The comments and follow-up to the Maddy Oden Conscious Woman of the Month article are still coming in.  Gloria Lemay just sent me a reference to an older case involving cytotec and failure to obtain informed consent - this one with a large verdict. Maddy has informed me that there is also a cytotec lawyers site - she is not sure how successful they are in gathering and winning cases, but some are won. Apparently most are settled out of court with gag clauses.

$2 million
Failure To Obtain Consent For Off-Label Use Of Cytotec
Case name withheld.
Plaintiff’s Counsel: Joseph J. Wadland and James L. Ackerman, Wadland & Ackerman, Boston and Andover
The plaintiffs were a 38-year-old woman and her husband who were expecting their first child. At about 41 weeks of gestation, the decision was made by her primary Ob/Gyn to induce her labor. A dose of 25 micrograms of Cytotec, a drug that the FDA has approved for the prevention of gastric ulcers, but not for the induction of labor or cervical ripening, reportedly was given vaginally. The care providers did not obtain the mother’s informed consent for the use of Cytotec that was being administered for an “off-label” indication in a high-risk situation. A series of complications arose, including the deceleration of the fetal heart rate and the baby was delivered via Caesarian section. The baby was lifeless and resuscitation efforts were unsuccessful. The mother also required a hysterectomy as a result of off-label use of Cytotec. When the claim settled on Aug. 7, 2001, it was the first reported settlement or verdict in Massachusetts involving the drug Cytotec.  And a few more maternity related lawsuits among the largest settlements in MA in 2001: http://www.masslaw.com/reprints/breakstone011402.htm 
 

Although the facts of this case are horrific, it is encouraging to see this as nearly all verdicts against OB/GYNs are for failing to do a cesarean or failing to do one soon enough.  These kinds of verdicts play a major role the rise in the cesarean rate - for every woman who sues for those reasons, hundreds of others are cut unnecessarily, causing unnecessary trauma and increased risk to the mothers and their babies.  Defensive medicine at its worst. 

Furthermore - and worthy of similar attention and concern - new obstetricians are no longer taught the skills necessary to handle out-of-the-ordinary vaginal births.  If your birth doesn’t go like clockwork, you’re off to the OR.  If your baby isn’t in a good position, you’re off to the OR.  Breech? Forget it - directly into the OR. Vaginal breech birth is no longer part of the curriculum. I could go on and on — and I know there are exceptions, but they are becoming increasingly rare.

More widespread publicity of cases such as the following is essential - the public needs to know about the dangers of these drugs, among others and of the risks inherent in many obstetric practices.    And that babies don’t all come out “on time” and in the same presentation.