Injury is a risk/complication of any drug therapy, and more damaging to the patient and the caregiver if the drug was selected, administered, dispensed, or monitored negligently, contributing greatly to the injury.  Obstetrical patients are at even greater risk, given the little known teratologic and embryo-fetal toxicity of drugs given during pregnancy and the perinatal period.

The facts and outcomes of the following Obstetric litigation cases will be presented and discussed:

1. Fatal electrolyte disturbance in hyperemesis gravidum
2. Renal Embryotoxicity following ARB Inhibitor in pregnant woman
3. Deformed skull in newborn following opiate therapy during pregnancy
4. ‘Off-label’ tocolytics and beta-blockers in a hypertensive premature labor resulting in fetal loss
5. False-positive morphine meconium in neonate resulting in action by child protective services
6. Negligent epidural infusion of Magnesium Sulfate in a laboring woman
7. Opiate toxicity and maternal death in an unmonitored woman in labor

Given the advanced complexity of obstetrics and reproductive medicine, it is interesting to note that the drug injuries leading to most litigation involve basic drugs used in therapy, some generations old, not the more complex therapies recently available.  It is also a poignant reminder that a highly sophisticated treatment of a high risk pregnancy can be damaged by a simple negligent act by caregivers or patients.

The goal of the presentation is to raise the level of awareness of these errors that lead to forensic litigation, and apply that new knowledge to individual practice sites for the improvement of care and reduction of injury.

Injury is a risk/complication of any drug therapy, and more damaging to the patient and the caregiver if the drug was selected, administered, dispensed, or monitored negligently, contributing greatly to the injury.  Obstetrical patients are at even greater risk, given the little known teratologic and embryo-fetal toxicity of drugs given during pregnancy and the perinatal period.