operating room by the codefendant obstetrician for cesarean delivery. In the operative report, the obstetrician incorrectly stated that the patient had previously given birth to 2 boys instead of 2 girls, and in the body of the report, he wrote that the patient had requested a bilateral tubal ligation (BTL) if she gave birth to another boy. She gave birth to a third daughter and, notwithstanding the sex of the baby, tubal ligation was performed.

The patient twice returned to the gynecology clinic after the birth of her daughter and was seen by an unnamed male physician who advised her that although reanastomosis could be performed, it could not be performed without difficulty because 2 cm of the fallopian tubes had been removed during the ligation. As a result, the patient deferred reversal of the tubal ligation because she feared complications.

In her lawsuit, the patient contended that she had undergone an unwanted, unconsented BTL that deprived her of the opportunity to have additional children, in particular, a boy. She further claimed that the risks of having the ligation reversed were significant enough at her age (34 years) that attempts at reversal were unwarranted, and they were unlikely to be successful without significant complications.

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