VBAC Home Delivery: MFM Physician Should Have Warned Now-Deceased Woman of Risks, Court Rules

August 3, 2020 | Strategic Insights for Ambulatory Care


In a case centering on whether a maternal-fetal medicine (MFM) physician should have warned a now-deceased woman with several risk factors of the elevated risks of a vaginal birth after cesarean (VBAC) at home, the Supreme Court of New York, Appellate Division, Second Department has reversed the trial court's grant of summary judgment to the physician and his practice, reinstating the medical malpractice complaint against them. According to the physician, a board-certified obstetrician and gynecologist specializing in MFM, he practices only MFM, and his practice is based entirely on giving consultations and performing and interpreting ultrasounds. He has only limited involvement with issues related to delivery, and he does not make recommendations regarding methods of delivery. He generally sees a pregnant patient for three ultrasound scans, usually performing the final scan at 32 to 34 weeks of gestation.

The physician provided blood testing and ultrasound studies to the patient on four visits during her pregnancy, and the last visit occurred two days before her death. At this last visit, the patient was at 41 weeks of gestation, the physician performed an ultrasound, and noted in her medical record that the infant was suspected to be macrosomic (large for gestational age), that the patient was of advanced maternal age, had a history of preterm delivery and a previous cesarean delivery, and was planning a VBAC. The physician also called the patient's midwife and advised the midwife to "proceed with caution" because large newborns may develop shoulder dystocia. The patient died two days later as a result of a uterine rupture and...

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