O'Brien and Ryan, LLP - Attorneys at Law
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Defense Verdict for OB/GYN in case involving Wound Infection after Caesarean

Tracie A. Vizza, Stephanie M. Hohing and paralegal Lexi Romney recently obtained a defense verdict on behalf of an obstetrician/gynecologist (OB/GYN) in the Philadelphia County Court of Common Pleas. The matter involved a patient who had undergone a caesarean section and presented to the hospital several days after her discharge with complaints of intermittent fever, purulent drainage from her incision, nausea, loose stools and lightheadedness. The patient was first evaluated and examined by a medical student and a resident physician. At the time of her evaluation, although there was drainage from the incision, the area was not warm, red or swollen. Additionally, the patient was not exhibiting a fever. The resident physician probed the incision which showed that it was a superficial wound. A culture was taken and sent to the lab. The resident physician also irrigated the incision area with saline fluid until it was clear. The defendant, the attending OB/GYN, also examined the patient and probed the area. The patient was diagnosed with a superficial wound infection. As there were no signs or symptoms of a systemic infection, Bactrim DS, a broad spectrum antibiotic, was prescribed. The patient was advised to call, or return to the hospital, with any worsening symptoms.

Thereafter, the patient had continued purulent drainage from the wound area over the course of the next couple of days. Although it was alleged that the patient and her mother contacted the hospital, at no time was the defendant informed of these calls and/or worsening symptoms. Two days after her presentation to the hospital, the culture report showed that the wound was infected with a bacteria known to be susceptible to Bactrim DS. The culture report also suggested that an infectious disease specialist be consulted. The defendant physician was also not advised of these findings.

The following day the patient presented to a different hospital at which time it was noted that the antibiotics failed and the infection had worsened. The patient was hospitalized for several days as she required a debridement procedure and IV antibiotics to treat the worsened infection.

Plaintiff alleged that the defendant should have prescribed a different antibiotic and had he done so, the patient would not have required the debridement procedure. The defense argued that the broad spectrum antibiotic given was appropriate as bacteria causing the infection was not known until the culture grew out greater than 24 hours later. Further, the defense argued that a broad spectrum antibiotic which treats MRSA was required as MRSA is common in recently hospitalized patients and is highly resistant to may antibiotics, including the penicillin based antibiotics, which plaintiff's expert testified was appropriate. The defense presented expert testimony by experts in OB/GYN and infectious disease. These experts established that the defendant acted within the standard of care and that the appropriate antibiotic was prescribed. After deliberation, the jury returned an unanimous verdict, finding that the defendant's care and treatment of the plaintiff was not negligent.


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