28 year old female in labor was administered an epidural by a resident anesthesiologist. The epidural was allegedly misdirected and the procedure was complicated by a dural puncture. As a result, the plaintiff had brain swelling and suffered from seizures.
Does the fact that dural puncture occurred indicate a deviation from the standard of care?
MEDQUEST EXPERT RESPONSES
Dural punctures are frequent in performing an epidural. It is a routine consequence of needle placement and usually does not result in side effects …however, there might be a post dural puncture headache, especially in pregnant women. The other aspects of this namely seizures, and brain swelling are not expected consequences and suggest that something else is going on. What, how and why this happened obviously is conjecture and I would need to see her complete chart to get an educated sense as to what transpired. Dr. M.D. – Anesthesiologist
A dural puncture is NOT a deviation from the standard of care. It is a well-recognized complication of epidural anesthesia/analgesia. The fact that the plaintiff had brain swelling and suffers from seizures needs to be explored further. Dr R.B. – Anesthesiologist
Dural puncture during the performance of an epidural does not constitute any deviation from the standard of care – it is a known complication of the procedure.
Dr A.W. – Anesthesiologist