Sunday, May 28, 2023

May 28, 2010: Fatal Referral After Fetal Demise

Operation Rescue obtained documents from a 2011 medical malpractice/wrongful death lawsuit filed by the family of Rebecca Charland, whose OB/GYN referred her to her death in the spring of 2010.

Rebecca had serious health problems from a condition known as antiphospholipid syndrome which can lead to the formation of blood clots, deep vein thrombosis, and miscarriage or stillbirth. When Rebecca went in for her 20 week ultrasound, she learned that her unborn baby had died, likely at least two weeks earlier to judge by fetal size.
              Washington Surgi-Clinic                        
Rather than arrange for care in a hospital, Dr. Supriya Varma referred her patient to a substandard abortion clinic, 
Washington Surgi-Clinic, operated by Dr. Cesare F. Santangelo in Washington, D.C.
Rebecca went to the abortion facility on May 19, 2010, for the first stage of the procedure. Santangelo lacked hospital privileges so he could not perform the procedure in a hospital himself, and he did not refer Rebecca to a qualified doctor who did have privileges. Her family also said that Santangelo failed to properly inform Rebecca of the significant risks due to her condition, her medications, and the length of time since her unborn baby had died. Santangelo inserted dilators into Rebecca's cervix and instructed her to return the next day for the procedure.
When Rebecca arrived the following day, Santangelo informed her that she was not yet sufficiently dilated. He took out the old dilators and inserted some new ones and instructed Rebecca to return the next day. However, about two hours later Rebecca returned to the clinic reporting abdominal pain. Santangelo was not at the clinic at that time so Rebecca waited.
Dr. Cesare F. Santangelo
At about 2:38 p.m., Santangelo performed the procedure to dismember and remove Rebecca's unborn baby. By 2:45 pm her oxygen levels dropped and she turned blue. Staff intubated her and administered medications. At 2:58 p.m. someone at the clinic called an ambulance.
EMS workers found Rebecca to be bluish-purple in color. They began effective resuscitation efforts which improved Rebecca's color. Her pupils once again became responsive to light. At 3:12 p.m., medics were unable to detect a pulse, so they defibrillated Rebecca. At 3:25 they transported her to George Washington University Hospital. There she was diagnosed with massive uterine bleeding caused by disseminated intravascular coagulopathy, or DIC, a condition in which clotting factors in the blood are not working properly. Patients with DIC can bleed out even from minor internal injuries. Because of the DIC, doctors at the hospital were unable to control the bleeding and pronounced Rebecca dead on May 28. 
The autopsy revealed that "fetal debris" had gotten into her blood stream. This can trigger DIC. Rebecca would be more vulnerable to hemorrhage than a normal patient due to her blood disorder.
Rebecca's family sued Santangelo and the clinic for $80 million. The case was dismissed, likely because the parties settled out-of-court. Rebecca's family did not file suit against the doctor who referred her to her death. 

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