ObGyn leaving for vacation urges induction

AN OBGYN OFFERED TO INDUCE LABOR at 39 weeks’ gestation for a couple’s first child because she was anticipating a vacation. In counseling, the ObGyn revealed no significant risks. The parents agreed and went to the hospital that afternoon.

Induction included cervical ripening with misoprostol followed by oxytocin, resulting in uterine tachysystole and an abnormal fetal heart-rate pattern. The child was born by cesarean delivery 25 hours after labor began.

The child suffered hypoxia, which caused hypoxic-ischemic encephalopathy, cerebral palsy, and spastic quadriparesis. He will always require 24-hour care.

PATIENT’S CLAIM Induction of labor was medically unnecessary. Informed consent was incomplete: induced labor increases the risks of hyperstimulation of labor, failure to progress, and cesarean delivery. The ObGyn was negligent: She had admitted several patients to labor and delivery that day, and delivered five babies in 19 hours, including three “unscheduled” cesarean deliveries. Because of the patient load, she was busy with other patients when a cesarean delivery became urgently needed for this baby. Hyperstimulation and fetal heart-rate abnormalities continued for several hours.

DEFENDANTS’ DEFENSE The suit was settled before trial.

VERDICT A $5.5 million Missouri settlement was reached against the ObGyn and hospital. The hospital was also required to implement new policies on induction, augmentation of labor, and informed consent.