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$1.2 Million Recovery: Pregnancy Diagnosis Error

Mistaken Diagnosis of Ectopic (Tubal) Pregnancy

Plaintiff, age 27, was 6 weeks pregnant at which time she was sent by her obstetrician to a radiologist for an ultrasound to confirm pregnancy size and dates. The radiologist mistakenly diagnosed Plaintiff as having an ectopic (tubal) pregnancy. A tubal pregnancy is not capable of being carried to term. Because an ectopic pregnancy will eventually rupture and cause hemorrhage and possibly death, it is medically necessary to terminate such a pregnancy. The radiologist telephoned Dr. Stewart, Plaintiff's treating obstetrician, and informed her of his diagnosis.

On the basis of the radiologist's diagnosis, Dr. Stewart administered Methotrexate to Plaintiff in order to terminate what she believed to be an ectopic pregnancy. Methotrexate, a chemotherapy agent, is a drug that is used by obstetricians to terminate ectopic pregnancies without surgery. It interferes with DNA synthesis. As a result, Methotrexate is known to cause birth defects in children born to exposed mothers. After it was discovered that Plaintiff had an intrauterine pregnancy rather than an ectopic pregnancy, she was referred to a maternal-fetal specialist who counseled that, despite the Methotrexate exposure, the chance of birth defects was low. Plaintiff elected to continue the pregnancy.

As a result of the Methotrexate exposure, however, the baby was born with multiple birth defects and died after three months as a result of complications caused by a congenital heart problems. Prior to trial, the radiologist and his group settled by payment of the sum of $950,000 and a consent judgment was entered.

Dr. Stewart adamantly denied responsibility and blamed the radiologist for providing the wrong diagnosis. Plaintiffs alleged that Dr. Stewart was negligent in accepting the radiologist's diagnosis without performing any additional tests to confirm the existence of ectopic pregnancy. The challenge that Plaintiffs' counsel faced was convincing the jury that Dr. Stewart was not entitled to rely solely on the diagnosis of the radiologist.

Compounding this difficulty were two factors: (1) the radiologist told Dr. Stewart in an emergency phone conversation that he definitely diagnosed an ectopic pregnancy and was in fear that the Plaintiff would rupture without prompt treatment; and (2) Dr. Stewart was a potentially formidable witness as a member of the Georgia Composite State Board of Medical Examiners. Since only two physicians in each specialty sit on this Board, Dr. Stewart was one of only two obstetricians in the State who were Board members. It was clear that Dr. Stewart, represented by one of the top medical malpractice defense lawyers in Georgia, Tom Carlock, was going to try to shift the blame to MedCross in order to exonerate his client.

With the assistance of co-counsel, Kimberly Rabren, Plaintiffs' lead counsel, Wayne Grant, was able to establish that Dr. Stewart was not entitled to rely entirely on the unconfirmed though strongly-expressed diagnosis of the radiologist. Mr. Grant argued that because of the possibility of birth defects posed by administering Methotrexate to a woman who is carrying a normal pregnancy, Dr. Stewart should have performed at least two beta HCG (hormone level) tests prior to administration of the dangerous drug. Mr. Grant argued that at 6 weeks, though a rupture of an ectopic pregnancy can occur, it is unlikely. Mr. Grant also argued that if Dr. Stewart truly believed that rupture was imminent, proper care would have required a surgical termination of the pregnancy (laparoscopic procedure) since the administration of Methotrexate would not eliminate the danger of rupture for several days.

Dr. Stewart contended that she had performed a beta HCG hormone test prior to administration of the Methotrexate and that the level was consistent with the existence of an ectopic pregnancy. Through the presentation of independent witnesses, however, Mr. Grant was able to prove that the lab did not issue the test results until after Plaintiff received the drug and was discharged from the hospital, thus making it impossible for Dr. Stewart to have had the readings at the time of administration. In order to cross-examine and impeach Dr. Stewart on this point, Mr. Grant used excerpts from Dr. Stewart's videotape deposition, shown by projector on an oversized screen. Mr. Grant was also able to establish through the cross-examination of Dr. Stewart's expert witnesses that the HCG level obtained, though not available to Dr. Stewart, was significantly higher than the level that one would expect to accompany a 6-week ectopic pregnancy and was more consistent with an intrauterine pregnancy.

As indicated previously, prior to trial, the radiology group defendants settled by payment of the sum of $950,000. One of the conditions of settlement was that the radiologists agree to the entry of formal consent judgment. Obtaining a consent judgment, according to Mr. Grant, was a key factor that allowed his clients to maintain a favorable venue. With the consent judgment in hand, Mr. Grant was able to maintain and conduct the trial Clayton County, the county in which the action was originally filed. Had there not been a consent judgment, after settlement with the radiology group, the case would have been transferred to Gwinnett County, an extremely conservative venue, widely known to be favorable to defendants.

At trial, the jury rendered an award against Dr. Stewart in the amount of $615,000. As a result of the settlement with the radiology group, Dr. Stewart was given a set-off of $380,010. After credit for the set-off, the total recovery obtained was $1,184,990.

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