Fatal necrotizing fasciitis in illegal abortion and the negligence tort

Abstract

The present paper is a case-based review on rare complications of illegal abortion, i.e., necrotizing fasciitis missed early by the treating gynecologists which landed up into a negligence tort against the physicians. The common complications of the abortion like incomplete abortion, haemorrhage, sepsis, etc. are usually handled successfully by the gynecologists; however, early detection often missed when a rare complication like necrotising fasciitis occurs. Eventually leading to litigations in case of death of the patient. The newer techniques have reduced the complications in medically terminated pregnancies (MTP); however, the deaths due to illegal abortions carried out by the clandestine abortion practitioners (CAP) poses a challenge, especially in rural areas. A 30-year-old woman went for an illegal abortion from a CAP to avoid social stigma. She developed sepsis & necrotising fasciitis (NF) of right lower limb due to intra-vaginal use of abortifacient herbs prescribed by the CAP. She was succumbed to the complications of necrotising fasciitis allegedly due to delayed diagnosis by the gynecologists. This led to a negligence tort filed by her family members against the treating gynecologists. The prudent medicolegal and medical steps are discussed here, that could have prevented such sequel.

Keywords: MTP; abortion; clandestine abortion practitioners; illegal abortion; necrotising fasciitis; quack; sepsis.