Failure to Perform Hysterectomy Resulting in Postpartum Death
The Frosell Case
In this case, we represented the Estate and family of Christine Frosell, a 31-year old wife and mother who suffered irreversible brain damage hours after giving birth to her second child. Mrs. Frosell was placed on a respirator until a terminal wean was undertaken 12-days later resulting in Mrs. Frosell’s tragic death. Mrs. Frosell’s brain damage and ultimate death were caused by medical negligence in failing to perform a hysterectomy in response to Mrs. Frosell’s uncontrollable post-partum bleeding. Mrs. Frosell is survived by her husband and two sons, now age 12 and 2.
This began on March 25, 2005, at 12:17 am when Mrs. Frosell gave birth to her second son. Immediately after the delivery, Mrs. Frosell began to bleed profusely from her uterus. Approximately 30 minutes later, there was an increase in the vaginal bleeding and the nurses found Mrs. Frosell’s bed clothing, as well as the linens, soaked with blood. The standard of care called for her obstetrician to take Mrs. Frosell to the operating room shortly after 12:40 am with surgery commencing immediately thereafter. Instead, the obstetrician waited until 1:15 am to take Mrs. Frosell to the operating room for a possible D&C (D&C is a procedure to scrape and collect the tissue from inside the uterus – Dilatation is a widening of the cervix to allow instruments into the uterus and Curettage is the scraping of the contents of the uterus). The obstetrician ordered a series of uterotonics until between 1:20 and 1:35 am. Compliance with the standard of care would have called for the completion of a course of multiple uterotonics and a D&C by 1:15 am.
After 2:00 am, the obstetrician felt that surgery was not an option on account of his suspicion of disseminated intravascular coagulation (“DIC” is a disorder in which the proteins that control blood clotting are abnormally active. It is a pathological process in the body where the blood starts to clot throughout the whole body. The increased clotting depletes the platelets and clotting factors needed to control bleeding, causing excessive bleeding. It occurs in critically ill patients); however, DIC is not a contraindication to surgery, and in fact, continued bleeding only serves to perpetuate the DIC. Although the standard of care mandated that a hysterectomy be performed, the obstetrician negligently failed to perform one. The obstetrician’s failure to implement surgical exploration by 1:35 am was a violation of the standard of care, as Mrs. Frosell’s bleeding continued and her blood pressure dropped to 60/30 requiring the need for chest compressions shortly thereafter. Instead, at 1:35 am, the obstetrician summoned an anesthesiologist.
Between 2:30 and 2:45 am, no blood pressure was recordable and by 3:05 am, Mrs. Frosell became pulseless. Between 3:05 and 6:00 am, the obstetrician and the anesthesiologist attempted to manage the hemorrhaging by infusing blood, frozen plasma, and other blood expanders, and by packing Mrs. Frosell’s vagina with gauze and sponges.
The anesthesiologist breached the standard of care by failing to notify the obstetrician of Mrs. Frosell’s deteriorating vital signs and communicating to the obstetrician the estimated blood loss. This is the anesthesiologist’s responsibility as she is the specialist who is most aware of the patient’s physiological status during surgery. By failing to keep the obstetrician informed of the clinical situation, the obstetrician wasted valuable time that he could have used to gain surgical control. The anesthesiologist was also negligent by failing to urge the obstetrician to perform a hysterectomy when the hemorrhage became life-threatening.
Upon arrival in the ICU, an EEG and CT scan of the brain were performed on Mrs. Frosell which demonstrated an anoxic brain injury. Neurology was consulted and gave the diagnosis of post-anoxic encephalopathy. Over the next few days, subsequent neurological exams demonstrated an anoxic encephalopathy with some preservation of brain stem function but no upper brain activity. After discussion with the family, a terminal wean from the respirator was undertaken on April 6, 2005.
Tragically, Mrs. Frosell died at 11:30 p.m. on April 6, 2005. The death certificate listed severe post partum hemorrhage, cardiopulmonary arrest, anoxic brain injury, and DIC as cause of death. Mrs. Frosell was survived by her husband Michael and two sons.
Professionally, Mrs. Frosell was employed as a team Leader with a company that provides housing and support services for persons with special needs. Mrs. Frosell was well educated – she had an Associate’s Degree, a Bachelor’s Degree, and a Master’s Degree – and intended to pursue her Doctorate after the birth of her second son.
The surviving husband and father is a police officer. As a result of this incident, Mr. Frosell’s mother moved in with him to help raise the boys. Losing his mother has been especially difficult for the 12-year old; he has participated in therapy programs where children are encouraged by trained adult volunteers to find ways to express their grief, from art, puppets, and telling stories, to writing on the wall-boards and sharing photographs of the person who died. He has also been clinically diagnosed with post-traumatic stress disorder.
On behalf of our client’s Estate, we brought suit against the obstetrician, the anesthesiologist, and the hospital. A few weeks prior to trial, the case settled for a multi-million dollar sum with each party contributing to the settlement. After the settlement, with the help of Harry S. Cohen & Associates, Mr. Frosell established a trust at a local bank in which the children’s settlement funds were placed.