Tubal ligation with intestinal perforation-Medical Malpractice?

In order to perform a tubal ligation operation, the abdomen is distended with carbon dioxide gas through a large needle, and the patient is put in a somewhat head down position so that the intestines will move out of the pelvis.

Once the abdomen is inflated, a small incision is made wherein the trocar, a large spike-like device that is hollow, within which the laparoscope will pass, is inserted. Care is taken not to perforate the intestines, particularly if there was a lower abdominal incision in which the intestines can get stuck to the inside of that abdominal scar.

Each fallopian tube, the size of a thin pink straw which is extending like arms off of each side of the body of the pear shaped uterus, is identified. It is grass with a forceps device that is attached to the electrocautery machine, and a burn is created. In the alternative, the tube can be clipped with a metal clip that secures it’s obstruction so no egg can pass down for fertilization.

In performing this operation, it is critical that at all stages the intestines are protected. Before the electrocautery device is turned on, it is essential that the intestines are not touching the tip of the electrocautery forceps. Likewise, when the punctures or created into the abdominal cavity, care is taken to be sure there is no injury to the intestines. As soon as the laparoscope is inserted, the gynecologist must check and see that there has been no damage to the intestines which can result in a perforation, and peritonitis from leakage, which if not timely recognized, could be deadly.

Obstructed Labor, The Cause of Severe Brain Damage

Once a woman goes into labor, it usually progresses in a steady fashion. The pelvic exam can determine the head of the fetus in relationship to the inside of the bones in the birth canal, the pelvis. There is a bony landmark in the pelvis which will be used as the guide in centimeters, as to whether not the fetal head it is minus or plus centimeters as a guide to gauge the progression of the labor.  If this woman is a primigravida, that is pregnant for the first time, now and having a vaginal delivery, this is called an “untried pelvis.” And if she has a narrow pelvis, the android shape, more male-like, as opposed to the gynecoid shape of the fuller pelvis, then this is a red flag that there may be a problem with the head of the fetus passing through the birth canal.

If there is no progression of labor down the birth canal, centimeter by centimeter, then this is a problem that may require a cesarean section rather quickly. The fetal heart monitor under these circumstances is really not the better way to determine if they will be a problem. If the umbilical cord is compressed, then the oxygenated blood supply from the uterus to the fetus would be impaired and the fetal heart rate would drop dramatically. That requires it immediately Cesarean section. But in this case of the failure of progression of labor, the umbilical cord is not compressed, but the head is repetitively forced against the inside of the solid bone pelvis. Unlike football players wearing a helmet, this fetal skull has no helmet, and its head is forced under great compression pressure, every few minutes, as opposed to an occasional football concussion. This repetitive concussion will cause brain damage. The failure to observe an obstructed delivery is a departure from the accepted standard of care.