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Obstetrics, genetics, and litigation

Acta obstetricia et gynecologica Scandinavica, 2021-06, Vol.100 (6), p.1097-1105 [Peer Reviewed Journal]

2021 Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). Published by John Wiley & Sons Ltd ;2021 Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). Published by John Wiley & Sons Ltd. ;Copyright © 2021 Acta Obstetricia et Gynecologica Scandinavica ;ISSN: 0001-6349 ;EISSN: 1600-0412 ;DOI: 10.1111/aogs.14095 ;PMID: 33483959

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  • Title:
    Obstetrics, genetics, and litigation
  • Author: Milunsky, Aubrey
  • Subjects: adverse pregnancy outcome ; Congenital diseases ; congenital malformations ; decision‐making ; encephalopathy ; ethics ; Genetic disorders ; Litigation ; malpractice ; Medical ethics ; Pregnancy ; syndromes ; Ultrasonic imaging
  • Is Part Of: Acta obstetricia et gynecologica Scandinavica, 2021-06, Vol.100 (6), p.1097-1105
  • Description: Introduction Claims of medical negligence are universal. Unexpected adverse pregnancy outcome may trigger litigation. Such outcomes, especially with neurodevelopmental sequelae, may be compounded by a genetic disorder, congenital abnormality, or syndrome. Material and methods This is a report of 297 cases in which a pregnancy complication, error, or incident occurred that was followed by progeny with a genetic disorder, congenital abnormality, or syndrome that spawned litigation. The author assessed, opined, and in many cases, testified about causation. Results Pregnancies complicated by hypoxic ischemic encephalopathy were not infrequently compounded by offspring with a genetic disorder, congenital abnormality, or syndrome. Multiple cases were brought because of missed ultrasound or laboratory diagnoses, or failures in carrier detection. Teratogenic medication prescribed before or during pregnancy invited legal purview. Failure to refer (or confer) for genetic evaluation or counseling in the face of significant risk, occurred repeatedly. Ethical breaches and hubris promptly led to litigation. Conclusions Many lessons and recommendations emerge in this report. These include the realization that the vast majority of errors in this series involved at least two caregivers, serial ultrasound studies are important, decreased fetal movements may signal a genetic disorder, congenital abnormality, or syndrome, family history and ethnicity are vital, cognitive biases profoundly affect decision‐making. Finally, the simplest of errors have the potential for causing life‐long grief.
  • Publisher: United States: Wiley Subscription Services, Inc
  • Language: English
  • Identifier: ISSN: 0001-6349
    EISSN: 1600-0412
    DOI: 10.1111/aogs.14095
    PMID: 33483959
  • Source: Journals@Ovid Open Access Journal Collection Rolling
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