At the conclusion of four hours of jury deliberations after a three-week trial, a Connecticut birth injury medical malpractice jury awarded $30.3 million in economic and noneconomic damages against an OB and her medical practice.
The then 32-year-old woman was under the care of the defendant medical group when she was admitted to the hospital to deliver her first first baby, on December 6, 2014. When the second stage of labor did not progress as expected, the defendant OB recommended a Cesarean section deliver, to which the woman agreed. Fifteen minutes later, the woman was brought to the operating room for the C-section delivery.
The woman’s Connecticut medical malpractice lawsuit alleged negligence in delaying delivery by C-section and that the her baldder and uterus were negligently injured during the C-section procedure that preculdes her from having more children in the future.
Cesarean Delivery And Bladder Injury
Cesarean section is the most common surgery performed in the United States. In 2009, 1.3 million births (32.3%) in the United States occurred by cesarean section.
Bladder injury during primary cesarean section delivery is about 0.2% and during repeat cesarean section is about 0.6%. The incidence of bladder injury during cesarean section ranges from 0.08 to 0.94%. Bladder injury was more likely to occur during emergent delivery (31% versus 11%). Most of the bladder injuries during cesarean section are intraperitoneal injury and usually it occurs at the dome of the bladder (95%), more than 6 cm—and often more than 10 cm—away from the trigone. The average length of bladder injury is 4.2 cm (1–10 cm). The most likely time bladder injury occurs is during the creation of a bladder flap (43%), another 33% of bladder injuries occur at the time of entry into the peritoneal cavity, and the remaining 24% of the injuries occur during uterine incision or delivery.
Sixty-two percent of bladder injuries are identified at the time of delivery of the infant and repair of the hysterotomy. Twenty-one (21)% of bladder injuries are recognized during the creation of the bladder flaps, 12% during entry into the peritoneal cavity, and 5% prior to fascial closure.
Iatrogenic bladder injury can be classified as follows:
Grade 5: intra- or extraperitoneal bladder wall laceration involving the trigone or bladder neck
Grade 1: contusion, intramural hematoma or partial thickness laceration
Grade 2: extraperitoneal bladder wall laceration <2 cm
Grade 3: extraperitoneal >2 cm or intraperitoneal <2 cm laceration
Grade 4: intraperitoneal bladder wall laceration >2 cm
The involvement of the posterior area of bladder may raise the suspicion of trigonal and ureteral involvement. Grade 5 injury warrants calling the urologist or urogynecologist.
According to one medical article:
Bladder injury as a consequence of postoperative adhesion is defendable;
Abnormal anatomy, e.g., when the bladder is high-up over the uterus inadvertent bladder injury is not negligent;
When cesarean section is done during full dilatation of cervix, as the head lies deep in the pelvis, inadvertent bladder injury is not negligent;
In the absence of abnormal anatomy, and if injury is not recognized intraoperatively, it may be proven as negligence.
If you or your baby suffered a birth injury during labor and delivery in Connecticut or in another U.S. state, you should promptly find a birth injury lawyer in Connecticut or in your state who may investigate your birth injury claim for you and represent you and your child in a birth injury case, if appropriate.
Visit our website or call us toll-free in the United States at 800-295-3959 to find birth injury lawyers in your state who may assist you.
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