Arizona – Obstetrics – Failure To Thoroughly Evaluate Possibility Of Rupture Of Membranes Leads To Birth Complications

The Board was notified of a malpractice settlement involving the treatment of a 33-year-old woman.

On 12/24/2010, a patient presented to determine whether she had experienced a rupture of membranes for 11 hours.  Her history included a positive GBS (Group B Streptococcus) culture.  Nursing staff evaluated her and reported to the obstetrician that she had not experienced a rupture of membranes.

The medical records document that a digital vaginal examination was performed by the nursing staff, but do not indicate that other testing was done.  The obstetrician was in the hospital but did not personally see the patient or examine her.  The obstetrician did not review the fetal tracing at the time.  Upon later review, the respondent noted “variables” along with hyper-variability of which she was not informed.

The patient returned the following morning with chorioamnionitis and was delivered by Cesarean section.  The infant died due to sepsis, hypoxic ischemic encephalopathy, and disseminated intravascular coagulation.

The Board judged obstetrician’s conduct to be below the minimum standard of competence given failure to perform a thorough evaluation and obtain an ultrasound when there was a question of rupture of membranes.

The Board ordered the obstetrician to be reprimanded.

State: Arizona

Date: November 2016

Specialty: Obstetrics

Symptom: N/A

Diagnosis: Obstetrical Complication

Medical Error: Failure to examine or evaluate patient properly, Failure to order appropriate diagnostic test

Significant Outcome: Death

Case Rating: 3

Link to Original Case File: Download PDF

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