Iud Perforation Of Uterus

[FitzAdam]

I had a Mirena IUD placed 10 wks after giving birth in Nov 2007.  It was an extremely painful experience.  Afterwards I had bleeding for about a week.  I went to see my gyn to check placement at the end of Dec 2007 and the strings were not in place.  I was sent for Ultrasound and abdominal xray and the IUD was found to be outside of my uterus in the left side of my abdominal cavity.  The ultrasound or maybe the xray showed that I had a retroflexed uterus.  I was told that I would have to have surgery to have it removed.  I understand that there is risk of perforation when an IUD is placed however since my uterus was not in a "normal" position, which should have been checked prior to placement, should the insertion not been done or at least should I have been told that there would be an even riskier chance of the perforation since my uterus was tilted?  I'm thinking she should at least reimburse me for the cost of the surgery of having it removed.  I will be haveing the surgery done with another doctor.

[Coltrane]

I agree with everything you say. Proper procedure is to "sound" the uterus prior to insertion and then place accordingly, or not at all. You are also correct that perforations happen all to often. I get questions about Mirena uterine perforations all the time. Here is the problem however:  Firstly, the case against the doctor would not be valuable enough to interest a lawyer in taking on the case. You have to hire an outside gyn to testify that your doctor did something "below the standard of care". Your doctor would strenuously deny that with his high priced lawyers. Even if the case gets close to trial, settlement value is maybe $25-50K and if you go to trial, the costs get into the 10s of thousands for your lawyer with a better then 50/50 chance of losing, with a defense verdict. It is simply not viable, presuming that your surgery is quick, simple and successful with no long term harm, which is probable.

Next, notwithstanding the many many complaints I see about the Mirena, and if I got 20 such questions in the past two years, there are probably 20,000 similar problems, I don't see anything on the web or elsewhere about a case against Bayer, the maker of the IUD. I think the problem is this: I handled hundreds of Dalkon Shield cases years ago along with thousands of others that joined the action. With that IUD, there was a very clear defect that caused pelvic infections and rendered thousands of women, some very young, infertile. Those types of cases were high in terms of damages of course and made a big legal action very successful. The problem with the Mirena seems to be only that it tends to break through the uterus all too often. Again, each individual case is not valuable enough and apparently no one had spent the big bucks to get scientific evidence of a design defect. Bottom line, grin and bear it I guess. Not unreasonable to ask your doctor to reimburse for out of pocket costs for the surgery but he will decline out of fear that this would constitute an admission on his part that he did something wrong. Good luck