Lessons Learned From a Review of Malpractice Litigations Involving Obstetric Anal Sphincter Injury in the United States

OBJECTIVE: The aim of this article is to review all litigations involving obstetric anal sphincter injury (OASIS) in the United States to highlight the most common allegations and factors that aided the involved obstetricians and gynecologists (ob/gyns). METHODS: We used Lexis Nexis, a comprehensive legal database, to search all publicly available high-profile federal and state level litigations related to OASIS. RESULTS: Of 68 cases that resulted and reviewed, 19 were deemed to be pertinent to the question being addressed. These 19 cases occurred between 1964 and 2011 and all alleged medical negligence. Among these 19 cases, 6 were ruled in favor of the plaintiffs, with most of them being awarded an amount ranging from US $110,000 to US $841,810.80. All 6 cases involved episiotomy. Thorough medical recordkeeping, comprehensive discharge instructions and counseling, and timely evaluation and referral to a female pelvic medicine and reconstructive surgery specialist were the key factors that aided the ob/gyns facing these litigations. CONCLUSIONS: Avoidance of episiotomy, thorough medical recordkeeping, comprehensive discharge instruction and counseling, and timely evaluation and referral to a female pelvic medicine and reconstructive surgery specialist may help an ob/gyn prevail in OASIS-related litigations.