A woman identifying as a man suffered a stillbirth after records disguised the fact that she was really a female.
The 32-year-old patient arrived at the hospital with severe abdominal pains, but misleading medical records meant nurses did not treat it as an emergency.
It was later revealed that the woman was pregnant.
Dr Daphna Stroumsa of the University of Michigan, told The New England Journal of Medicine that the woman was “classified as a man” in her medical records.
Doctors were informed that the patient was an obese male who had stopped taking medicine for high blood pressure.
However, after revealing herself to be transgender, an ultrasound showed her to be pregnant and the baby at risk.
Doctors prepared for an emergency caesarean, but tragically the transgender patient delivered a stillborn baby moments later.
Dr Stroumsa said the medical records misled staff from considering her actual medical needs.
Doctors said a woman showing up with similar symptoms “would almost surely have been triaged and evaluated more urgently for pregnancy-related problems”.
Dr Tamara Wexler called it “a very upsetting incident” with a “tragic outcome”.