simultaneous ectopic/intrauterine pregnancy

Daughter had ectopic pregnancy diagnosed and was sent to another MD to have it removed. Second MD did not do ultrasound to confirm but did do surgery that day. She had prolonged bleeding, pain after procedure and called MD office twice but was told this "was normal." She asked to speak to the doctor but was told "he was too busy to talk to patients on the phone." She had what she thought was a period after this but still had intermittent spotting, etc. Went back to doctor and was told she is 19.5 weeks pregnant....they missed the intrauterine pregnancy in April when she had the ectopic. They have confirmed that this IS a case of co-existing tubal and intrauterine pregnancies. She wants to sue and I don't blame her. Thoughts?

[AnnieBrooke]

She can only get remunerated for what it cost her to have this mistake happen.  If a jury were to decide she wasn't damaged, there will be no point to a lawsuit.  If she did not want to be pregnant, they could possibly decide for her, but if she wanted to be pregnant, they might decide that a little pain and bleeding was par for the course with many pregnancies and there was no proof hers wasn't one of those despite the missing of the one pregnancy in the hunt to deal with the ectopic.  If the baby she has in utero is damaged and it can be PROVEN that it was from the doctor's mistake, then she has a case against them for the baby's sake.  But just having been treated shabbily does not a successful lawsuit make.  I would consider filing a complaint with the medical review board rather than a lawsuit.  She should be sure to document everything they did or didn't do.  

[wonderme]

Hi.  Wow...how do they feel she and the baby are doing?  I hope well.

AnnieBrooke -- just wondering what your background is?  You seem well versed both medically and legally...just curious if you were an attorney and/or in the medical field.

I am not either of those things, however, I would suggest that she speak to an attorney...I do not see any harm in getting their opinion.  I would think being disregarded and NOT getting proper prenatal treatment for 2-3 months and during critical growing time, could warrant negligence.  Where I live, negligence negates everything - you can not be negligent, especially when you hold yourself out as an expert!

Curious why he didn't follow up with her and how he could miss the intrauterine pregnancy entirely.

In addition, I would think she may have a case for pain and suffering...now and the worry she may have for not getting treatment for all those months.  Again, I am NOT an attorney or a doctor, but I think I would be pretty sympathetic to her if I were sitting on a jury.  Just my opinion.

Good luck!!

[tmv]

If the ectopic was in the fallopian tubes, then it is a matter of life and death to the mother. If they do not remove it, it can rupture and death can occur quickly. My sister's ruptured in the er and they took her straight to surgery. She later required 2 units of blood to get her count up to 1/2 of what it was prior. I would just be very thankful that you still have your daughter, but that may just be me. Also, it is not uncommon for a  dr not to have time to talk to a pt as they are double and sometimes triple booked. I understand her being upset, but they truly saved her life and I don't feel there is any room for suing. Best wishes.

[AnnieBrooke]

I agree with you tmv.  I don't think this lady's daughter got good treatment regarding her uterine pregnancy.  But lawsuits and their success hinge on a lot of things, and in this case the medical intervention she did get saved her life by dealing effectively with the ectopic, plus nobody can say whether she would have had pain and cramping and such with her uterine pregnancy even if they hadn't been short with her when she called with problems and questions.  In my pregnancy when I had a vanished twin, they were concerned about me and talked to me daily and put me on bedrest, and I STILL had pain and cramping and lost the twin, so it's not a matter of good care making all outcomes positive.  She is lucky on something important (proper care of an ectopic), and unlucky on something not as bad (cramping and pain and unanswered questions with early pregnancy).  It would be a stupid attorney on the part of the doctor who would miss the opportunity to point this out.  Maybe she would get an award, but it takes forever, and there are appeals, and it costs a lot of time and money to sue, and it's just not worth it in a situation where the case is not obvious.    

wonderme -- As it happens, I'm a law-school graduate, but what I'm saying here about the cost of appeals and the hassles comes from a business-law class I had as an undergraduate.  They had us read a list of all the tort suits in a given time frame in our state and how long they took, if there was an award, how much the award was, how long the appeal took, and if the award stood up.  The time frames were years, not months, and only one or two out of several hundred came out to big awards.  Not that someone with a good case should hesitate to sue, but having a grievance doesn't translate as automatically into a big "pain and suffering" award as the media  reporting cases would have us believe.  I'd encourage the lady to talk to a lawyer if she wants, maybe the mom doesn't have all the details of the things the doctor's office did wrong.  But rudeness and indifference aren't enough, the person needs also to have real damage as a result.  (One can't say "There MIGHT have been a real problem," either.) The mom doesn't say that there is presently danger to either the daughter, the child, or the pregnancy.  There is such a thing as a "wrongful birth" suit, but the mom doesn't say the daughter didn't want the pregnancy.  The daughter is alive and (presumably desirably) pregnant, and unless she can show compelling damage during the time the doctor's office was sloppy and indifferent to her, most juries will say "What's she got to complain about?"

[4EVERDK]

I think that you could sue and get what you want out of it, its malpractice(sp?)  The doctor is totaly at fault because he didn't do an ultrasound himself.  If he can't seem to take a few minutes and order an ultrasound to make sure what he was looking at then, looks like he should be sued...

[4EVERDK]

Oh okay I totaly misunderstood that for some reason, I thought that they went into have a ectopic removed that didn't even exist.  Okay... I don't really know if you could sue but I still think there should have been more ultrasounds done.  But she is very blessed!

[Nicki1433]

On what grounds would you sue on?  Either way, the ectopic had to be removed otherwise it could've killed her.  At least the other baby is okay!

I had a friend who had a co-exsisting pregnancy in the tube and intrauterine.  They didn't know this until surgery either.  They accidentally poked a hole in her uterus during surgery which caused hemmorhaging.  She had to have a hysterectomy.  Lost both babies and the ability to have any future children.  She was 22 years old.

Count your blessings!

[AnnieBrooke]

Did she also lose both ovaries?  If not, and if she is young enough, she could have her eggs fertilized by her husband's sperm in the lab and have a surrogate carry the baby.  Sounds very sci-fi, but it is done often.  I hope it's not too late for that, and that is one the original doctor's malpractice coverage should pay for.

[wonderme]

Hey all...just want to point out that I agree that assuming she wanted to be pregnant, then yes she is lucky to be so -- and glad the ectopic was handled.

Do we know how the baby is doing at 20 weeks?

I, however, disagree on the responsibilty of the doctor.  Number 1 he MISSED the intrauterine pregnancy altogether EVEN though she reported continued issues -- for 3+ MONTHS!

Secondly, by his negligence, he caused her to miss the oportunity to have any screening and/or diagnostic procedures to ensure both healthy baby and healthy pregnancy OR to identify any potential problems.  

All that being said, it often does take a great deal of time for these cases to run their course -- HOWEVER, if an attorney feels she has a case, it would likely be taken on contingency so she would not incur fees for the case unless a settlement was recovered -- often doesn't even go to court and gets settled by malpractice insurance.

I often hear about doctors being double and triple booked -- to me that's NOT an excuse to be negligent -- just because she got lucky that he didn't cause her to lose the other pregnancy, doesn't mean that he isn't negligent.

I realize that people make mistakes, but if we just let them (doctors) get away with it, then we might be the next patient that gets suboptimal care -- and possibly with a far worse outcome!  I've had minor problems/miscommunications with my doctor and wouldn't report them or sue them, BUT really missing a pregnancy until halfway through and denying a patient/baby care for half of the pregnancy is in my eyes unacceptable -- regardless if everything turns out okay.

BTW -- get a new doctor!!

[Nicki1433]

What a money hungry society we live in!!!  I cannot believe that she would even consider filing a lawsuit.  Cramps, pain, bleeding, etc ARE NORMAL after a surgery like that.  The doctor was right in saying that.  Even IF he would've seen the intrauterine pregnancy prior to surgery it still would've had to be done!  She should be lucky she's even alive...let alone is still pregnant with one child.  Good grief!  Everyone makes mistakes and I certainly hope that I don't get sued for all the ones that I make.  

If there's an issue with the baby that she doesn't want to deal with then she would've had the option to abort, but now she still has the option to put the baby up for adoption!  

Yes, she does need a new doctor b/c she doesn't trust the one she has now...but a lawsuit (I'm sure she could get a lawyer to persuit it, but morally I think it's wrong).

[wonderme]

I just want to point out that this may not be a matter of getting money...but rather of holding the doctor accountable for his obvious negligence.

It is great that he took care of her ectopic-- I do NOT debate that -- but that doesn't mean he gets a freebie for missing the other pregnancy -- especially when she had continued complaints.  I wouldn't accept it.

I realize that we all come from different perspectives, but I've seen the rampage misdiagnoses have caused in friends' lives -- some nearing death and others many months or years of pain/discomfort.  Yes, many doctors are wonderful and caring people -- mine included, but I sure wouldn't want to run across this doctor and put my baby in his hands.  

How much time would it have taken to phone her back when he DID have time?  What about a follow-up exam in less than three months?

I don't think any of it is about the money (although I can't speak for the original poster) but I would be pretty upset to have been denied all the reassurance that goes along with proper care.

[AnnieBrooke]

I don't disagree.  This is why I said to the original poster that filing a complaint with the medical board would be a good thing to do.  A lawyer I know always comes into her office first thing in the morning and asks the secretary, "Any malpractice claims against us?  Any Board complaints?" meaning, against herself.  She's being facetious, of course -- she's a good lawyer and has never had a malpractice claim or Board complaint.  But the point is, she takes the threat of each thing equally seriously.  If you want to get the attention of a licensed professional and get them to change their ways, filing a complaint with the body that licenses them is as significant as an attempted lawsuit.  They sure as heck don't want to lose their license.

The reason I discouraged a lawsuit was that she fell through the cracks between two doctors, and one may even have thought the other did the necessary ultrasound, it could have been an innocent error.  Sure, the callousness of the doc who said he was too busy to talk was appalling, but someone will ask "Why didn't she go back to her first doctor right away?" or some other thing.   Since it's not cut and dried, then you get to the time, effort and emotionality that go into a suit .  They often backfire against the person filing the suit.  It can be so not worth it.  I would do what I could, but I wouldn't try to sue because it would be hard on ME.  She has other things to think about now, and moving forward is better than digging up this.