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May 2016: Defense Verdict in Case Involving Uterine Atony

May 12, 2016

Senior Trial Partner Michael A. Sonkin, assisted by associates Samantha Shaw and Katherine Baxter, obtained a defense verdict in the Supreme Court Kings County following a three week trial. The case was tried before Justice Gloria Dabiri and involved a 37-year-old woman who delivered twins via Cesarean section and then was found to have uterine atony and heavy bleeding that was unresponsive to medical treatment. A life-saving hysterectomy was performed after the patient appeared to develop a coagulopathy. During the hysterectomy, an inadvertent transection of the left ureter occurred that was not known to the physicians. A cystoscopy was performed in the operating room and showed dye in the bladder but without visualizing the ureteral jets. This demonstrated that at least one, and potentially both ureters, was functioning, although it did not rule out the possibility of injury to one of the ureters.

 

Following this inconclusive study, the decision was made to transfer the patient to recovery without seeking a urology consultation due to her extreme blood loss (9 liters) and the risk for further complications by prolonging the surgery. Post-operative elevation in her creatinine was recognized promptly and a transected ureter four centimeters proximal to the bladder was identified. A nephrostomy tube with drainage bag was placed, and the patient ultimately underwent a repair two months later.

 

Plaintiff argued that a urologist should have been called to the operating room once the difficulty of the surgery was recognized and certainly once the cystoscopy was inconclusive, and that a urologist would have identified the injury and repaired it in the operating room to avoid the need for the nephrostomy tube and drainage bag. The defense successfully argued that the post-partum hemorrhage was life threatening, that the primary focus was appropriately on controlling her bleeding, and that further exploration and cutting of tissue necessary to identify and repair the ureter would have posed unacceptable risks to the patient. Following the lengthy trial, the jury deliberated for approximately twenty minutes before delivering a unanimous defense verdict.

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