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New trial granted in case of woman who died from infection while pregnant

A widower who sued two Charlottesville doctors for negligence after his wife died of E. coli infection will receive a new trial after the Supreme Court of Virginia granted his appeal this month.

The medical malpractice lawsuit, which was initially filed in 2015, details the final days of Jaclyn Tahboub, who died in 2013 due to complications from an infection while pregnant. Her husband, Shareef Tahboub, sued her doctors — Siva Thiagarajah and Mikhail Michael Levit — as well as Sentara Martha Jefferson Hospital, alleging that his wife did not receive timely treatment that could have saved her life.

During a 2018 trial, medical experts testified to the standard of care expected and after the plaintiff presented his case a Charlottesville Circuit Court judge granted a motion to strike the evidence, which asserted the evidence was insufficient to prove causation. Shareef appealed this ruling and had his appeal granted Feb. 13 by the Supreme Court of Virginia.

“On a motion to strike at the conclusion of Shareef’s case-in-chief, the circuit court was required to view all of his evidence in the light most favorable to him, presuming that the jury would believe it all and draw all logical inferences from it in his favor,” the state Supreme Court wrote in its opinion. “The court erred by failing to do so.”

The initial complaint alleges that during Jaclyn Tahboub’s first pregnancy in 2011, she was diagnosed with an incomplete cervix and Thiagarajah surgically placed a cervical cerclage, a type of reinforcing stitch, to prevent premature birth. After her baby was born, the stitch was left in place.

In 2013, Thiagarajah surgically placed a second cervical cerclage after being unable to locate the first one, according to the complaint. When she was five months pregnant with another child, Jaclyn reported pain in her abdominal region on Dec. 20, 2013. When her husband asked if she could have an infection, Thiagarajah denied the possibility, according to the suit.

After she again reported pain two days later, Thiagarajah prescribed painkillers over the phone. On Dec. 26, 2013, Jaclyn again called Thiagarajah but reached Levit instead, who initially gave her the same advice before telling her to go to the hospital.

After going to Sentara Martha Jefferson Hospital, Jaclyn experienced a rupture and then was transferred to the University of Virginia Medical Center. There she began to experience heavy bleeding, fever, multiple organ dysfunction and other complications.

According to the complaint, UVa doctors immediately suspected chorioamnionitis — an infection that affects fetal membranes — and later tests determined E. coli had caused the infection.

UVa staff performed an emergency delivery, according to the complaint, after which Jaclyn suffered major hemorrhaging. She was admitted to the intensive care unit, where she remained until she died on Dec. 31, 2013.

During the 2018 trial Shareef Tahboub called two medical experts, one of whom, Dr. Frederick Gonzalez, a specialist in fetal medicine, testified that infection is a common risk following cerclage surgery.

According to the opinion, which cites the trial, Gonzalez testified that Jaclyn’s reports of pain should have led to a physical exam, which should have been followed up by treatment, had the exam led to a suspicion of infection.

“He testified that he could not conclusively state that ‘she had chorioamnionitis on the 22nd, but she probably had an infection that led to the chorioamnionitis a short time later.,” the state Supreme Court opinion reads. “He testified that “if she was diagnosed with infection on the 22nd and treated, she would have survived. . . . I’m sure if there was an infection on the 22nd and she was diagnosed and treated, she would have survived.’”

Levit not going to the hospital to examine the woman was a breach of the standard of care, Gonzalez said during the trial. According to the opinion, the nurse who treated Jaclyn also testified that some tests required to assess her condition were outside a nurse’s scope of practice.

The defense, on the other hand, argued that the plaintiff’s experts had not mentioned the impact treatments could have caused to the fetus, nor acknowledged that treatment of an infection with the antibiotics would have “required immediate delivery of the fetus, then only 24 weeks old.”

“The evidence of Jaclyn’s treatment history at [UVa] shows it took several days before her infection was brought under control, and that her strain of E. coli was antibiotic-resistant,” a summary of the defense’s argument reads.

The state Supreme Court ruled that when a judge granted the defense a motion to strike that portion of the plaintiff’s evidence, they overreached.

Consequently, the case has been remanded to Charlottesville Circuit Court. A new trial date has yet to be set.

Source: www.dailyprogress.com

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