Opera Singer Says Operation Ruined Her Career

     CINCINNATI (CN) - An opera singer's career is threatened by flatulence and incontinence caused by a nurse-midwife who botched an episiotomy done without consent during childbirth, the woman claims in court.
     Amy Herbst and her husband, Army Staff Sgt. James Herbst, sued the United States of America in Federal Court.
     Herbst, who has sung with the Nashville Opera, claims her career has been put on hold due to injuries caused by a nurse-midwife at the Blanchfield Army Community Hospital (BACH) in Fort Campbell, Ky. during the delivery of her first child.
     "Her first stage of labor lasted 3 hours and 30 minutes. Her second stage lasted 50 minutes. Certified Nurse-Midwife (CNM) Tiffany Williams reported, in plaintiff Amy Herbst's medical record for the admission at BACH, that she performed a midline episiotomy. Thereafter, a male infant was delivered. He weighed 7 lb. 11 oz. and had Apgar scores of 8 and 9 at one and five minutes respectively," the complaint states.
     "CNM Williams reported repairing the episiotomy with the following annotation in the medical record: 'Midline episiotomy with 2d degree extension repaired with 3-0 vicryl'.
     "At no time during the labor and delivery process was plaintiff Amy Herbst informed about the possible need for or the risks and benefits of an episiotomy. At no time was she asked to consent, nor did she consent, to the performance of an episiotomy. Further, no physician was called to assess or repair and no physician assessed or repaired the episiotomy."
     Herbst claims that after she was released from the hospital, she "began to experience fecal urgency and incontinence, including periodic leaking of stool and excessive flatulence."
     She explained her symptoms to a different nurse midwife at her follow-up appointment and exam, and say she was told she "had suffered a 'complete breakdown of the episiotomy and perineum and the external sphincter is disrupted and the vagina and rectum are basically connected without any perineal body.'"
     A colorectal surgeon at Vanderbilt University Medical Center told her she would need reconstructive surgery to repair the damage, but that "this would likely not eliminate the lack of control of flatus and [she] may require additional surgeries in the future."
     "Plaintiff Amy Herbst was also advised that once the repair was performed all future pregnancies would require delivery by Cesarean section. When the plaintiff expressed her concern regarding the risk to her singing career posed by Cesarean section, health care providers 'encouraged her to consider potentially delaying the procedure until she (had) completed all of her reproduction.' Accordingly, plaintiff Amy Herbst elected to postpone the repair of her perineum and anal sphincter.
     "As a result of her incontinence and excessive flatulence, plaintiff Amy Herbst has been unable to work as a professional opera singer."
     The Herbsts seek $2.5 million in damages for medical malpractice and loss of consortium.
     They are represented by Charles Allen, with Goodman, Allen and Filetti, of Glen Allen, Va.