Case details

Doctor claimed plaintiffs gave proper informed consent

SUMMARY

$0

Amount

Verdict-Defendant

Result type

Not present

Ruling
KEYWORDS
autoimmune disease, fractures, heart, irreparable injury, ischial, pelvic, pelvic ischial spine fractures, pregnant, pudendal nerve, severe vaginal tears, Sjogren's syndrome., spine
FACTS
In or around 2012, plaintiff Emily Wu, a licensed optometrist, went into labor and presented to Santa Monica UCLA Medical Center & Orthopaedic Hospital, in Santa Monica. Wu previously became pregnant with her first child while suffering from an autoimmune disease, Sjogren’s syndrome. As a result, she required the services of a high-risk, maternal-fetal medicine specialist and subsequently consulted Dr. Khalil Tabsh, a maternal-fetal medicine specialist and Chief of Maternal-Fetal Medicine at UCLA Medical Center, to provide prenatal and obstetrical care. Thereafter, Wu’s pregnancy progressed without complication. While at Santa Monica UCLA Medical Center, her delivery was complicated by a prolonged second stage of labor, which lasted approximately 5.5 hours with pushing. The fetus descended into the birth canal, but was in an occiput posterior position, which can make vaginal delivery more difficult. When the fetal heart monitor tracing became problematic, Tabsh offered Wu and her husband the option of a vacuum-assist delivery or a Cesarean section delivery. Wu and her husband elected to proceed with a vacuum-assisted delivery because the baby was down to a +2 station in the pelvis and because Tabsh believed the baby could be delivered quickly with the vacuum. Thereafter, the delivery was accomplished within approximately 15 minutes by vacuum, but Wu sustained significant vaginal lacerations and lost approximately 3,000 cc of her blood volume. To stop Wu’s bleeding, Tabsh inserted a Bakri balloon into the vagina and left it in place for 24 hours to tamponade the bleeding vessels. Subsequent to the baby’s birth, Wu developed a severe pudendal neuralgia. Wu sued Tabsh; Santa Monica UCLA Medical Center & Orthopaedic Hospital; and the hospital’s operator, the Regents of the University of California. Wu alleged that Tabsh was negligent in performing the delivery and in obtaining proper informed consent and that this negligence constituted medical malpractice. She also alleged that Santa Monica UCLA Medical Center and the Regents were liable for Tabsh’s actions. The matter ultimately continued against Tabsh only. Plaintiff’s counsel contended that Wu and her husband were not given adequate information about the risks of a Cesarean section versus a vacuum-assisted delivery, so they were unable to give a proper informed consent. Counsel also contended that the delivery was unduly traumatic, resulting in severe vaginal tears and possible pelvic ischial spine fractures, which produced an irreparable injury to her pudendal nerve. Counsel further contended that the hemorrhage and compression of the nerve by the Bakri balloon may have occluded the nerve’s blood supply. In addition, plaintiff’s counsel contended that the balloon was not approved by the U.S. Food and Drug Administration for use in the vagina, as it was only approved for use in the uterus, and that Tabsh should have summoned the assistance of an interventional radiologist, who could have occluded the bleeding source without impairing blood supply to the pudendal nerve. Defense counsel denied all of Wu’s allegations, arguing that Wu and her husband were given appropriate information about their choices and were able to give their properly informed consent. Counsel also argued that the risks of the Cesarean section outweighed the risks of a vacuum-assist delivery. In addition, counsel argued that the Bakri balloon was used in an off-label, but appropriate, manner and that it was necessary to prevent Wu from going into shock and possibly hemorrhaging to death. Defense counsel further argued that there was no guarantee that an interventional radiologist could have forestalled Wu’s bleeding in a timely manner and that Tabsh’s timely action to control Wu’s bleeding resulted in the birth of a healthy child who sustained no injury other than a scalp laceration that healed without residual sequelae., Wu sustained significant vaginal lacerations and lost approximately 3,000 cc of her blood volume. To stop Wu’s bleeding, Tabsh inserted a Bakri balloon into the vagina and left it in place for 24 hours to tamponade the bleeding vessels. Subsequent to the baby’s birth, Wu developed pudendal neuralgia, resulting in severe pain due to damage to the pudendal nerve. She subsequently underwent multiple vaginal nerve blocks and received daily narcotic medication. Wu claimed that as a result of her pain, she has significant restrictions in her activities of daily living and with her work as a licensed optometrist. She also claimed she could no longer enjoy intimacy with her husband, plaintiff Brian Turk, an actor, nor conceive more children in the future. It was further alleged that because Wu’s pain and suffering has not resolved within the five years since the delivery of her child, those symptoms are likely permanent. Thus, Wu sought recovery medical costs, lost earnings, and damages for her past and future pain and suffering. Turk sought recovery for his loss of consortium.
COURT
Superior Court of Los Angeles County, Los Angeles, CA

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