This case takes place in Illinois and involves a woman who underwent an emergency C-section. During the delivery of the infant, the OBGYN noted several adhesions which were apparently interfering with the c-section procedure. The OBGYN decided to cut the adhesions in order to facilitate the delivery, at which point the patient began to hemorrhage. There was an attempt to stem the bleed and the patient was transferred to the PACU, where surgeons feared she was experiencing an amniotic fluid embolism. She was returned to the OR where a full hysterectomy was performed. Following this surgery, the patient continued to bleed, and the doctors were unable to locate the source of bleeding in time to save her life.
Question(s) For Expert Witness
- 1. Do you routinely treat patients with similar presentation to the one in this case? Do you routinely perform C sections?
- 2. Have you ever had a patient develop this complication?
- 3. Are you able to review the medical records and opine on this case on behalf of the plaintiff?
Expert Witness Response E-000239
Yes I do have experience with patients such as the one in this case. I have had patients bleed and develop DIC after delivery, I have done hysterectomies after a c/section but never had a patient die in this situation. Yes Lysis of adhesions may be necessary and appropriate, since this is something that would only be found at the time of surgery. I’m not sure why a patient would bleed so much, unless there was something else besides adhesions– could this have been a placenta accreta? Was pathology obtained on the uterine specimen? There may be more to this than it seems.
Expert Witness Response E-016421
I do a lot of cesarean sections, and run into adhesions frequently. Not sure how bleeding from adhesiolysis and partial hysterectomy are related. It is very unlikely that while in the PACU, no blood pressure monitoring was done. It is very rare for young woman to die after cesarean sections. There is something missing in this story.