ob/gyn malpractice
TRANSCRIPT
OB/GYN MALPRACTICE
SCOTT M. LEWIS Member of the Bar of the State of Ohio
Wiley Law Publications
JOHN WILEY & SONS
New York · Chichester · Brisbane · Toronto · Singapore
SUMMARY CONTENTS
PART I LEGAL ASPECTS OF OBSTETRICAL AND GYNECOLOGICAL MALPRACTICE
Chapter 1 Liability of the Physician 3
Chapter 2 The Physician's Case, Defenses, and Countersuits 55
Chapter 3 The Trial of a Malpractice Case: Pleading and Practice 79
PART II MANAGEMENT IN THE ANTEPARTUM PERIOD
Chapter 4 Prenatal Care and Diagnosis 111
Chapter 5 Preeclampsia and Eclampsia 143
Chapter 6 Fetal Maturity: Prematurity and Postmaturity 155
Chapter 7 Amniocentesis 173
Chapter 8 Hemolytic Disease of the Newborn 187
Chapter 9 Drug Therapy in Pregnancy 201
Chapter 10 Abortion 213
PART III MANAGEMENT OF LABOR AND DELIVERY
Chapter 11 Normal Labor and Dysfunctional Labor 235
Chapter 12 Pelvic Dystocia and Cephalopelvic Disproportion 255
Chapter 13 Induction of Labor and Oxytocin Stimulation 269
Chapter 14 Fetal Distress 285
Chapter 15 Abnormalities of the Cord and Placenta 307
Chapter 16 Obstetric Anesthesia and Analgesia 325
Chapter 17 Presentation, Position, and Breech Delivery 341
Chapter 18 Shoulder Dystocia and Brachial Plexus Injury 359
Chapter 19 Cesarean Section 367
Chapter 20 Forceps Operations 383
Chapter 21 Maternal and Newborn Concerns in the Postpartum Period 399
PART IV MEDICO-LEGAL CONCERNS IN GYNECOLOGY
Chapter 22 Contraception 423
Chapter 23 Dilation and Curettage 449
Chapter 24 Hysterectomy 455
Xlll
XIV
Chapter 25 Chapter 26
Appendixes
SUMMARY CONTENTS
Gynecological Diseases Gynecological Cancer
Glossary of Obstetrical and Gynecological Terms
Table of Cases Index
469 479
503 567 573 587
PART I
Chapter 1
§ 1.1 § 1.2 § 1.3 § 1.4 § 1.5 § 1.6 § 1.7 § 1.8 § 1.9 § 1.10 § 1.11 § 1.12 § 1.13 § 1.14 § 1.15 § 1.16 § 1.17
§ 1.18 § 1.19
§ 1.20 § 1.21 § 1.22 § 1.23 § 1.24 § 1.25 § 1.26 § 1.27
§ 1.28 § 1.29 § 1.30 § 1.31
DETAILED CONTENTS
LEGAL ASPECTS OF OBSTETRICAL AND GYNECOLOGICAL MALPRACTICE
Liability of the Physician
Basis of Liability-Generally
Elements of the Malpractice Case: Checklist
Medical Records Liability for Unauthorized Release of Records
The Organization of Obstetrical Records
Analyzing the Medical Record
Medical Guidelines for Records Altered Records: "Badges of Suspicion"
Medical Authorities Expert Evaluation of Case
Professional Negligence-Generally
Physician-Patient Relationship Establishment of Standard of Care Causation and Damages
Hospital Liability-Generally
-Liability for Negligence of Hospital Employees
-Liability for Negligent Acts of Physicians, Surgeons, Interns, and Residents -Liability for Failure to Supervise and Review Patient Care
- The Standard of Care Applicable to Hospitals.
Res Ipsa Loquitur-Generally
-Inference of Negligence
-Defendant's Exclusive Control of Instrumentality
- Applications in Obstetrical Cases
Breach of Express Warranty
Informed Consent
Exceptions to Requirement of Infonned Consent
Wrongful Life, Wrongful Birth, and Wrongful Pregnancy-Generally -Wrongful Birth
- The Benefit Rule
-Wrongful Life
- Wrongful Pregnancy
xv
XVI DET AILED CONTENTS
§ 1.32 Products Liability in Drug Cases-Generally
§ 1.33 Unavoidably Unsafe Products and the Duty to Warn
§ 1.34 Physician's Duty to Warn of Risks of Oral Contraceptives
Chapter 2 The Physician's Case, Defenses, and Countersuits
§ 2.1 A vailable Defenses-Generally
§ 2.2 Standard of Care § 2.3 The Defense of Contributory Negligence-Generally
§ 2.4 -Failure to Reveal Medical History
§ 2.5 -Failure to Return to Physician
§ 2.6 -Failure to Follow Instructions
§ 2.7 Comparative Negligence "
§ 2.8 Assumption of Risk
§ 2.9 Res Judicata and Collateral Estoppel
§ 2.10 Statutes of Limitations- Generally
§ 2.11 - The Cause of Action
§ 2.12 - Time of Accrual of the Cause of Action
§ 2.13 Countersuits for Malicious Prosecution
§ 2.14 Other Theories of Countersuit
Chapter 3 The Trial of a Malpractice Case: Pleading and Practice
§ 3.1 Introduction
§ 3.2 Plaintiff's Complaint
§ 3.3 Parties-Defendant
§ 3.4 Defendant's Answer
§ 3.5 Deposition of the Plaintiff
§ 3.6 Deposition of the Physician
§ 3.7 Other Discovery
§ 3.8 Motion Practice
§ 3.9 Jury Selection-Generally
§ 3.10 -Plaintiff's Jury Selection
§ 3.11 -Jury Selection for the Defendant-Physician
§ 3.12 Plaintiff's Opening Statement
§ 3.13 Defendant's Opening Statement
§ 3.14 Introducing Medical Records
§ 3.15 Medical Records and the Physician-Patient Privilege
§ 3.16 Establishing the Standard of Care
§ 3.17 Qualification of the Expert-Generally
§ 3.18 -Nonobstetrician as Expert
§ 3.19 Subject Matter of Expert Testimony
§ 3.20 Bases of Expert's Opinion
§ 3.21 The Hypothetical Question
§ 3.22 Use of Treatises to Establish Standard of Care
§ 3.23 Jury Instructions
PART II
Chapter 4
DETAILED CONTENTS
MANAGEMENT IN THE ANTEPARTUM PERIOD
Prenatal Care and Diagnosis
MEDICAL ASPECTS
§ 4.1 Introduction
§ 4.2
§ 4.3
§ 4.4
§ 4.5
Initial Patient Visit
Physical Examination
Subsequent Visits The Diagnosis of Normal Pregnancy
LEGAL LIABILITY
§ 4.6 Errors in Diagnosis of Normal Pregnancy-Generally
§ 4.7 - Diagnosis as Tumor
§ 4.8 - Diagnosis as Gallbladder Condition
§ 4.9 -Other Misdiagnoses
§ 4.10 -Exploratory Surgery § 4.11 Failure to Diagnose Pregnancy: Wrongful Pregnancy
MEDICAL ASPECTS: ECTOPIC PREGNANCY
§ 4.12 Ectopic Pregnancy: "The Great Masquerader"
§ 4.13 Diagnosis of Ectopic Pregnancy
§ 4.14 Treatment of Ectopic Pregnancy
LEGAL LIABILITY: ECTOPIC PREGNANCY § 4.15 Failure to Diagnose Ectopic Pregnancy
§ 4.16 Diagnosis of Ectopic Pregnancy as Constipation
§ 4.17 Diagnosis of Ectopic Pregnancy as Salpingitis
MEDICAL ASPECTS: RUBELLA § 4.18 Rubella § 4.19 Effects of the Virus
§ 4.20 Immunization
LEGAL LIABILITY: RUBELLA
§ 4.20 Failure to Diagnose Rubella: Wrongful Birth and Wrongful Life
Chapter 5 Preeclampsia and Eclampsia
MEDICAL ASPECTS
§ 5.1 Preeclampsia and Eclampsia-Generally
§ 5.2 Significance of Preeclampsia and Eclampsia
§ 5.3 Diagnosis of Preeclampsia and Eclampsia § 5.4 Prevention of Preeclampsia and Eclampsia § 5.5 Treatment of Preeclampsia and Eclampsia
LEGAL LIABILITY
§ 5.6 Failure to Diagnose Preeclampsia and Eclampsia
§ 5.7 Misdiagnosis of Eclampsia as Gallbladder Condition § 5.8 Failure to Obtain Patient's Records
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§ 5.9 § 5.10 § 5.11
DETAILED CONTENTS
Failure to Treat Preeclampsia
Administration of Spinal Anesthesia to Eclamptic Patient Delayed Treatment of Eclampsia
Chapter 6 Fetal Maturity: Prematurity and Postmaturity
MEDICAL ASPECTS: PREMATURITY § 6.1 Assessment of Maturity § 6.2 Prematurity § 6.3 Iatrogenic Prematurity § 6.4 Premature Labor
§ 6.5 Arr~st of Premature Labor § 6.6 Premature Rupture of the Membranes-Generally § 6.7 Management of Premature Rupture of the Membranes
§ 6.8 Incompetent Cervix § 6.9 Intrauterine Growth Retardation
LEGAL LIABILITY : PREMATURITY § 6.10 Negligent Amniotomy § 6.11 Premature Cesarean Section § 6.12 Intrauterine Growth Retardation as Defense
MEDICAL ASPECTS: POSTMATURITY § 6.13 Postmaturity § 6.14 Evaluation of Postmaturity § 6.15 Management of Postmaturity
LEGAL LIABILITY: POSTMATURITY § 6.16 Failure to Assess Postmaturity
§ 6.17 Misdiagnosis of False Labor § 6.18 Delayed Delivery § 6.19 Failure to Perform Cesarean Section
Chapter 7 Amniocentesis
MEDICAL ASPECTS
§ 7.1 Amniocentesis-Generally § 7.2 Indications for Amniocentesis § 7.3 Standards for Performance § 7.4 Prenatal Detection of Genetic Disorders
§ 7.5 Genetic Counseling § 7.6 Fetal Maturity Assessment § 7.7 Amniocentesis Technique
§ 7.8 Complications of Amniocentesis-Generally § 7.9 -Maternal Complications § 7.10 -Fetal Complications
DETAILED CONTENTS
LEGAL LIABILITY § 7.11 Failure to Advise of Amniocentesis: Wrongful Birth § 7.12 Failure to Advise of Amniocentesis: Wrongful Life
§ 7.13 Negligent Performance of Amniocentesis
Chapter 8 Hemolytic Disease of the NewBorn
MEDICAL ASPECTS § 8.1 Rh Hemolytic Disease-Generally § 8.2 Pathogenesis of Hemolytic Disease § 8.3 Identification of Rh-sensitized Mother § 8.4 § 8.5 § 8.6 § 8.7 § 8.8 § 8.9
Prevention of Hemolytic Disease
Diagnosis of Hemolytic Disease
Treatment of Hemolytic Disease ABO Hemolytic Disease
Hyperbilirubinemia
Treatment of Hyperbilirubinemia
LEGAL LIABILITY § 8.10 Negligent Administration of Incompatible Blood § 8.11 Failure to Administer RhoGAM
§ 8.12 Reliance on Erroneous Test Results
§ 8.13 Blood Exchange Transfusion
Chapter 9 Drug Therapy in Pregnancy
MEDICAL ASPECTS
§ 9.1 Historical Perspective § 9.2 Prenatal Drug Therapy Dilemma
§ 9.3 Immunosuppressants
§ 9.4 Antimicrobial Agents (Antibiotics)
§ 9.5 Hormones and Antihormones § 9.6 Socially Used Drugs § -9.7 Anticonvulsants
§ 9.8 Anticoagulants § 9.9 Miscellaneous Drugs
§ 9.10 Prevention of Teratogenesis
LEGAL LIABILITY
§ 9.11 Liability of the Physician
§ 9.12 Drug Product Liability Actions and the Duty to Warn § 9.13 Unavoidably Unsafe Products and the Duty to Warn
Chapter 10 Abortion
MEDICAL ASPECTS § 10.1 Definitions
§ 10.2 Viability and Roe v. Wade
xix
xx DETAILED CONTENTS
§ 10.3 Spontaneous Abortion-Generally § 10.4 Missed Abortion § 10.5 Threatened Abortion § 10.6 Incomplete and Inevitable Abortions § 10.7 Habitual Abortion § 10.8 Therapeutic or Elective Abortion-Generally § 10.9 Medical Guidelines for Elective or Therapeutic Abortion § 10.10 Indications for Therapeutic Abortion § 10.11 Dilation and Curettage § 10.12 Risks of Dilation and Curettage § 10.13 Hysterectomy and Hysterotomy § 10.14 Intra~amniotic Solutions to Effect Abortion § 10.15 Failure to Terminate Pregnancy § 10.16 Septic Abortion § 10.17 Summary of Complications of Abortion § 10.18 Abortion Follow-Up
LEGAL LIABILITY
§ 10.19 Legal Issues-Generally § 10.20 Wrongful Pregnancy § 10.21 Negligent Perforation of Uterus § 10.22 Duty to Continue Care of Patient
PART III
Chapter 11
MANAGEMENT OF LABOR AND DELIVERY
Normal Labor and Dysfunctional Labor
MEDICAL ASPECTS
§ 11.1 Stages of Labor
§ 11.2 Changes before Labor § 11.3 Cervical Effacement and Dilatation § 11.4 False Labor
§ 11.5 Stations of the Fetal Head § 11.6 Engagement
§ 11.7 Detection of Ruptured Membranes § 11.8 Dysfunctional Labor-Generally § 11.9 Complications of Uterine Dysfunction
§ 11.10 Uterine Dysfunction and the Friedman Curve
§ 11.11 Identifying Disorders of Labor § 11.12 Categories of Dysfunctional Labor § 11.13 -Prolonged Latent Phase § 11.14 - Treatment of Prolonged Latent Phase Disorder § 11.15 -Protracted Active Phase Dilatation § 11.16 - Treatment of Protracted Dilatation Disorder
§ 11.17 § 11.18 § 11.19 § 11.20
DETAILED CONTENTS
- Protracted Descent Phase Disorder - Arrest Disorders Duration of Second Stage of Labor
Precipitate Labor
LEGAL LIABILITY
§ 11.21 Mismanagement of Abnormal Labor-Generally § 11.22 Cephalopelvic Disproportion and Prolonged Labor § 11.23 Mismanagement of Precipitate Labor § 11.24 Misdiagnosis of False Labor
Chapter 12 Pelvic Dystocia and Cephalopelvic Disproportion
MEDICAL ASPECTS § 12.1 Dystocia of Pelvic Origin § 12.2 Pelvic Measurements § 12.3 Dystocia Due to Fetal Factors § 12.4 Cephalopelvic Disproportion § 12.5 Detection of Cephalopelvic Disproportion-Generally § 12.6 X-ray Pelvimetry § 12.7 Management of Cephalopelvic Disproportion
LEGAL LIABILITY
§ 12.8 Mismanagement of Cephalopelvic Disproportion
Chapter 13 Induction of Labor and Oxytocin Stimulation
MEDICAL ASPECTS § 13.1 Induction of Labor-Generally § 13.2
§ 13.3 § 13.4 § 13.5 .§ 13.6
§ 13.7 § 13.8
Amniotomy
Risks of Amniotomy Oxytocin Stimulation Guidelines for Oxytocin Administration Risks of Oxytocin Discontinuation of Oxytocin Contraindications of Oxytocin
LEGAL LIABILITY
§ 13.9 Introduction § 13.10 Administration of Oxytocin in Breech Presentation § 13.11 Administration of Oxytocin in Cephalopelvic Disproportion § 13.12 Contraindicated Administration of Oxytocin § 13.13 Failure to Monitor Effects of Oxytocin
§ 13.14 Premature Amniotomy
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XXll DETAILED CONTENTS
Chapter 14 Fetal Distress
MEDICAL ASPECTS
§ 14.1 Definition and Clinical Signs
§ 14.2 Electronic Fetal Heart Monitoring-Generally
§ 14.3 Indications for Use of Electronic Monitoring § 14.4 Fetal Heart Rate
§ 14.5 Baseline Fetal Heart Rate
§ 14.6 Variability of Fetal Heart Rate § 14.7 Periodic Fetal Heart Rate Changes
§ 14.8 - Pattern of Early Deceleration
§ 14.9 -Pattern of Late Deceleration
§ 14.10 -P~ttern of Variable Deceleration
§ 14.11 Monitoring Instrumentation-Generally
§ 14.12 -External Fetal Heart Monitoring
§ 14.13 -Internal Fetal Heart Monitoring § 14.14 Fetal Blood Sampling
§ 14.15 Indications for Fetal Blood Sampling § 14.16 Meconium
§ 14.17 Herpes Virus Infection during Pregnancy
§ 14.18 Treatment of Fetal Distress
LEGAL LIABILITY
§ 14.19 Failure to Use Electronic Fetal Heart Monitor
§ 14.20 Failure to Respond to Fetal Distress
Chapter 15 Abnormalities of the Cord and Placenta
MEDICAL ASPECTS § 15.1 Umbilical Cord Prolapse
§ 15.2 Diagnosis of Cord Prolapse
§ 15.3 Management of Cord Prolapse
§ 15.4 Iatrogenic Prolapse
§ 15.5 Loops of the Cord § 15.6 Placenta Previa § 15.7 Signs and Symptoms of Placenta Previa
§ 15.8 Diagnosis of Placenta Previa
§ 15.9 Ultrasonic Localization
§ 15.10 Management of Placenta Previa § 15.11 Abruptio Placenta
§ 15.12 Diagnosis of Abruptio Placenta
§ 15.13 Treatment of Abruptio Placenta
LEGAL LIABILITY
§ 15.14 Negligent Management of Cord Prolapse § 15.15 Negligent Management of Abruptio Placenta
DETAILED CONTENTS
§ 15.16 § 15.17
Negligent Management of Placenta Previa
Negligent Management of Placenta Accreta
Chapter 16 Obstetrical Anesthesia and Analgesia
MEDICAL ASPECTS § 16.1 Significance of Anesthesia-Generally
§ 16.2 Medical Guidelines for Anesthesia § 16.3 Special Considerations in Obstetrical Anesthesia § 16.4 Analgesia and Sedation during Labor § 16.5 Paracervical Block § 16.6 Pudendal Block § 16.7 Spinal Anesthesia § 16.8 Complications with Spinal Anesthesia § 16.9 Contraindications to Spinal Anesthesia
§ 16.10 Epidural Block § 16.11 Complications of Epidural Block § 16.12 General Anesthesia for Cesarean Section § 16.13 Aspiration of Vomitus in General Anesthesia
§ 16.14 Treatment of Aspiration § 16.15 Prevention of Death in Obstetric Anesthesia
LEGAL LIABILITY § 16.16 Aspiration of Vomitus
§ 16.17 Failure to Obtain Informed Consent to Spinal Anesthesia § 16.18 Administration of Saddle Block § 16.19 Saddle Block Administered to Eclamptic Patient § 16.20 Negligent Endotracheal Intubation § 16.21 Administration of Paracervical Block § 16.22 Administration of Epidural Anesthesia § 16.23 Administration of Valium
Chap,ter 17 Presentation, Position, and Breech Delivery
MEDICAL ASPECTS § 17.1 Presentation and Position-Generally § 17.2 Cephalic Presentation § 17.3 Vertex Presentation and Positions § 17.4 Vertex Delivery § 17.5 Normal Spontaneous Vaginal Delivery § 17.6 Episiotomy § 17.7 Delivery of the Shoulders § 17.8 Face Presentation
§ 17.9 Brow Presentation § 17.10 Transverse Presentation § 17.11 Route of Delivery
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§ 17.12 § 17.13 § 17.14 § 17.15 § 17.16 § 17.17
DETAILED CONTENTS
Breech Presentation-Generally
- Incidence and Diagnosis
-Significance of Breech Presentation -Management of Vaginal Breech Delivery
- Methods of Vaginal Delivery
-Trends in Management of Breech Presentation
LEGAL LIABILITY
§ 17.18 Failure to Perform X-ray Pelvimetry
§ 17.19 § 17.20
§ 17.21
Chapter 18
Hyperextension of Head Excessive Force in Vaginal Delivery Injury to Mother in Footling Breech
Shoulder Dystocia and Brachial Plexus Injury
MEDICAL ASPECTS
§ 18.1 Significance of Shoulder Dystocia § 18.2 Treatment of Shoulder Dystocia
§ 18.3 Brachial Plexus Injuries
LEGAL LIABILITY
§ 18.4 Occipital Fracture and Brachial Plexus Injury
§ 18.5 Diabetic Mother and Shoulder. Dystocia
Chapter 19 Cesarean Section
MEDICAL ASPECTS
§ 19.1 Definition and Types
§ 19.2 Indications and Contraindications-Generally
§ 19.3 Specific Indications for Cesarean Section § 19.4 Repeat Cesarean vs. Vaginal Delivery
§ 19.5 Complications of Cesarean Section
§ 19.6 Incidence of Cesarean Section
§ 19.7 Medical Guidelines for Cesarean Section
LEGAL LIABILITY § 19.8 Legal Aspects of Cesarean Delivery-Generally § 19.9 Failure to Perform Cesarean Section
§ 19.10 Delayed Performance of Cesarean Section
§ 19.11 Premature Performance of Cesarean Section
§ 19.12 Negligent Performance of Cesarean Section
Chapter 20 Forceps Operations
MEDICAL ASPECTS § 20.1 Forceps Operations-Generally
§ 20.2
§ 20.3 § 20.4
Definitions and Classifications
Indications for Forceps Delivery Prerequisites for Use of Forceps
§ 20.5 § 20.6 § 20.7
§ 20.8
DETAILED CONTENTS
Application of Forceps Low Forceps Operations Midforceps Operations
Vacuum Extraction
LEGAL LIABILITY § 20.9 Use of Forceps in Cephalopelvic Disproportion § 20.10 Misdiagnosis of Position § 20.11 Forceps in Transverse Lie
§ 20.12 Forceps in Shoulder Dystocia § 20.13 Misapplication of Forceps § 20.14 Failure to Use Forceps
Chapter 21 Maternal and Newborn Concerns in the Postpartum Period
MEDICAL ASPECTS: POSTPARTUM MANAGEMENT § 21.1 Maternal Complications in the Postpartum Period-Generally
§ 21.2 Medical Guidelines § 21.3 Postpartum Hemorrhage § 21.4 Causes and Prevention of Postpartum Hemorrhage § 21.5 Management of Postpartum Hemorrhage § 21.6 Postpartum Shock
§ 21.7 Management of Shock § 21.8 Placenta Accreta § 21.9 Infections
LEGAL LIABILITY: POSTPARTUM MANAGEMENT § 21.10 Mismanagement of Postpartum Hemorrhage
§ 21.11 Abcess from Uterine Packing
MEDICAL ASPECTS: CARE OF THE NEWBORN. § 21.12 Immediate Care of the Newborn § 21.13
§ 21.14 § 21.15
§ 21.16 § 21.17 § 21.18
Evaluation of the Newborn
Suctioning and Meconium Aspiration Resuscitation of the Newborn-Generally
Resuscitative Standards and Procedures Ventilation and Cardiac Massage Retrolental Fibroplasia
LEGAL LIABILITY: CARE OF THE NEWBORN
§ 21.19 Inadequate Resuscitation § '21.20 Liability for Retrolental Fibroplasia
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PART IV
Chapter 22
DETAILED CONTENTS
MEDICO-LEGAL CONCERNS IN GYNECOLOGY
Contraception
INTRODUCTION
§ 22.1 Introduction
MEDICAL ASPECTS: ORAL CONTRACEPTIVES § 22.2 Oral Contraceptives: Benefits and Risks § 22.3 § 22.4 § 22.5 § 22.6 § 22.7 § 22.8
Cardiovascular Effects
Neoplasia
Hypertension
Other Effects of Oral Contraceptives Contraindications to Use of Oral Contraceptives
Monitoring of Patients
LEGAL LIABILITY: ORAL CONTRACEPTIVES
§ 22.9 Failure to Obtain Informed Consent
§ 22.10 Administration to Patient with Migraine Disorder § 22.11 Failure to Diagnose Patient with Thrombophlebitis
MEDICAL ASPECTS: IUD § 22.12 Intrauterine Devices: Types § 22.13 Adverse Effects
§ 22.14 Contraindications to IUD Use § 22.15 Insertion and Replacement
LEGAL LIABILITY: IUD
§ 22.16 Breach of Duty to Wa~ § 22.17 § 22.18 § 22.19
Failure to Locate and Remove IUD
Improper Insertion of IUD Legal Liability of the Dalkon Shield
MEDICAL ASPECTS: STERILIZATION
§ 22.20 Sterilization
§ 22.21 Indications for Sterilization
§ 22.22 Contraindications and Hazards
LEGAL LIABILITY: STERILIZATION
§ 22.23 Failure to Obtain Informed Consent
§ 22.24 Injury to Patient
§ 22.25 Wrongful Pregnancy
Chapter 23 Dilation and Curettage
MEDICAL ASPECTS § 23.1 Technique of Dilation and Curettage
§ 23.2 . Indications and Complications
DETAILED CONTENTS XXVll
LEGAL LIABILITY § 23.3 Failure to Perform Dilation and Curettage § 23.4 Premature Release from Hospital § 23.5 Perforation of Uterus
§ 23.6 Incomplete Dilation and Curettage
Chapter 24 Hysterectomy
MEDICAL ASPECTS § 24.1 Incidence of Hysterectomy § 24.2 Medical Indications for Hysterectomy
§ 24.3 Types of Hysterectomy
§ 24.4 Complications of Hysterectomy
LEGAL LIABILITY § 24.5 Bases of Liability-Generally
§ 24.6 Failure to Obtain Informed Consent
§ 24.7 Negligence-Generally
§ 24.8 Unnecessary Hysterectomy
§ 24.9 Removal of Healthy Organs § 24.10 Postoperative Care
Chapter 25 Gynecological Diseases
MEDICAL ASPECTS
§ 25.1 Pelvic Infections-Generally
§ 25.2 Gonorrhea § 25.3 Syphilis § 25.4 Herpes
§ 25.5 Salpingitis
§ 25.6 Endometriosis
LEGAL LIABILITY
§ 25.7 Improper Diagnosis and Treatment of Endometriosis § 25.8 Misdiagnosis of Syphilis
§ 25.9 Misdiagnosis of Gonorrhea § 25.10 Misdiagnosis of Pelvic Inflammatory Disease
Chapter 26 Gynecological C~ncer
MEDICAL ASPECTS: BREAST CANCER § 26.1 Breast Cancer-Generally
§ 26.2 Forms of Breast Cancer
§ 26.3 Signs and Symptoms of Breast Cancer § 26.4 Diagnosis of Breast Cancer § 26.5 Differential Diagnosis § 26.6 Treatment of Carcinoma of the Breast § 26.7 Women at High Risk for Breast Cancer
xxviii DETAILED CONTENTS
LEGAL LIABILITY: BREAST CANCER § 26.8 Failure to Diagnose Breast Cancer § 26.9 Failure to Obtain Informed Consent
MEDICAL ASPECTS: CERVICAL CANCER § 26.10 Carcinoma of the Cervix: Types and Definitions § 26.11 § 26.12
Diagnosis of Cervical Cancer
Treatment of Cervical Cancer
LEGAL LIABILITY: CERVICAL CANCER § 26.13 Failure to Diagnose Cervical Cancer § 26.14 Failure to Obtain Informed Consent
MEDICAL ASPECTS: OVARIAN CANCER
§ 26.15 <;lvarian Neoplasms § 26.16 Signs and Symptoms of Ovarian Cancer § 26.17 Diagnosis and Management of Ovarian Cancer
LEGAL LIABILITY: OVARIAN CANCER § 26.18 Liability Arising from Treatment of Ovarian Cancer
Appendixes
A. Sample Medical Records B. Authorization for Release of Medical Records
C. Expert Medical Evaluation for Plaintiff D. Expert Medical Evaluation for Defendant E. Physician's Letter to Patient Who Fails to Keep Appointment F. Physician's Letter to Patient Who Fails to Follow Advice G. Complaint H. Answer of Physician
I. Answer of Hospital J. Direct Examination of Plaintiff's Expert K. Consent Form L. Abbreviations in Medical and Hospital Records M. Hospital Obstetrical Rules and Regulations N. Physician Notes O. Interrogatories of Defendant-Physician
Glossary of Obstetrical and Gynecological Terms
Table of Cases
Index