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Legal: Delay in diagnosis of pelvic abscess

After delivery, pelvic abscess was overlooked.

A 44-year-old Texan delivered vaginally in 2004. About 24 hours after delivery she complained of pain in her pubic area and had difficulty walking. The obstetrician diagnosed a separated pubic symphysis.

The woman was discharged 3 days after delivery, and at an office visit 2 days later was again noted to have separated public symphysis. Two days after that she called 911 and returned to the hospital with severe back and right leg pain. A pelvic x-ray film confirmed the separation and an MRI revealed a collection of fluid in her right iliopsoas muscle. She was diagnosed with sciatica and referred to a neurologist.

Her doctors saw her twice more and saw no sign of infection until 15 days after delivery, at which point she reported fever, nausea, vomiting, chills, headaches, and other symptoms. A CT scan revealed a pelvic abscess. The patient then began to complain of joint pain and was diagnosed with bacterial endocarditis and septic arthritis. She underwent successful heart surgery.

The physicians argued the patient had a hereditary condition which caused her pubic symphysis to separate, which can happen during delivery, and that the pelvic abscess developed after the delivery.

A defense verdict was returned.

Department editor DAWN COLLINS, JD, is an attorney specializing in medical malpractice in Long Beach, CA. She welcomes feedback on this column via e-mail to DawnCF@aol.com