Legal: Who was responsible for this postpartum hemorrhage?

A 39-year-old Missouri woman delivered her third child by VBAC in 2002. The obstetrician left the hospital about 25 minutes after the delivery but returned promptly when called back due to the patient's severe bleeding, and a hysterectomy was performed.

The woman sued the obstetrician, claiming he failed to perform an adequate inspection of the cervix and/or uterus and that a cervical tear and/or retained placenta caused the massive bleeding. She contended that the physician could have repaired a tear immediately after delivery or removed any placenta and avoided the hysterectomy.

The obstetrician contended that he had done a thorough inspection of the uterus and placenta and maintained that in order to save her life, an emergency hysterectomy was the only option with massive bleeding. A defense verdict was returned.

Videotaping of deliveries is controversial and there are differing opinions on whether to allow it at all, or if allowed, what situations are appropriate. There are many institutions that inform patients they have a blanket policy that does not allow filming of deliveries. Often the fear is that a tape may be used against caregivers in a malpractice case to show either what is claimed to be substandard care or what to jurors can look like a chaotic or unanticipated emergency situation. In the case described here, it was fortunate for the physician that the delivery was videotaped and the obstetrician actually used the patient's own film of the delivery in his defense. The tape showed the physician did examine the patient and inspect the placenta and supported his claim.

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
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