Pro-life nurse sued for removing IUD without patient’s consent

Here is the court document, which is pretty short and to the point: a woman went into a facility to have an adjustment made to her IUD, and the nurse practitioner “accidentally” pulled out the IUD.

As that happened, Defendant Olona stated “Uh oh, I accidentally pulled out your IUD. I gently tugged and out it came.” She then explained, “I cut the string than went back and gently pulled and out it came. It must have not been in properly.” Olona then stated, “having the IUD come out was a good thing.” She asked Ms. Van Patten if she wanted to hear her “take” on the situation. Without receiving a response, Defendant Olona stated, “I personally do not like IUDs. I feel they are a type of abortion. I don’t know how you feel about abortion, but I am against them. What the IUD does is take the fertilized egg and pushes it out of the uterus.” Defendant Olona stated, “Everyone in the office always laughs and tells me I pull these out on purpose because I am against them, but it’s not true, they accidentally come out when I tug.”

As much as I agree with the NP’s beliefs — that IUDs are abortifacient and that Mirena (the IUD in question, which has a hormone to prevent ovulation) may not always prevent ovulation, so may also be abortifacient — I cannot agree with what she did.

Assuming that what is in the court document is true, if this NP always “accidentally” pulls out IUDs when she tugs, then she needs at the minimum better training in how to properly place or maintain them. If she is against IUDs, she needs to be in another branch of the profession so she won’t have to deal with them, or have other measures in place to assure that she won’t be called on to violate her conscience by properly maintaining an abortive device. If she thought the woman was ignorant of the possible abortifacient qualities of Mirena, then she can educate her with the IUD intact, and then remove it if the woman wants it. And if the woman doesn’t want it removed, then the NP can remove herself from the room and get someone else to serve the woman.

Now, onto what I think is even more important, and that is the Civil Battery charge against the NP:

27. Defendant Olona intentionally removed the IUD without Ms. Van Patten’s consent to do so.
28. Defendant Olona’s conduct fell below the standard of care in the medical industry, which requires consent by the patient prior to conducting any procedures.
29. Defendant Olona’s conduct and actions constituted a civil battery upon Ms. Van Patten.
30. The intentional removal of the IUD proximately caused Ms. Van Patten damages and injuries.
31. Defendant Olona’s actions arose out of the negligence in the performance of medical treatment.
32. Defendant Olona’s actions were intentional, malicious, willful, and wanton.
WHEREFORE, Plaintiff requests compensatory damages against Defendant, including loss of consortium for her and her husband, Peter Van Patten, together with all costs and attorneys’ fees.

I would like to see something of this sort brought against every birth attendant who performs “any procedure” without “consent by the patient” — especially ones that cause unnecessary pain, bleeding, or “loss of consortium” (the woman can’t or won’t have sex). If removal of an IUD (which causes a little bleeding and menstrual-like cramps; and led this couple to abstain from sex for fear of pregnancy) without a woman’s consent constitutes battery worthy of a lawsuit that will compensate for the pain and loss of sex, how much more justified is a lawsuit because a woman’s vagina is cut against her will (episiotomy), or she is coerced or threatened into or given a C-section against her will? I’ve never had any of these — IUD removal, episiotomy, or a C-section — but I daresay the pain and loss of consortium caused by intentional cutting into a woman’s vagina or abdomen is a great deal more than that which is caused by the unwanted removal of an IUD.

This is not to minimize what this woman went through. Just to say that the comparatively small amount of pain and bleeding and lack of sex (either two weeks until the DepoProvera shot became effective, or 4 weeks until she got another IUD implanted — the court document says both, but only one can be true) is nothing compared to the amount of pain and loss of sex caused by an unnecessary episiotomy or C-section. When 73% of women whose vaginas were cut during birth were not given a choice about it (Listening to Mothers Survey – II, p. 19), then something needs to change. If enough lawsuits are filed on behalf of these women and their husbands and their babies due to the unnecessary and possibly “intentional, malicious, willful and wanton” use and overuse of unwanted interventions, then birth as we know it may change.

7 Responses

  1. My OB did not get my consent before performing the episiotomy. I didn’t know it was performed until I realized she was stitching. Can I sue her? (My husband videotaped my labor, there was no complications happened to me and my baby, it seems like it was performed routinely. The doctor’s explanation is that she wants to prevent tear since it was not controlled… however, everybody knows what she said is controversy, the fact is episiotomy was performed against my will)

    Now I found out the episiotomy is healed but the vagina left wide open because a few stitches short. (It could be the doctor didn’t sew well or the stitches came apart/broken) I am so unhappy with it. I am not sure if Doc can fix it.

    Can I sue the Doc? Have anybody heard any lawsuit cases like this? how possible I win the case?

    • You can probably technically sue, but it might be difficult to win the case — you would have to get a lawyer’s opinion on that (and it may vary depending on where you live — different states have different laws concerning lawsuits or procedures such as this). It may be that you signed a blanket consent form authorizing her to do whatever she thought was best in your labor and birth. Make no mistake — *I* think that she violated you in performing a medical procedure (technically a surgery, since it involved cutting tissue) without your informed consent, but that doesn’t mean a jury will. There may be other avenues — writing the doctor, any of her superiors (either in her private practice or at the hospital where you gave birth), or the state medical board, protesting her violation of informed consent. Technically, according to the Emergency Medical Treatment and Active Labor Act (EMTALA), your doctor has to abide by your wishes from the time you are admitted to the hospital until after the placenta is birthed — perhaps you can file a complaint with whatever regulatory agency deals with that; although if you did not tell her *not* to cut, she may think she has your tacit approval (or could claim that in court). However, I have heard many stories of women expressly saying, “I do not consent!!” and it being done to them anyway (whether that’s episiotomy or being given general anesthesia so a C-section can be performed against their will).

      But this sort of thing needs to stop. On the one hand, I want this treatment of women to STOP, by whatever legal means necessary — and if it takes a lawsuit to do that, or if it can be handled by milder means (regulatory or state health organizations, etc.), I don’t know. But I also want to give you a realistic idea of the difficulties that may lie ahead. Most people will have the attitude that since you didn’t die and the baby didn’t die, nor did you suffer a major negative event (downplaying the problem with the healing of the episiotomy), that you don’t have much of a case. And I’m sure that the woman in this article dealt with the same attitudes, and pressed on. This is a big deal to you, and I think it is indicative of larger problems, with this doctor in particular, and the area of birth (and women’s health) in general.

  2. To Cathy –
    I could have sworn that was me who wrote your article.
    The same thing happened to me. There was an episiotomy performed on me without my consent and I didn’t even know what it was. I have it on video and on the video the RN is telling the doctor not to perform it, and he’s saying only a little bit. This is a very disgusting thing that can be done. Patients should have to sign something saying they know what an episiotomy is. This is flat out wrong! How dare a doctor – yet male doctor decide what to do with my body. He didn’t even listen to the female RN, who I’m sure has seen many births and is more concerned of the female patient then him. I’m so upset especially now reading all these articles. How come there isn’t a law in place saying, the doctors must have female consent and the female must know what it is. Come on now

  3. Please read up before you waste any more of your time or a lawyer’s time. You signed forms (assuming you didn’t deliver on the street) which said that you agreed to be treated by the physician as need. I’ll bet it even included inforamation on episiotomies as this is a very common procedure performed to prevent indiscriminate tearing of the vaginal wall. For Pete’s sake, instead of looking for cash you need to verify your information.

  4. You signed a permit to allow the provider to deliver your baby. This includes using his judgement on how much and what kind of medication you receive, whether or not a C-section is indicated for safety of babe or mom and performing such acts to ensure mother and child are safe. Episiotomies are performed to prevent indiscriminate tearing of the cervicx,vagina,and vulva which is far, FAR worse than sewing up a clean, straight line. Instead of checking for ways to fill your purse with a little extra cash perhaps you should educate yourself.

    • Signing a consent form does not (or at least should not) give a doctor carte blanche to do anything s/he wants — only what is necessary or medically sound. And the woman still should be consulted and given the right of informed consent *and refusal*. You are familiar with the concept of informed consent, aren’t you?

      An episiotomy is cut only during pushing stage, when the cervix is already fully dilated, and the baby is past the cervix, and does not affect whether the cervix tears or not.

      As far as a repair of the vagina and vulva, yes it is easier for the DOCTOR to have a “clean, straight line” to sew up, but it is far easier for the MOTHER to have a naturally torn perineum, which heals faster and better than a cut. [A tear follows the path of least resistance, and goes around individual cells; whereas a cut goes through cells and does much more damage. Plus, a cut is by definition a second-degree injury, while most tears are only first-degree. Finally, almost all third and fourth-degree injuries were started as episiotomies and extended (or should I say, they indiscriminately tore?) into or through the anal sphincter. Very few natural tears end up as third or fourth-degree injuries. For all these things, a tear is much better for the mom, statistically speaking, although in individual cases, an episiotomy *may* be warranted.]

      Episiotomies used to be recommended for 100% of vaginal births, but we now know that there is no benefit and great risk when they are used routinely. While some birth attendants do use them routinely, particularly on first-time moms, this is not medically indicated nor is it backed up by sound medical literature. Birth attendants should have a very low episiotomy rate – much less than 20%, and preferably in the low single digits.

      Yes, education is a wonderful thing!

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