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Failure to properly treat pre-eclampsia

Multi-million dollar recovery for a young Allegheny County woman who suffered permanent kidney damage due to failure to properly treat pre-eclampsia. The patient ended up with an organ transplant.

Pre-eclampsia is a condition in which a pregnant woman develops high blood pressure and elevated levels of protein in the urine during pregnancy. Depending on how high the blood pressure and protein levels are, pre-eclampsia can present serious risks to the mother including seizure. The only "treatment" for pre-eclampsia is delivery of the child. Therefore when an expectant mother develops pre-eclampsia that is "severe" the best practice is to keep the patient hospitalized under 24 surveillance and, if they are at least 33- weeks gestation, deliver them within 48 hours. The benefit of 24-hour monitoring in the hospital, as opposed to sending the mother home, is that you can immediately deliver the baby at the first sign of any deterioration in the mother's condition.

In this case, the mother's blood pressure and protein were high enough to classify her as having severe pre-eclampsia, but the doctors sent her home with instructions to take her blood pressure and return to the hospital if it got above a certain level. Our expert says that was not the appropriate way to manage pre-eclampsia because it shifted the burden of managing care to the patient herself. She should have been kept in the hospital under 24-hour surveillance. This woman went home, her condition did deteriorate, and she suffered a placental abruption before she could get back to the hospital and deliver the baby. Although the baby survived the placental abruption, the significant blood loss caused by the abruption led to permanent kidney damage known as acute tubular necrosis, i.e. death of part of the kidney. As a result of the kidney damage, this young mother was on dialysis for a few years and ultimately required a kidney transplant.

The burden of being on dialysis for a few years and then having a transplant, all the while having a newborn at home, placed a tremendous stress on this new mother and her husband. That was clearly part of our damages in the case. Additionally, as a result of having an organ to transplant, she would have to be on anti-rejection drugs for the rest of her life. Those are very expensive medications and, unfortunately, they have certain side effects, e.g., they suppress the immune system and make people very prone to infection and/or, in some rare cases, they can lead to skin cancer and lymphoma. All of that formed part of our damage claim in this case. Additionally, the husband and wife had a claim for how this entire ordeal impacted their relationship and the stability in the household.

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