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A 35-year-old woman was booked for a breast implant exchange.

The day of surgery, a urine HCG was negative.

Ten days prior a serum HCG had also been negative.

The surgery itself was uneventful.

She had some issues with a post op infection requiring antibiotics and pain medicine.

3 weeks after her surgery a urine HCG was positive.

She went to see her OB who performed an ultrasound.

She was prescribed Cytotec and went through with an abortion.

Here is the timeline of events as included in court records:

She sued the anesthesiology and surgical team for the loss of her pregnancy.

An anesthesiology defense expert was hired.

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Danesthesia .11 months ago

I'm Anesthesiology & Critical Care Medicine.

I see you debated including this case, but I am glad you did. Is there precedent in medical malpractice like there is in other areas of law? If so, this could be a sentinel case. At the risk of seeming hyperbolic, this cases essentially claims that an anesthesiologist should be able to predict the future.

I cannot adequately express my disappointment that this case was filed. Someone really believes there was a breach in standard of care here???

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J CAuthor10 months ago

There is precedent in med mal too where past court decisions are looked at and influence how new cases are handled. I do think this case will be withdrawn or dismissed, but we will see how it plays out. I hope we at least get an expert response first. Like you I am wondering what they will argue the breach in standard of care will be.

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Judith Kelley11 months ago

I’m not an OB. I am a physician, and a woman who had interest in her own reproductive capabilities, so consider my knowledge when reading this.

LMP was roughly 14 days before surgery. So surgery likely happened near the time of ovulation. Assuming she was not interested in having sex with fresh breast incisions, the sex act that resulted in this pregnancy was probably day or two pre op. This is too soon to be detected by either serum or urine testing.

Short of instructing this patient to refrain from intercourse from LMP to surgery, I don’t see a way to prevent this foreseeable but undetectable event.

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J CAuthor11 months ago

I agree with your timeline. As there are waivers for refusal of pregnancy testing, perhaps it should be expanded to understanding the limitations of pregnancy testing. I don’t actually think this should be a solution for liability, but by the time the anesthesiologist has met the patient there is nothing further to be done.

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Jennifer Anderson11 months ago

I'm an anesthesiologist and former practicing litigation attorney. I can't believe that any attorney took this case. I do feel for the patient who lost her pregnancy and who attributes that loss to anesthesia. Her OBGYN is to blame there - assuming that the pregnancy was abnormal (we don't actually know if that was the case), abnormalities in early pregnancy are incredibly common.

Where is the causal link to anesthesia vs other potential causes including random chance, parental medical history, or the patient's lifestyle (medications, substances, environmental exposures)? Even if the anesthetic did cause pregnancy abnormalities (a huge "if"), then what should the anesthesiologist have done differently? Perhaps counsel the patient on the limited sensitivity of HCG urine testing in early pregnancy?

I'd argue that anesthesiologist liability in this case would create a dangerous precedent and steer anesthesiologists away from providing care to women of childbearing age.

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J CAuthor11 months ago

Well said.

A blood hcg day of could detect a pregnancy earlier. I am wondering if we will see that argued. After all what could have been done different? It would be dishonest to call that a standard of care though.

There also seems to be just poor understanding /bad information received by the patient.

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Young W11 months ago

Another episode of "blame anesthesia" just dropped from an outpatient clinic. Sigh.

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