Retained Placenta, D&c Uterine Rupture

[Evian]

Long story short: I gave birth to my first child and was left with a small portion of the placenta still attached to the inside of my uterus. This went undetected until almost a month later amid my almost constant complaints of pain and bleeding which were in the meantime attributed to a uterine infection 10 days after the birth. When an ultrasound finally revealed the retained placenta, I was scheduled for a D&C the next morning. During the procedure, my uterus was ruptured which would have explained the strange symptoms I experienced after the procedure had I been informed of it. I called the doctor twice in the 2 weeks following the surgery and there was no concern or need for a followup sooner than 3 weeks out. The Saturday morning after the second call my symptoms had escalated and been accompanied by a virus which was frightening because I not being a doctor could not distinguish that from the systemic infection I knew by this point I had been placed at risk for. At the prompting of a nurse we know, I went to the emergency clinic who then referred me to the emergency room for tests they could not do - specifically a CT scan. This revealed a pooling of blood next to the uterus where I had been feeling the unexplained pain that they had no explanation for but said it wasn't serious. When I followed up with my doctor the following Monday, I was told that it could only be a result of intestinal gas and everything was fine. I was told that the shoulder pain I had for a week after the procedure that was identical to the pain I had with my previous gallbladder removal was also referred pain from intestinal gas. I was specifically told that there was no way that there could have been any air in my abdominal cavity after the surgery. I didn't find out until later that week at a second opinion with another doctor that in the surgery notes it was stated that the doctor suspected a uterine rupture during the procedure, but was not able to find it. I learned then that this would explain the pelvic and shoulder pain.

I understand that given the risks of retained placenta, I was very fortunate not to have developed any more problems than I did. However, this disrupted our lives for months and filled the first few months of my time with my new baby with fear. It has led to more than $10,000 in extra medical bills for which I am being held responsible. A large portion of those bills is the emergency room, which could have been easily avoided simply by taking my concerns seriously and being honest about what had happened.

I have been told that I will probably just have to pay for this, because malpractice is so hard to prove and this is a difficult state for it. I don't expect any help(or honesty) from the doctor without it being forced. I thought I should check on this one more time before going that route for 2 reasons: 1. Ten thousand dollars seems to be a pretty high price for the privilege of 2 months of pain, bleeding and fear. 2. Paying for it and saying nothing seems tantamount to sending the doctor a note confirming that she can get away with anything and gee I sure hope nobody dies next time.

Is this something you think I should and/or a lawyer would pursue or should I just suck it up and be more selective next time?

[Harper]

Ann,

I am sorry to hear about your continued problems as a result of the failure to determine the remaining placenta.

The simples response would be that it will  probably be difficult to hire an attorney.  It costs $25,000 to litigate the simplest malpractice case to trial and I have spent upwards of $150,000 to litigate complex malpractice cases to trial.  The value of your case will not warrant an attorney to spend $25,000 to $150,000 to litigate the case.  The value is determined by the severity of a permanent injury and it sounds like thankfully you have recovered.

You may find an attorney who will attempt to negotiate with the providers to pay something.  Hospitals are more willing to do this than physicians.  Generally, physicians have a right to refuse settlement negotiations by their insurance carrier because they are obligated to report an negotiations to their malpractice insurer.  Some states also require a reporting to the Board of Medical Examiners if there is a settlement by a physician.

I suggest you speak to a lawyer to see if he/she is willing to attempt and negotiate a settlement.

Again, I am sorry to hear about your treatment.  I wish you the best in the future.

Very truly yours,

Paul D. Friedman, M.A., Ph.D., J.D.