Kansas City, Missouri Medical Malpractice Blog

What would you do if you were in the midst of delivering your child and you thought something was wrong? Ideally, you wouldn't have to worry, because your doctors and nurses have you hooked up to a variety of machines that are keeping track of how you and your baby are doing. They have years of training; you just have a feeling.

It's always a tragedy when something goes wrong during birth, but it's especially heartbreaking when medical staff may have missed obvious signs that the delivery wasn't going well. A St. Louis-area woman has just filed a lawsuit against the obstetrician and the certified nurse midwife who delivered her daughter, along with the hospital where she was born. She believes they ignored clear signs of fetal distress but took no action. As a result, she claims, her daughter was born with a catastrophic brain injury.

Diagnostic errors "are completely underrepresented in terms of what we pay attention to," says the lead author of a new study just published in the medical journal BMJ Quality & Safety. If the Johns Hopkins University School of Medicine researchers are right, failure to diagnose patient conditions accurately and in time may be the cause of as many as 160,000 instances of preventable, permanent harm or wrongful patient death in the U.S. every year.

The study was a statistical analysis of medical malpractice claims in a national database that were filed between 1986 and 2010 and which resulted in payouts to the victims. The researchers analyzed some 350,000 such claims representing an inflation-adjusted $38.8 billion in total payments. To their shock, they discovered that diagnostic errors accounted for a full 35 percent of those payouts.

This may be simply because failure to accurately diagnose an illness throws the entire treatment plan off track from the beginning, the study's lead author points out. "It can be wrong diagnosis, no diagnosis or delayed diagnosis," he explains. "If you get the diagnosis wrong, the chances of getting the therapy right are greatly reduced."

Missouri residents expect a certain standard of care from doctors and health professionals. Whether they are receiving treatment for a severe injury or something as simple as the common cold, patients expect that their ailment will be correctly diagnosed and they will receive the correct treatment in the end.

But a recent story out of Washington reminds us that this isn't always the case, and that despite our best efforts, we can't always protect ourselves from someone else's negligence. It's a story that began in 2004; and despite a mistrial and years of waiting, one doctor's failure to diagnose cancer ended in a court victory for the patient.

Recently, a committee of the American Congress of Obstetricians and Gynecologists reviewed the available research on the risks and benefits of cesarean-section births performed purely at the request of the mother. Overall, the group determined that more women experience fewer complications from vaginal birth, and the group recommended that doctors strongly encourage mothers to choose that option.

The evidence appears to be less convincing, however, when it comes to birth injuries. It appears that C-sections, while still carrying some risk, result in fewer injuries to the infant during birth.

Currently, as many as 2.5 percent of all births in the U.S. are performed by C-section for no medical reason but at the mother's request. Often, women choosing C-sections say they're worried about the potential for urinary incontinence or sexual function from vaginal childbirth. Others simply cite their fear that natural childbirth will be too painful.

"If [a mother's] main concern is a fear of pain in childbirth," the group wrote, "then prenatal childbirth education, emotional support in labor, and anesthesia for childbirth should be offered."