Medicine has advanced significantly through the centuries. From the 17th century, when William Harvey discovered that blood is circulated continuously throughout the body by the heart, to 19th-century breakthroughs in germ theory, anesthesia, and antiseptics, to 20th-century innovations like vaccines and antibiotics, the field of medicine has become incredibly sophisticated. We have longer lifespans and more choices than ever in what to do with them. One thing that has given women more choices is contraception. We have moved beyond the early days of diaphragms and hopeful douching to today, when a woman can have a device implanted to prevent pregnancy.
However, what happens when an implantable contraceptive is not properly placed or removed? What complications might arise from the faulty removal of IUDs? Can it be considered medical negligence if a woman gets pregnant as a result of the faulty placement of an IUD? A New Mexico medical malpractice attorney with Erin Marshall Law may be able to assist you with proving your medical provider was negligent in the placement or removal of your implantable birth control and the injuries caused as a result. Call (505) 218-9949 to book an appointment to review your case.
Examples of Implants Women Might Get
There are many birth control options, including “the pill,” diaphragms, condoms, and injectable hormones. However, most options require either placing the device (such as condoms or diaphragms) immediately before intercourse, or regular, consistent use, such as taking a daily pill or seeing a medical provider every few weeks for injections.
Implants are a long-term option, allowing women and their partners to have peace of mind about preventing pregnancy while also not having to worry about it. However, there is more than one kind of contraceptive implant, and there are also other implants a woman might get that could potentially be incorrectly placed or removed.
Implantable Birth Control
An intrauterine device (IUD) is a common T-shaped contraceptive that is inserted in the uterus. When properly placed, an IUD is a long-term, reversible form of birth control that works by preventing sperm from fertilizing an egg. IUDs can be either hormonal, releasing progestin and may cause lighter or no periods, or copper, which contains no hormones and might cause heavier periods. IUDs can last for three to ten years, depending on the type, and are 99% effective at preventing pregnancy, while also restoring fertility almost immediately upon removal of IUDs.
Another implantable birth control is the subdermal implant. This is a small, flexible rod placed beneath the skin of the upper arm. Subdermal implants are hormonal with a constant release of progestin and are more than 99% effective. When properly placed, subdermal implants are approved for use for up to three years at a time, though they have been shown to be effective for up to five years. A medical provider can remove them at any time and insert a new one immediately for continued contraception. When a woman is ready to stop use, fertility can return almost immediately, though in some cases, it may take up to a year.
Other Implants That Can Be Problematic
While birth control is a very common implant that women get, breast implants are another. Women may get breast implants because they would like larger or differently-shaped breasts, or they may get them to reconstruct the breasts after a mastectomy. Improper placement of breast implants can cause an unnatural appearance, asymmetry, pain, and difficulty moving the arm. Improper removal can lead to complications such as residual silicone particles, capsular contracture, nerve damage, infections, or aesthetic issues such as sagging or a deflated appearance.
Complications of Faulty Placement of IUD or Other Implants
With IUDs and subdermal implants, proper placement is imperative. Faulty placement can result in several problems, including potential pregnancy. While the primary purpose of birth control is preventing pregnancy for most women, some of the other possible complications may be more concerning for many.
Some of the potential complications from the faulty placement of IUDs include:
- Pain
- Abnormal bleeding
- Uterine perforation (puncturing the uterine wall)
- IUD migration into the abdominal or pelvic cavity, damaging the bladder, bowel, or other organs (a result of uterine perforation)
- IUD expulsion, causing abdominal pain and bleeding
- Pelvic inflammatory disease (infection of the reproductive system that can cause infertility, ectopic pregnancy, and chronic pelvic pain if left untreated, according to the American College of Obstetricians and Gynecologists)
- Difficult removal that may require special tools or surgery to retrieve the IUD
- Insertion of a defective IUD (for example, a flawed design, manufacturing defect, or failure of the manufacturer to warn users or providers about potential risks, also known as informed consent)
- Nerve or blood vessel injury
- Subdermal implant migration, requiring surgical removal
- Subdermal implant migrating into a major blood vessel or pulmonary artery (rare)
- Blood clots associated with inadvertent intravascular insertion of a subdermal implant
- Deep or incorrect insertion of a subdermal implant
- Hematoma at the implant insertion site
Complications of Faulty Removal of IUDs or Other Implants
While it may initially seem as though removal of IUDs or other implants would resolve any potential issues, removal can also be improperly handled and cause additional or new issues for the woman. Even if the placement went smoothly and did not result in issues, there is still a possibility that removal can cause problems.
Some of the potential problems arising from faulting removal of birth control devices include:
- IUD strings may retract into the cervix, making it difficult to retrieve
- IUD may break during removal, requiring surgical retrieval of remaining pieces
- At least one case of uterine artery rupture, as reported by the National Library of Medicine
- Uterine perforation
- Intestinal perforation (possible complication of uterine perforation)
- Compromised fertility
- Continued hormonal side effects
- Ectopic pregnancy
- Infection and scarring from multiple removal attempts
- Neurovascular injury when seeking deeply inserted or migrated subdermal implants
- Difficulty locating subdermal implant
Many potential injuries may result from the faulty placement or removal of IUDs.
Would Pregnancy Resulting From Faulty Placement Be Considered Medical Malpractice?
For both removal of IUDs and placement of IUDs that are not handled properly, pregnancy becomes a significant concern. However, women often are not sure if pregnancy would be considered an injury for the purposes of filing a medical malpractice claim, particularly in cases where they ultimately decide they are happy about the pregnancy. While it can be more difficult to connect an unintended pregnancy to a faulty IUD or subdermal implant removal, it can be done, particularly if it was an incomplete removal (leaving part of the device behind), failed or difficult retrieval, or if the IUD is displaced.
Faulty placement of IUD or a subdermal implant is often easier to connect to an unintended pregnancy, also known as a wrongful conception or wrongful pregnancy. This, as well as faulty removal, can be grounds for a medical negligence claim, with the basis being that the provider’s negligence directly led to the conception. If you believe that your pregnancy was caused by the faulty removal or placement of an IUD, an experienced medical malpractice attorney with Erin Marshall Law may be able to assist you with determining if you have a claim, gathering evidence, and negotiating with the provider or their insurance company.
Proving Malpractice for Faulty Placement or Removal of Implants and IUDs
Four elements must be established to proceed with a medical malpractice claim in New Mexico. However, there are also other considerations that must be examined when making the decision to proceed with a claim.
Elements of Malpractice
There are four elements to medical malpractice. If any of the four are missing, a claim is unlikely to be successful. These elements are:
- Duty of Care: This is the relationship between the provider and the patient, which means the provider owes the patient a professional duty.
- Breach of Duty: This means the provider failed to meet the accepted standard of care. For IUDs, this can mean failing to rule out pregnancy before insertion, improper insertion technique, failing to ensure the IUD is properly installed before concluding the procedure, incorrectly prescribing or administering birth control, or failure to remove an IUD that has perforated the uterus.
- Causation: This means proving that the provider’s breach of duty was the direct cause of the unintended pregnancy or other resulting harm.
- Damages: This requires the patient to show that they suffered specific, compensable damages as a result of the negligence, such as lost wages, pain and suffering, and medical bills.
Understanding how to identify malpractice can influence how a case is pursued.
New Mexico’s Statute of Limitations
NMSA § 41-5-13 (1978) provides that patients who have experienced medical negligence have three years from the date of the malpractice, even if the harm was not discovered until later. This can be particularly important concerning IUDs, which can be placed for up to ten years. While patients should prioritize their health and ensure that they have taken all steps to reduce or repair the harm caused by improper placement or removal, they should also consider seeking the assistance of legal counsel as soon as possible to ensure their rights are protected.
Medical Review Commission Requirement
Before a medical malpractice claim can proceed, it must first go before the New Mexico Review Commission, per NMSA § 41-5-14 (1978), unless the alleged malpractice is by a hospital or outpatient health care facility. This committee reviews the case and delivers a decision indicating whether they think there is substantial evidence of the events claimed, whether they rise to the level of malpractice, and whether there is a reasonable medical probability that they caused the patient’s injury. The committee’s decision is not binding, and the patient can still proceed with the case even if the committee’s review indicates they do not think there is a claim.
Why You Might Need a Medical Malpractice Attorney
Placement of subdermal birth control implants or IUDs, and their subsequent removal, are medical procedures. As such, they come with some inherent risks. However, improper placement of IUD or faulty removal of IUDs can result in severe harm, including unintended pregnancy or infertility. An experienced New Mexico medical malpractice attorney may be able to assist in determining whether what you experienced was medical negligence. They may also be able to assist in gathering evidence, negotiating with the provider or their insurance company, and, if it becomes necessary, representing you in court. Call Erin Marshall Law at (505) 218-9949 to schedule your consultation to review your case and learn more about your legal rights and options.
