Uterine and Colonic Rupture During Routine OBGYN Procedure

This case involves a thirty-two-year-old female who gave birth with the assistance of a midwife and no complications were noticed during the vaginal delivery. Several weeks later, the patient began to develop abdominal pain and vaginal bleeding, and it was determined that the patient had retained products of her placenta. The patient underwent a D&C procedure to evacuate the retained products of childbirth, but the procedure was met with significant complications. The OBGYN acknowledged that the uterus was perforated during the procedure, but had decided to let the lesion heal on its own. Approximately eight hours after the procedure, however, the patient was rushed to the ER with severe abdominal pain and was discharged without a thorough workup. Two days later, the patient was rushed to an ER and a perforated colon of three centimeters behind the uterine puncture was identified. As a result, the patient required a colostomy and a forty-day hospital stay.

Question(s) For Expert Witness

1. What are the recognized complications of this procedure?

Expert Witness Response E-001236

Bleeding, infection, uterine perforation, cervical laceration, and bowel and bladder injury are all recognized complications of this routine procedure but that does not mean they should happen nor should the bowel injury go unrecognized for an extended period of time, as it did in this case. This should have been noticed immediately and repaired at once.