Legal: Was C/S in twins with spontaneous ROM delayed?

May 1, 2009

A woman was admitted to the hospital with a twin pregnancy and spontaneous rupture of membranes.

An Indiana woman was admitted to the hospital with a twin pregnancy at 35.5 weeks' gestation with spontaneous rupture of membranes. She was seen by the attending obstetrician, who determined that both fetuses were breech and that one had ruptured membranes. She was therefore placed on fetal monitors. The following morning, another obstetrician took over her care, became concerned about a prolapsed cord, and decided to do a cesarean section. This was performed 2.5 hours later. The first twin was delivered successfully, but the second twin with the ruptured membranes was stillborn.

The woman sued both obstetricians involved and the hospital, claiming that she should have had an immediate C/S upon hospital admission and that when the order was given to perform a C/S, the physician should have made sure it was done in a more timely manner. She alleged that the FHRs could not be monitored properly due to her large size and thus delivery was indicated much earlier.

The claims against the hospital and delivering physician were dismissed on summary judgment and the case proceeded against the admitting obstetrician. He argued that an immediate C/S was not required and that the FHRs were being monitored. The jury returned a defense verdict.