Postpartum Hemorrhage [Judge Bans Expert's Testimony]
Case #209
A 23-year-old woman G2P0 at 40 weeks gestation was admitted to L&D in labor.
Labor progressed slowly.
She was seen by a nurse midwife, OBGYN residents, and the attending physician was Dr. S.
She was ultimately taken for a C-section for arrest of dilation.
After the C-section, she suffered a postpartum hemorrhage.
Massive transfusion protocol was activated and the patient was given 11u RBCs, 6u FFP, 1u platelets, and 2u cryo.
After several days in the ICU, she was discharged home.
Over a week later, she returned again with excessive bleeding.
She was diagnosed with a uterine artery pseudoaneurysm, which was embolized by IR.
The patient filed a lawsuit against Dr. S, his employer, and the hospital.
She did not sue any of the residents or the midwife.
The alleged damages were primarily emotional as described here:
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The plaintiffs hired an expert witness (Dr. P), who wrote the following opinion:
The defense hired their own expert:
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The defense attorney deposed the plaintiff’s expert Dr. P.
He was unable to cite any literature to support his claim and admitted to having similar complications himself.
The defense filed a motion that would prevent Dr. P from testifying.
After extensive arguing between the defense and plaintiff, the judge ruled that Dr. P’s testimony was unreliable and would not be allowed.
The defense next filed a motion to dismiss the lawsuit given that they no longer had an expert witness.
The judge dismissed the case:
MedMalReviewer Analysis:
It’s refreshing to see the courts throw out the opinion of a doctor who gives poor testimony that does not align with published guidelines. Dr. P made a fool of himself at multiple points in his deposition, and singlehandedly ruined his client’s case. Hopefully he doesn’t get any more work as an expert witness, and the plaintiff’s attorney learns a lesson about bringing cases with poor merit.
I can sympathize with the patient that she had a miserable birth experience and suffered a lot of pain. However, suing the doctor who literally saved your life and worked hard to avoid a hysterectomy is the pinnacle of entitled and ungrateful behavior. Cases like these are part of the reason why so many doctors burn out and healthcare costs so much.
The presence of a uterine artery pseudoaneurysm is a rare but interesting aspect of this case. I had not previously done much reading about this diagnosis, and found this article to be an excellent case-based overview. It most commonly presents in a delayed fashion following C-section, and can cause catastrophic hemorrhage. EM doctors and other generalists would be wise to remain cognizant of this issue.
Last week’s case (for paying subscribers) concerned a radiofrequency ablation of medial branch nerves in the cervical spine.
The patient’s spinal cord was accidentally ablated instead, leaving her with permanent neurological deficits.
The patient also sued the anesthesiologist and CRNA for sedating her too deeply, preventing closer monitoring of her neurologic status during the procedure.
How devastating. It is refreshing that it’s thrown out. But it just doesn’t take away getting “served” sending in the piece of paper with credentialing for doing a good job. There also has to be some kind of recourse for this type of “expert”
You took the words out of my mouth with point 2. I don't want to sound insensitive toward a patient who clearly went through a harrowing experience, but I'm not sure it gets more ungrateful than to sue the physician who saved your life and your child's. It reminds me of the case you posted where a patient sued the oncologist WHO CURED HIS CANCER because of a temporary side effect from bleomycin.
All this to say nothing of the plaintiff's expert, who at minimum should be reviewed by ACOG who saw fit to grant them fellowship designation. This smacks of unethical testimony, especially when his standards as an "expert" would have found his own practice of obstetrics to be riddled with malpractice.