$1.5 million awarded to cesarean mom

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Mon Jan 1, 2007 1:09 am (PST) http://www.childbirthsolutions.com/articles/birth/cesarean/cesarean_lawsuit.php

A Plaintiff's Verdict: Meador v. Stahler and Gheridian

The $1.5 million award to a Massachusetts woman and her family in

Meador v. Stahler and Gheridian made news as a rare instance of a

malpractice judgment based on an allegedly unwanted and unnecessary

cesarean section rather than a failure to perform such an operation.

The plaintiff, Meador, did not claim that the procedure was

negligently performed or that the rare and disabling physical

complications that resulted from it (which left her largely bedridden

and unable to work or meet her family responsibilities for several

years) were foreseeable. Instead, she claimed that the defendant

obstetricians had misrepresented the risks of the alternative procedure

(vaginal birth after prior cesarean) and ignored her persistent pleas

for this alternative. Moreover, she alleged, they compelled her passive

assent to the surgery in an emotionally coercive manner while she was

progressing normally in labor, despite their having previously agreed

to such a trial of labor.

Because the consequences of the cesarean were unforeseeable, and

because Meador had signed a consent form for the surgery (to be used in

case of emergency), this case did not meet the technical requirements

specified under Massachusetts law for an action based on informed

consent. Instead, the case was brought on the theory that the

physicians' failure to obtain the patient's informed consent

constituted substandard, negligent medical care. The forensic

psychiatrist'

s

expert testimony emphasized that the pro forma signing of a consent

form did not constitute true informed consent, especially in light of

the physicians' alleged disregard of the patient's expressed wishes and

their inaccurate representation of the risks and benefits of the

approach she preferred.

The psychiatrist also explained to the jury

how Meador's life history left her vulnerable to experiencing the

denial of informed consent as a highly traumatic event. Having coped

since childhood with serious illnesses in her family, Meador had viewed

doctors and nurses as nurturing figures who helped her gain control of

potentially tragic situations. She had learned that choice was still

possible even amidst illness and death. She had even been inspired to

become a nurse herself and to teach this discipline to others. Thus,

when she experienced a sudden loss of choice and control during

childbirth, she reacted with intense fear and horror and felt she had

been betrayed by health professionals, whom she now feared and

mistrusted. In this way she lost her accustomed strategy for coping

with life. Moreover, having helped hold her original family together in

the face of tragic illness, Meador saw the family she had created torn

apart by her sudden and devastating loss of

control in a medical situation. The jury's recognition of the

importance of the emotional facts of the case was highlighted by its

awarding almost one-third of the total damages for loss of consortium.

Thus, it was not simply the physically disabling consequences of the

surgery, but the loss of personal decision-making power concerning her

body, her health, and the birth of her child, that caused Meador to

suffer from Post-Traumatic Stress Disorder. Similarly, her husband's

experience of loss of consortium was exacerbated by the physicians'

failure to consult him to interpret his wife's wishes during labor.

Instead of having participated in a true informed-consent process, he

was left to feel powerless and helpless. In this way, forensic

psychiatric testimony established a persuasive causal link between the

lack of informed consent and the physical and emotional damages

suffered by the patient and her family.

Source: http://www.forensic-psych.com/