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Br J Obstet Gynaecol. 1988 Feb;95(2):113-5.

Failed sterilization and the law.

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District General Hospital, Eastbourne, East Sussex.



Litigation in the UK resulting from sterilization failures is on the increase, with claims averaging 40,000/case. This suggests that physicians must be extremely careful with preoperative counseling and the conduct of the sterilization procedure. Failed sterilization litigation may allege negligence, trespass to the person, or breach of contract. It is important be patients be informed that there is a risk of failure, especially when sterilization is performed at the end of a cesarean section procedure or induced abortion. Patients should be asked to sign the specially designed consent form, and the record should state that the implications of the procedure and its risks were explained. Another way failures can be minimized is through improvements in surgical technique. If there are problems with laparoscopic visualization, a laparotomy should be performed and patients with obesity or pelvic adhesions should be warned of this possibility in advance. Laparoscopic sterilization should be performed only by those with thorough training in the method, and junior staff should be carefully supervised. Given the fact that the world "sterilization" implies permanence, which can't be guaranteed, it is suggested that the procedure be referred to by what is actually done--e.g., tubal ligation and excision or laparoscopic application of clips to the fallopian tubes.

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