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Lawsuit: Procedure Without Patient's Consent Ruined Her Career

As professional singer with the Nashville Opera, a Cincinnati woman was aware that having a C-section could endanger her career. What she didn’t expect was that an episiotomy during natural childbirth could force her to put her career on hold indefinitely. In fact, she couldn’t have expected it, because she was never told an episiotomy might be performed. Moreover, no one discussed the potential risks and benefits of the procedure or obtained her consent to perform one.

Unfortunately, a nurse-midwife at a Kentucky military hospital performed one anyway, apparently botched it, and left the singer with an embarrassing, uncomfortable and career-halting condition. She and her husband are now suing for medical malpractice.

An episiotomy is an intentional cut to the perineum meant to prevent vaginal tearing during childbirth. The procedure was once routine but, according to the Mayo Clinic, the generally accepted standard of care today is to do episiotomies only when extensive tearing seems likely, the baby is placed abnormally, or a quick delivery is necessary to prevent harm to the infant.

According to the lawsuit, there was no obvious reason for the episiotomy and the nurse-midwife performed it without a doctor’s recommendation. The nurse-midwife repaired the incision shortly after the birth, but even a successful episiotomy puts the patient at risk for infection, serious discomfort and painful intercourse.

The opera singer’s procedure was not successful. According to her lawsuit, she suffered a “complete breakdown of the episiotomy and perineum and the external sphincter is disrupted and the vagina and rectum are basically connected without any perineal body,” leaving her with fecal incontinence, severe flatulence and other problems.

She will need reconstructive surgery, but that probably won’t be enough to resolve the distressing problem, so more surgeries will likely be needed in the future. Worse yet, any future children will need to be delivered by C-section — at great risk to her ability to sing professionally. Therefore, she has been obliged to put her career on hold, and she and her husband are seeking $2.5 million in damages for malpractice and loss of consortium.

There are situations when episiotomies are warranted, but never as a surprise. Every patient deserves a full explanation of the risks and benefits of everything doctors expect to happen — and anything that might happen, and why — in any medical procedure.

Source: Courthouse News Service, “Opera Singer Says Operation Ruined Her Career With Flatulence,” Kevin Koeninger, Jan. 20, 2014