Panminerva Medica 2020 May 14

DOI: 10.23736/S0031-0808.20.03946-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Episiotomy: a medicolegal vicious cycle

Simona ZAAMI ¹ ✉, Errico ZUPI ², Lucia LAZZERI ², Gabriele CENTINI ², Michael STARK ^{3, 4}, Antonio MALVASI ^{5, 6}, Fabrizio SIGNORE ⁷, Enrico MARINELLI ¹

¹ Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy; ² Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic University of Siena, Siena, Italy; ³ The New European Surgical Academy (NESA), Berlin, Germany; ⁴ ELSAN Group Hospitals, Paris, France; ⁵ International Translational Medicine and Biomodelling Research Group, Department of Applied Mathematics, Institute of Physics and Technology State University, Moscow Region, Russia; ⁶ Department of Obstetrics and Gynecology, Santa Maria Hospital, GVM Care and Research, Bari, Italy; ⁷ Department of Obstetrics and Gynecology, Misericordia Hospital, Grosseto, Italy

The present study aims to analyze the litigation trends and ensuing compensatory damages brought about by the use of episiotomy, in order to outline a set of cautionary rules meant to limit the scope of legal aftermath for both doctors and health care facilities. The authors have set out to gain an insight into the controversial practice of episiotomy, in light of available research data and official positions of various scientific and medical associations, with a close focus on the legal and medical viability of the procedure itself. Court data and trial records have been taken into account as well, via searches into legal databases and search engines (Justia, Lexis, Jurist.org, Venice Courthouse, etc...). The review showed that most episiotomy-related lawsuits stemmed from a routine use of that procedure, which is almost universally advised against, and without valid informed consent having been gained. Ultimately authors have seen fit to underscore the need for patients potentially eligible for an episiotomy (selective episiotomy) to receive thorough and understandable information in a timely fashion including the necessity and the effectiveness of the procedure as well as the risks involved, so that a well-informed decision can be made based on factual data.

KEY WORDS: Episiotomy; Litigation; Delivery, Court cases; Settlement; Claims