Some physicians in the past few weeks have expressed frustration over a verdict issued last month by the Taichung District Court, which ordered an obstetrician and a hospital to pay NT$14 million (US$431,101) in compensation for medical malpractice in delivering a baby who died after birth.
The court said in the verdict that the mother had received prenatal checkups at a hospital in Taichung and during the labor induction on June 28, 2019, the obstetrician found meconium (the baby’s first feces) in the amniotic fluid.
Although there was a risk of meconium aspiration syndrome (MAS) — a condition in which a newborn breathes a mixture of meconium and amniotic fluid, which can lead to respiratory distress, severe illness or death — the obstetrician attempted a vacuum-assisted vaginal delivery, but to no avail, the court said.
Following a prolonged labor and an increased risk of MAS, the obstetrician later suggested a caesarean section (C-section), but the newborn was found to have a slow heartbeat, cyanosis, poor blood circulation and metabolic acidosis, and therefore was intubated and transferred to a neonatal intensive care unit at another hospital.
The newborn died of meconium aspiration pneumonia and respiratory failure in the evening, while an autopsy showed that he had subgaleal hemorrhage, a condition often associated with vacuum extraction.
The parents of the newborn filed a lawsuit, saying the infant died due to the obstetrician’s negligence.
The court ruled that the obstetrician was at fault for performing vacuum extraction given the circumstances and that subgaleal hemorrhage might have worsened the newborn’s illness.
The parents should be paid medical fees, funeral expenses and about NT$12 million for “parent support” — meaning financial support that the child could have given his parents after they retire — in compensation, it ruled.
The Taiwan Association of Obstetrics and Gynecology on June 28 issued a statement criticizing the verdict.
Association chairman Huang Jian-pei (黃建霈) said finding meconium in amniotic fluid is common, occurring in about 20 percent of births, and it is not among the 20 reasons for a C-section covered by the National Health Insurance.
If the verdict is upheld, it would set an example, and more obstetricians might practice defensive medicine, while medical students might be discouraged from pursuing high-risk specialties, he said.
Social media influencer Bluepigeon (蒼藍鴿), a former National Taiwan University Hospital (NTUH) pediatrician, said the verdict was “extremely chilling,” and assuming a newborn would grow up and financially support their parents is problematic.
NTUH obstetrician Shih Jin-chung (施景中) said the large sum of compensation is unreasonable and a big blow to physicians of high-risk specialties such as neurosurgeons and cardiovascular surgeons.
A quarter of physicians already practice aesthetic medicine and the verdict adds insult to injury, he said.
Pediatrician and Taiwan Primary Care Association president Lin Yung-zen (林應然) said the verdict would affect medical students’ career choices.
Based on the “parent support” logic, there should be a law asking patients whose lives were saved to pay doctors for the rest of their lives, Lin said.
The potential effects of the ruling on Taiwan’s healthcare need to be carefully considered. It might further erode trust in the doctor-patient relationship and more parents might choose to sue in similar cases, instead of applying for the government’s no-fault childbirth accident emergency relief. It might also encourage physicians to practice defensive medicine and worsen the existing shortage of physicians in some departments including surgery, obstetrics and gynecology, pediatrics, and emergency medicine.
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