A Washtenaw County Circuit Court jury awarded a teacher $2.5 million in a medical malpractice verdict, after suffering permanent injury during a procedure at St. Joseph Mercy Hospital. Amy Garcia suffered a miscarriage in 2007 causing the death of her 14-week-old fetus and as a result required a dilation and curettage procedure.
Dr. Norman Gove, an obstetrician and gynecologist, told Garcia that the procedure was routine, according to her testimony. The lawsuit contended that Gove failed to properly supervise the resident physician’s work and in an effort to remove the fetal remains had inserted ring forceps through the perforated uterus and ended up grabbed a piece of bowel that snapped back. The patient’s rectum and bowel were then torn, the suit states.
Every field of surgery has its own common surgical errors. In obstetrics and gynecology, recurrent surgical errors involve injuries to the ureter during hysterectomies, injuries to the baby during a Cesarean section, and various injuries during operations for prolapse. This case involves a uterine perforation during a dilation and curettage (D&C). Whether there is a fetus in the uterus or not, most uterine perforations during D&C’s are preventable with the exercise of proper care and surgical technique. Each case is different, however, but if the uterus ends up having to be removed as a result of the perforation, one of the key pieces of evidence is the pathology report which will describe the area of the perforation in detail. It is important to remember that a D&C, however, is a “blind” procedure in the sense that the surgeon cannot see the inside of the uterus or the tips of the surgical instruments; the procedure is essentially done by feel.
As this case illustrates, if an instrument does perforate through the uterine wall, the nearest anatomical structure outside the uterus is usually a portion of bowel. This means that when a perforation occurs and the surgeon withdraws the instrument that caused the perforation, bowel may be “attached” to that surgical instrument as the instrument is removed.