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There is only one thing that frightens an obstetrician more than a difficult shoulder dystocia delivery—getting a letter from a plaintiff attorney notifying you that you are being sued for alleged malpractice in a shoulder dystocia delivery you did several years ago. 

What is especially upsetting is that you remember that delivery, how quickly everything happened, and how well you performed in the heat of the moment to save that baby's life. You did your best, but the result was still a brachial plexus injury. 

Imagine this scenario: You have been following this 22-year-old primigravida patient since she transferred into your practice at 18 weeks gestation. She tells you that she started her pregnancy weighing 195 pounds; it is now two weeks before her due date and she weighs 248 pounds. 

She failed her 28-week glucose screen; after the 3-hour oral glucose tolerance test, she was diagnosed as being a gestational diabetic. Despite referrals to a dietitian and to the Diabetes Clinic, her blood sugar control and dietary compliance have not been good. At her prenatal visit last week, her fundal height was measured at 43 cm.

Imagine this:

Dr. Mary Smith, the Chair of the Obstetrics and Gynecology department at County Hospital, was en route to a meeting with Dr. John Bart, Chief Medical Officer. The purpose of the meeting was to review patient complaints originating out of her service. While waiting for the elevator, Dr. Smith was hurriedly approached by an obviously distressed Susan Jones, the Labor & Delivery head nurse.