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Medical Malpractice/Salpingectomy Failure


In 2012 I was diagnosed with my 3nd ectopic pregnancy on the left side.  The first resolved on it's own.  The 2nd was treated with methotrexate.  My Dr. and I decided to treat the 3rd with surgery to remove the tube in an effort to remove the problem on the left and preserve my fertility.  My right tube and ovary were healthy.  My doctor did not perform the surgery (he had his own medical emergency the night before) so one of his associates from his practice did.  I ended up having another ectopic in 2014, this time I was told it was on the left ovary.  It was treated with methotrexate. I was recently pregnant again and once again I was told that it was possibly on the left ovary. I was treated with methotrexate.  I thought this was an odd form of treatment because my HCG numbers were extremely high.  I ruptured and ended up in emergency surgery. After surgery, my doctor informed me that I had an ectopic in the left tubal stump and that he removed the stump and the pregnancy. I was in disbelief and confused, mainly because in his notes he put that I was a former salpingostomy patient and not salpingectomy.  I gathered all of my medical records from the hospital from 2012 to the present.  After reviewing my records, I realized that I was never pregnant in my left ovary or left tubal stump/Remanent.  I was devastated to learn that my left tube was never removed in 2012 only the ectopic.  All this time I was lead to believe that the tube was gone and encouraged to continue to try to get pregnant naturally. Looking through the records it is very evident that my Dr. was not forthcoming with this information over the years.  My medical records and billing reflect what I was told in 2012 that the tube was removed (salpingectomy).  However, the pathology report from this emergency surgery and past ultrasounds indicate that my tube with attached fimbriae wasn't removed until 2016. Do I have any legal recourse against this?

Jeanice:  Interesting that you sent your question to me.  I guarantee you, very few attorneys would even attempt to reply to your question.  It is complicated and ultimately, only a GYN could offer an informed opinion on whether your medical providers did something that was BELOW THE STANDARD OF CARE and that this led to harm for you.  At the end, I will give you a legal point of view.  Turns out that in the 1980s I represented a large number of women who used the Dalkon Shield IUD, got PID, and many had ectopic pregnancies due to scar tissue in the tubes.  Back then, surgery was the only option.  Anyhow, I am somewhat familiar with the terminology and the physiology.

Remember, I am not a doctor.  But here are my thoughts:  If you had a THIRD ecoptic pregnancy in the same tube, and although you wanted to preserve fertility and doctors and patients generally want a conservative approach before surgery, seems to me that tube AND THE OVARY should have been removed in 2012.  If this was the plan and this is what the STANDARD OF CARE would require (I believe it would) and the reason you didn't have a salpingoophorectomy at the time was because of a lack of communication between the doctor who knew you and the doctor who did the surgery did not or that the substitute doc simply didn't review your history, then that would be malpractice in my opinion.  

Also, treating the most recent pregnancy on the left with methotrexate instead of surgery when the HCG is high or increasing and considering the multiple events in that tube, well, I can't understand it.  The one term you use in the story that I am not familiar with is the "stump". If there is a stump, does that mean part of the tube was in fact removed?  Anyhow, here is my opinion on the question of "legal recourse".

Firstly, there is a Statute of Limitations issue.  In my State of CA you must file your claim within one year from when the negligence event occurred or one year from when you "knew or should have known" that you might have been a victim of med mal, but with few exceptions, not later than 3 years after.  Fraud by the doctor is an exception or, the clock does not run while you are still being actively treated by the defendant doctor. You can look up the time limit in your own State. Just google Statute of Limitations Medical Mal {your State}.

Next, you must understand that any med mal case is extremely difficult, defended vigorously by the doctor's insurance company with the best lawyers around, and very very expensive.  Your lawyer would have to figure on spending probably $5-10,000 right up front to hire expert GYNs to review your history, determine there was malpractice and be willing to act as your required expert witness.  Thousands more to depose the experts on the other side who will say that in light of your interest in preserving fertility, your doctors acted in your interests and WITHIN THE STANDARD OF CARE.........regardless of what the truth may be.

This would be a case that would likely never be settled or if it was, it would be very close to trial by which time your lawyer would have spent 10s of thousands of $$ out of his pocket and hundreds of hours of work and then face a trial with less than a 50% chance of recovering anything except a black eye so to speak.

But the clincher is this for me:  If our argument is that they should have totally removed the left tube (and ovary?) in 2012 but negligently failed to do so, your damages are confined to treatment or surgery subsequent to 2012 that would have been avoided.  The malpractice did not cause you infertility, just unnecessary procedures, arguably.  I realize that ectopics can be life threatening but fortunately, I presume, you did not die or suffer any residual medical harm.  So, the damages are not going to be well into the 6 figures and therefore, no law firm would be willing to take on the case.  We take on cases to earn a living. There would be at best a very remote chance of accomplishing anything but lose money, lots of it, and lots of time, in your case.  So, for these reasons, I don't see any legal recourse and on the STatute of Limitations question, you might have a good argument that you are not too late but it is guaranteed that there would be a huge, expensive  legal battle just on that issue before we ever got to the merits of the malpractice claim.

By the way, how can it be just a coincidence that you have all of these conceptions in the left tube, and never the right one?  Anyhow, this is probably a lot more than you expected, more than I intended, but I did find it interesting, academically speaking. Conclusion: Did you receive sub-par medical care?  Possibly.  Do you have a viable medical malpractice case? No way.  Hope this helps.  Best of luck.  

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Glenn A. Dorfman


Thirty-four years experience in personal injury, medical malpractice and medical product liability law. Qualified to answer all questions regarding injuries and the law, except for worker`s compensation. Also wide experience in medical product defect cases ie current litigation regarding the Johnson&Johnson (DePuy)defective hip implant cases and Mirena IUD issues


Thirty-four years experience handling cases involving auto accidents, trips and fall, fires, dog bite,medical malpractice and defective medical product cases with particular emphasis in 2012 and beyond with the DePuy ASR (Johnson&Johnson) defective hip implant cases. Twenty-five years of experience with defective IUD issues as well

Jurisdoctor Degree 1976 and Member in good standing with CA State Bar Assoc. since 1976

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