November 2011 Archives

If you ask people what worries them most about going to a hospital, they will likely give an answer relating to having an operation or getting a shot.  Probably very few will respond with being the victim of a medical error.  Perhaps people should think a little more about this issue as medical errors occur more often than you might think.  In fact, statistics show that almost every patient who enters a hospital experiences some type of medical error at least once during their hospitalization.  Although most medical errors do not create a serious injury or any injury at all, sometimes they do.  Some medical errors result in severe and permanent injuries, even the death of the patient.

How is it that hospitals can sometimes be the most dangerous places for the sick and injured?  Many medical errors occur right after surgery, including after a successful surgery.  For example, a patient who has an elective surgical procedure or even a simple operation, may become the victim of medical negligence if they are not properly monitored in the post anestehesia care unit (PACU) or on the surgical floor after they have recovered from the anesthesia, thus resulting in an anesthesia error.  A simple miscommunication between nurses and doctors can result in a catastrophic injury to the patient.  When a medical error occurs and someone is seriously injured or dies, the patient or the patient's family will benefit from having this negligence investigated.  An experienced medical malpractice attorney should be consulted in this situation.

Dr. Bruce Fagel is both a leading medical malpractice attorney and a licensed medical doctor.  In addition to his 30 year experience as a medical malpractice lawyer, Dr. Fagel also practiced emergency room medicine for over 10 years.  In fact, Dr. Fagel witnessed many medical errors in the emergency room and post anesthesia care unit.  Dr. Fagel was also on hospital committees and consulted with other doctors, which provided insight as to how medical staff make medical mistakes, and how doctors, nurses, anesthesiologists, and hospitals can cover up medical errors.  Doctors and nurses sometimes violate hospital rules and procedures, and even try to hide their negligence.

A simple lapse in judgment or miscommunication from a medical professional can cause catastrophic injuries to a patient.  Because medicine is complicated and patients do not have extensive knowledge about the medical field, a victim of medical malpractice may simply accept a doctor's explanation that he or she did not commit a negligent act, when in fact they may have.  A patient can be intimidated when confronting a doctor about a serious medical error or medical negligence.

Dr. Fagel's unique background as both a leading medical malpractice attorney, and a licensed physician makes him the ideal protector for victims of medical malpractice and medical negligence.  Dr. Fagel also has extensive court room experience, including a successful track record of winning cases and obtaining maximum settlements for his clients. If you or a family member has been the victim of medical negligence or medical malpractice, contact the Law Offices of Dr. Bruce G. Fagel & Associates right away for a free consultation.

Brachial plexus birth injuries cause permanent life long suffering to children and their families.  The brachial plexus is a number of nerves running from the spine and proceeding through the neck and armpit region into the arm. The brachial plexus supplies the arm with nerve impulses. If an infant's head and neck are twisted during childbirth, these nerves may be stretched and damaged, resulting in a permanent injury, such as partial or complete paralysis of the arm on the affected side of the body. This condition is referred to as erbs palsy.

Brachial plexus injuries begin when a baby can't fit properly through the birth canal due to its size.  In situations like this, the doctor should facilitate delivery via a cesarean section or C-section.  Sometimes it's too late for the doctor to facilitate a cesarean section or the dangers of a C-section may be too great.  If this is the case, the doctor needs to very carefully maneuver the baby through the birth canal, ensuring the protection of the brachial plexus.  If the doctor is not careful, he or she may damage the brachial plexus nerves by applying too much pressure when twisting and pulling the baby's head.  In some cases, the brachial plexus nerves can even be avulsed or actual pulled out of the sockets to the spinal cord.

A baby that has injury to the brachial plexus is born with erbs palsy or brachial plexus injury.  The symptoms will be immediately noticeable as the baby's arm will be limp and weak.  In some cases the body can recover, but if it doesn't, the baby will be left with a permanent injury in which he or she will never be able to move their arm for life.

Some of the reasons an obstetrician may not prepare for a brachial plexus dilemma include failure to properly monitor the pregnancy, track the size of the baby near delivery, or define a correct delivery date.   If a C-section is not the best option, the doctor can rotate the baby for a more efficient delivery.  Excessive force to deliver the baby must be avoided to prevent brachial plexus or other serious birth injuries from occurring.  

When presenting brachial plexus birth injury cases to a jury, Dr. Bruce G. Fagel explains the anatomy of a baby, the circumstances the doctor was faced with, and what actions the doctor took to cause the injury to the baby.  If your baby suffered a brachial plexus injury, erbs palsy, or any other type of birth injury from medical negligence, contact Dr. Bruce G. Fagel & Associates right away for a free consultation.  You may be entitled to compensation for a life time of medical care for your child.

A doctor, obstetrician, nurse, or other medical professionals have an obligation to provide a standard level of treatment and care to a pregnant woman, during childbirth and after childbirth.  The baby's health and well-being depends on it.  Delivery mistakes can lead to catastrophic and permanent birth injuries, including erbs palsy, cerebral palsy, mental retardation, or even death.

Dr. Bruce G. Fagel, a leading medical malpractice attorney specializing in birth injuries, and a licensed medical doctor, uses his medical and legal expertise to explain to the jury where medical negligence occurred in a medical malpractice birth injury case. Dr. Fagel first explains to a jury what a normal labor and delivery process looks like, then proceeds to explain where things went wrong.  Birth injuries can occur from a number of problems, including the umbilical cord prolapsing through the birth canal as the infant's head is moving through the canal and getting trapped against the head, causing the cord to kink.  This will cause the blood supply to be cut off, or the cord could even wrap around the baby's neck or other body part, cutting off the blood supply severely.  This can cause severe injuries to the baby's midbrain area, which is the area that affects coordination and motor skills.  This type of injury can result in the baby getting cerebral palsy, which can prevent the baby from being able to walk or control his or her muscles.  In this situation, the child will have normal mental and cognitive functions, but not have normal physical functions.  Other birth injuries may include problems with the placenta not functioning properly, which can deprive the infant from a proper supply of blood or oxygen to the brain.

In a medical negligence or medical malpractice case, attorneys like Dr. Fagel need to demonstrate to a jury how the actions taken by the medical staff, failure to take the proper actions, or failure to take the necessary actions promptly, caused the birth injury to the child.  An experienced medical malpractice birth injury attorney will understand how to determine the exact cause or causes of the birth injury, including the circumstances leading up to the negligence.  Another example of negligence relating to a birth injury may be the medical staff failed to properly read or interpret the fetal monitor strip, which may have produced the warning signs that the baby's heart rate suddenly dropped.  Failure to notice the warning and taking prompt action may have led to a serious and permanent brain injury to the child.   If you believe your child suffered a birth injury related to medical negligence or medical malpractice, you should consult with a birth injury attorney such as Dr. Bruce G. Fagel immediately.  You may have a case for medical negligence or medical malpractice.

Cerebral palsy is a serious birth injury that occurs because of an injury to the brain during childbirth or delivery, from a lack of oxygen or blood flow to the brain, or trauma. Cerebral palsy is not caused by muscle or nerve damage, but rather from abnormalities in the brain that control muscle movement.  At this time there is no cure for cerebral palsy and children who have cerebral palsy may need extensive medical attention for their entire lives.

Cerebral palsy may not even be identified in a child for months or years; however, by the age of six months, early signs may start to become noticeable and by three years, most symptoms will be apparent.  There are three main types of cerebral palsy:

Spastic cerebral palsy - this is the most common form of cerebral palsy and can be identified by difficult or stiff movement.  Approximately 80% of cerebral palsy victims have spastic cerebral palsy.  

Athetoid cerebral palsy - approximately 10% of cerebral palsy victims have athetoid cerebral palsy.  It can be identified by involuntary movements, or movements that are uncontrollable.

Ataxic cerebral palsy - this type of cerebral palsy can be identified by a distorted sense of depth perception and balance.  Children with ataxic cerebral palsy show signs of shakiness, may be unsteady, and have difficulty coordinating muscle movements.

Additional cerebral palsy symptoms may include developmental delays, abnormalities in muscles or reflexes on one side of the body, seizures, dragging a foot or leg when walking, trembling in arms or legs, or abnormal posture.

Parents who suspect their child may have cerebral palsy or believe the cause may have been from medical malpractice, face a problem with the statute of limitations, as the statute of limitations places a limitation on how much time a parent has to file a lawsuit or risk losing the ability to recover damages and a lifetime of care necessary for the child.  

If you suspect your child has cerebral palsy and it occurred due to medical negligence, you should immediately consult with a medical malpractice birth injury attorney such as Dr. Bruce G. Fagel.  The Law Offices of Dr. Bruce G. Fagel & Associates specializes in birth injuries, including cerebral palsy.  If you have a case for medical malpractice, Dr. Fagel can help you recover compensation to provide the medical care your child will require for the rest of his or her life.

One of the most frightening prospects any parent can face is finding out their child was born with a serious birth injury.  There are several types of birth injuries that can occur during the labor or delivery stage, including injuries to the brain of the baby from a lack of oxygen or blood flow, or from trauma or infection; trauma occurring for example if the baby can't fit through the birth canal and forceps or vacuum suction improperly applied cause physical damage to the infant.

Often, these injuries are preventable.  For example, if the baby's head is too large to fit through the birth canal, a doctor likely could have prevented the birth injury by using a caesarean section to remove the baby.  If the baby did not receive adequate oxygen or blood flow to the brain and was born with cerebral palsy for example, the problem may have been traced back to a number of factors, including the failure of the doctor to detect a prolapsed umbilical cord, or failing to perform a C-section if necessary.

Preventable birth injuries may occur if the medical staff fails to properly monitor the fetal heart rate monitor.  The fetal monitor strip is the baby's way of communicating with the doctors and nurses during the mothers labor.  See the fetal monitor strip video for a visual demonstration of how to interpret a fetal monitor strip.  Doctors and nurses look at the fetal monitor strips to see where there are abnormalities or problems that should be recognized during labor.  If the baby's heart rate suddenly drops, the fetal heart rate monitor will alert the medical staff so proper action can be taken to save the baby.  However, if the staff fails to monitor the fetal heart rate monitor or act swiftly when an emergency arises, the baby may be deprived of adequate blood and oxygen flow to the brain and other organs of the body, which may cause severe permanent injuries, even death.

There are many types of preventable birth injuries that may occur during labor or delivery.  Brachial plexus injuries involve damage to the nerves that exit the spinal cord in the neck and supply nerve impulses to the arms.  If the head of the baby is twisted or bent to an extreme during the birthing process, such as when a doctor tries to twist the baby's head that is too big to easily fit through the birth canal, these nerves can be stretched and damaged, leading to paralysis in the arms or hands, or the ability for a baby to sit up or crawl.

A lack of oxygen flow to the brain of the baby, known as hypoxia or asphyxia, can lead to severe injuries, including paralysis and cerebral palsy, if not detected early and corrected.  The fetal heart rate monitor can also help warn medical staff if the baby's heart is not functioning properly and delivering a proper blood and oxygen supply to various organs of the body, including the brain.

If there have been any major problems during labor or delivery, and the baby requires admission to the neonatal intensive care unit (NICU), the parents need to understand the possibility of long term care for their child.   The parents should request a pediatric neurologist or developmental pediatrician to outline a plan for therapy and medical intervention early in the child's life.  If medical negligence or medical malpractice was the cause of the birth injury, the parents should seek a consultation with a medical malpractice attorney who specializes in birth injuries as soon as possible.  If medical negligence was the cause of the injury, financial compensation may be awarded to pay for the medical care the child may require for the rest of his or her life.

A catastrophic brain injury resulting from a severe hypoxic or ischemic event is the type of medical malpractice case that represents the greatest cost to hospitals, society and the families of injured victims.  A hypoxic brain injury occurs when the brain is deprived of sufficient oxygen for a prolonged period.  An ischemic brain injury happens when there is an insufficient blood flow to the brain or a specific area of the brain, such as when a blood clot occurs in an adult or the blood supply to the baby is restricted from the placenta or umbilical cord.  Many of these injuries are preventable.  For example, a hypoxic brain injury in an adult that is preventable usually occurs because of the patient's underlying condition that they went into the hospital to have treated.  This condition then worsens, causing cardiac or respiratory arrest.  A hypoxic brain injury in a newborn child that is preventable often occurs because the condition of the baby in the uterus deteriorates and causes injury before the delivery, and the medical staff fails to recognize the problem and take action in time.

Several causes are responsible for preventable severe hypoxic or ischemic brain injuries:

• Inadequate communication
• Improper assumptions
• Mentality of healthcare providers

Inadequate communication is the greatest problem regarding preventable severe injuries that occur in hospitals.  This occurs with the failure of the medical staff, including doctors and nurses, to properly communicate with each other.  This often happens during a shift change as well.  Also, the communication problems often involve more than one medical staff member.  Therefore if multiple staff members are miscommunicating, the problem becomes more difficult to trace, and the ability for the hospital to trace the root cause and prevent the problem from happening again is very difficult.

Improper assumptions of responsibilities are another critical problem with preventable brain injuries.  Many staff members just assume other members of the staff have performed various tasks related to the patient's medical care or assume other members of the staff have not conducted these tasks.  This could result in a patient getting an overdose of medication for example.  If a hospital has a high turnover rate or the medical staff is not familiar with each other, they are likely to make more mistakes because they fail to understand how each staff member functions or what areas of responsibility each staff member will handle in various situations.  Doctors may believe nurses are handling certain areas of the patient's care or if multiple doctors are working with a patient, may incorrectly assume another doctor is handling certain areas of the patient's care, when in fact this may not be the case.

Mentality of healthcare providers is an overlooked area of medical malpractice.  Often with cases involving medical negligence, doctors or nurses who are negligent are lacking the specific skill or knowledge in a specific area related to the condition of the patient.  Instead of asking for help from a more qualified doctor or nurse, one who has a better knowledge-base in that specific area, their pride stands in the way and they attempt to solve the problem themselves, until they realize they are in over their heads.  Another problem is the medical staff failing to recognize the warning signs the medical equipment is providing them.  For example, if a baby is hooked up to an electronic fetal monitoring device and the machine is showing a problem with the patient, the medical staff may incorrectly believe the machine is malfunctioning, wasting precious time trying to correct the problem or find another machine, rather than attending to the needs of the infant.

Most doctors and nurses have great difficulty understanding why legal liability flows from the nature of the injury or death, rather than from the recklessness of their actions. As a result of this medical-legal disconnect, and the fact that doctors and nurses cannot maintain a constant state of high alert, preventable catastrophic injuries will continue to occur in hospitals and even though such injuries may be completely out of proportion to the actions of the doctors or nurses, the financial impact to the doctors and hospitals will be based on the outcome of those actions.

There are many advantages to retaining the services of an attorney who is also a physician.  One area that is particularly useful is with the deposition. A deposition is basically a formal question and answer process where we ask questions of a doctor or nurse about what happened beyond what is written in the medical records.  The deposition allows us to probe into the thoughts of the medical staff and find out what their reasons were for doing things the way they did. 

As a physician, I know what the answers from doctors, nurses, and medical staff should be, so consequently when doctors go off on a tangent and begin answering questions with a lot of medical jargon, I am able to cut through it. I am able to get to the specifics of what happened and why things occurred that should not have occurred if normal care was utilized and the standard of care was appropriate in a particular case.  This becomes especially important when we get into issues about the medical cause of specific problems; doctors have a tendency to confuse the issues by answering in different ways.  So as a physician I'm able to basically ask them very specific questions and follow their train of thought wherever they are going and get the most information relevant to winning the case.

Another area where clients benefit from having a lawyer who is also a licensed medical doctor is with the medical records.  Before an attorney can take on a case, he or she must determine if the case will likely be successful, whether tried in front of a jury, or settled prior to trial.  Most of the evidence that is crucial to winning the case will be located in the medical records.  It is critical that the attorney who handles your medical malpractice case, be extremely knowledgeable about both medical malpractice law and the medical field.  This is why I maintain my medical license after practicing emergency room medicine for over 10 years. I find that having a strong medical background provides me with a strategic advantage when dealing with doctors and medical staff.  At the Law Offices of Dr. Bruce G. Fagel & Associates, medical malpractice is all we do.  We want to make sure we are the most knowledgeable source in one area, and one area only, medical malpractice. 

Diagnostic physicians, who rely on diagnostic tests, need to inform referring clinicians when test results produce urgent or unexpected findings.  Test communication failures for diagnostic testing are placing physicians at an increased risk of medical malpractice claims, as reflected in an article selected as the "CME Activity of the Month" in the most recent edition of Journal of the American College of Radiology (JACR).

During the past decade, clinicians have dramatically increased their orders for diagnostic examinations.  During the period between 1996 and 2003, there has been an increase by approximately 40% for malpractice payments related to diagnosis.  This problem was reflected in the article by Brian D. Gale, MD, MBA, assistant professor of radiology at SUNY Downstate Medical Center in Brooklyn.  

During the period of 1991 to 2009, National Practitioner Data Bank data showed communication failure awards was responsible for an increasing proportion of total United States malpractice awards for providers.  The proportion jumped from .93% in 1991 to 2.31% in 2009.  The total indemnity payout for all medical specialties claims dramatically rose from $21.7 million in 1991 to an alarming $91 million in 2010.  This averages out to a $4.67 million increase annually.  Factors that contributed to the communication failures included long turnaround time, delays in reporting findings, and failure of the patients and physicians to receive the results.

There is hope for improvement however.  Dr. Brian Gale suggests that using semi-automated critical test result management systems may help to improve the patient safety and work flow, improve the notification reliability for everyone in the loop, and provide legal documentation.  Dr. Gale suggests healthcare organizations need to have a clear set of policies in place to address reportable test results, to make sure patients and referring providers are notified and followed up with.

As more knowledge surfaces regarding cancer screenings, expert groups are recommending less frequent screenings for prostate, breast, and cervical cancers. It appears from numerous clinical trial studies and analysis of medical data that previous recommendations such as annual Pap tests for women be less frequent, in the case of Pap tests, every three years instead.

Studies are showing that not only may testing too frequently for cancer potentially cause harm to patients, it also appears to be a financial burden to the health care system.  However, some doctors are walking the fine-line between saving money and risking a lawsuit for failure to detect a treatable cancer in time.

An article in the NYTimes.com titled, "Considering When It Might Be Best Not to Know About Cancer" breaks down new screening recommendations from expert medical groups:

• Women in their 40's do not appear to benefit from mammograms
• Women ages 50 to 74 should have mammograms every two years, instead of every year
• P.S.A. screening test for prostate cancer does not save lives and causes enormous harm
• Pap tests for women for cervical cancer should be every three years, instead of every year

Expert medical groups are now questioning if prostate cancer screenings are saving any lives at all.  These groups fear that the screening often leads to disabling treatments for men, who really didn't need to treat the cancer in the first place.

A mammography study revealed that out of 138,000 cancers detected in women each year, somewhere between 120,000 to 134,000 of these cancers are already lethal and beyond being treatable or the cancers will grow slowly and not need to be treated at all.

Dr. Otis Brawley, chief medical officer with the American Cancer Society states, "Screening is always a double-edged sword.  We need to be more cautious in our advocacy of these screening tests." However, many doctors and specialists, such as urologists, radiologists, and oncologists believe screening is necessary to detect and treat cancer early.  Questions are also arising whether this subject is coming up simply due to costs and the modern healthcare crisis.

Regarding costs, The New England Journal of Medicine posted an article concluding $5.2 million must be spent on screening to prevent one prostate cancer death. Estimates are this amount is actually higher than that.  This brings up the issue of how much to spend in order to save lives.  It also creates a dilemma for doctors who will have a difficult time explaining the new guidelines to patients.  Some doctors may make recommendations based on their own beliefs and the wishes of the patient's for more screening.  Also, as more cancers are being determined not to be treatable, or not be a threat, the issue of cancer screening has become even more complicated; likely leaving many patients wondering when and if they should be screened.

Harbor-UCLA Medical Center recently failed government inspections, including failure to keep its operating rooms clean and failure to keep patients safe from possible infections, as reported in the October 30th edition of the Los Angeles Times.   Violations included the hospital staff not washing their hands, operating rooms kept at the wrong humidity level, and building violations, including dusty ceilings and holes in the ceilings. 

The failure of the hospital to keep a sanitary environment puts the patients at risk for infection.  This is not the first time Harbor-UCLA Medical Center was warned for keeping an unsanitary environment.  In fact, earlier this year, infection control problems were so serious, that the federal government sent a letter threatening to revoke their Medicare funding, which in essence would financially cripple the medical center.  Federal inspections such as this provide important protection for the public.  Los Angeles County Supervisor Mark Ridley-Thomas stated, "Thank God for the federal inspection.  It is necessary for the purposes of accountability and quality of care."

The hospital's chief executive Delvecchio Finley stated that the hospital had addressed all the concerns with the exception of issues relating to the age of the hospital.  Los Angeles county is investing $323 million to build a 190,000 square foot building at the hospital that will replace the emergency room and surgical facilities.  This move is necessary as the current conditions of the hospital are unacceptable and will not be in compliance.  The Times states the hospital had 80,600 patients visit the emergency room and 23,000 patients were admitted to the hospital in the last fiscal year.  Harbor-UCLA Medical Center also took on additional patients after the closure of Martin Luther King Jr./Drew Medical Center in 2007.   James Lott, executive vice president of the Hospital Association of Southern California stated, "The reports should put Harbor-UCLA on alert that it needs to improve - quickly.  We only have to recall what happened with the former King/Drew Medical Center. The downfall of that hospital started with these types of alerts."

The California Department of Public Health has also fined the hospital four times for medical errors that put the patients at serious risk of injury or death.  The state also claims a patient who was hit by a car died in the hospital because a nurse failed to closely monitor his condition.  A union representative for the nurses, Katarina Del Valle Thompson believes inadequate staffing has also contributed to the problems.  "The best thing we could do to minimize the chances of errors would be to staff adequately."

The average length of a pregnancy is 38 weeks.  If a pregnancy results in a delivery before 37 weeks, it is classified as pre-term.   A premature delivery can happen between 26 to 36 weeks of pregnancy.  Any delivery below 26 weeks is extremely dangerous and poses a severe risk of permanent neurologic injury to the child.   Even a delivery before 32 weeks represents a serious risk to the baby, as the lungs mature between 32 and 34 weeks.   Because the lungs haven't fully matured yet, a child delivered earlier than the 32 to 34 week time frame may not receive enough oxygen to the brain, which is known as hypoxia. In addition, a child born before 34 weeks will usually require assistance with ventilation in the neonatal intensive care unit (NICU) for the first few weeks.  The NICU specializes in the care of premature or ill infants.  Mother's who are expecting a premature delivery should seek out a hospital with a NICU.

Premature babies have a lower risk of brain injury the longer they stay in the mother before delivery.  If a baby is delivered after 34 weeks, it will usually have a low risk of brain injury or permanent brain injury.   The mother of an expected premature infant can also be given steroids to help decrease the risk of brain injuries and lung problems for the baby.

A premature baby may run into many medical problems, including having difficulty breathing.  Preterm babies are at a higher risk for a brain hemorrhage.  Additional organs such as the gastrointestinal tract and the nervous system may be affected.  A premature baby will be at a higher risk for infections, maintaining body temperature, and may even have difficulty feeding. 

A premature baby who survives the birth may run into additional medical issues, including cerebral palsy, developmental delays, chronic lung disease, hearing, and vision problems.  It is important that a doctor pays close attention to a mother expecting to deliver a premature baby.  If you delivered a premature baby that has suffered injuries as a result of a doctor's negligence, you may have a case for medical negligence or medical malpractice.  

Pregnancy-induced hypertension (PIH) is a medical term for the mother having high blood pressure during the pregnancy.  It is critical for a doctor to pay close attention throughout the pregnancy if the mother has PIH.  Failure to monitor PIH can result in dangerous conditions for the health of the baby. 

Advanced stages of PIH or eclampsia, can result in seizures.  If Pregnancy-induced hypertension becomes serious enough, the mother may have to deliver the baby early or prematurely.  If this is the case, there is a chance of serious injury to the baby, including a stillbirth delivery.   PIH can restrict blood flow to the fetus's important organs, including the uterus, placenta, brain, kidneys, and liver.  Without the proper blood flow to these vital organs, the fetus may not get the amount of nourishing fluids it needs to develop, grow, and even survive in the womb.

Symptoms of Pregnancy Induced Hypertension:

• High blood pressure
• Protein in the urine
• Water retention
• Nausea or vomiting
• Headaches
• Blurry vision
• Pain in the upper abdomen

Since some of these symptoms may be normal or relate to other symptoms, it is important for pregnant women experiencing any of these symptoms to contact their doctor for a checkup.  The doctor will check the mothers' blood pressure and urine levels.  The doctor may conduct additional tests including an ultrasound, a kidney check, and examine the placenta for proper blood flow.

A doctor may also recommend eliminating salt, drinking up to 8 glasses of water a day, exercising, avoiding junk foods such as fried foods, avoiding caffeine and alcohol, and possible medication, depending on the severity of the condition and the proximity to delivery.  The doctor should also request additional checkups to properly monitor the condition of the baby. 

As long as the doctor recognizes PIH early enough, closely monitors, and treats the woman throughout the pregnancy, it should be completely manageable and not create any problems.  Early detection and careful monitoring are the keys to delivering a healthy baby and avoiding any injuries to the mother as well.  However, if the doctor fails to recognize or treat PIH, this may cause injuries to the baby or even death.  If this happens, there may be grounds to file a medical malpractice lawsuit against the doctor.