Re: Now we get sued over undiagnosed nuchal cords....
From: art fougner, md (evsono@pipeline.com)
Wed Jun 21 12:01:58 2000
explain to me please how one can perform a biophysical profile and not
look at the fetus?
art
At Wed, 21 Jun 2000, Scotia Phillips, RT,CNMT, RDMS wrote:
>
>At Sun, 18 Jun 2000, Betsy Hyde wrote:
>>
>>At 9:27 PM 6/17/00, Deborah Wage, FNP,CNM wrote:
>>>I've always hated it when my sonographers put in the comment section:
>>>
>>>"a single loop nuchal cord was noted". BFD. But geez, now it is a
>>>liability.
>>
>>is this any different than asking for a BPP at term and getting "EFW >4900g"?
>>
>>had a primip this week....totally freaked out because the sonographer told
>>her the baby was almost 11 lbs. The MD seeing her did a clinical EFW (9-8)
>>and had me do an EFW (w/o telling me why). My EFW was 9-4.
>>
>>I attended this woman in labor. She was totally freaked out by the
>>sonographers comments, and I had a great deal of difficulty convincing her
>>that her labor was normal, we wouldn't do cowboy/cowgirl stuff etc.
>>
>>She had a totally uncomplicated NSVD of a 9-3 baby.
>>
>>I think that sometimes our sonographers can set us up.....
>>
>>--
>>Betsy Hyde CNM
>>Branford, CT
>>
>Why don't you have a talk with your sonographers, discuss the
>inaccuaracy of sonographic determined weights for large babies. Better
>yet, help them by routinely providing delivery date and size of all
>babies to determine accuracy.
>It might be interesting to compare your estimated weights with the
>sonographers on a routine basis.
>
>As far as asking for a BPP and getting a weight, did you really ask for
>a BPP only, or did you ask for a sonogram?
>Did you give the sonographer the indication for the scan or did you just
>send the patient? If you specifically asked for BPP only and a complete
>exam was performed, is this the policy of the facility?
>
>Many times, an exam is order but specifics are not relayed to the
>sonographer. For instance, a new doc told me all she wanted to know was
>if the baby was breech. Now, since I am paid by the scan and due to
>lack of reimbursement for sonography outside the global fee, if all you
>want is position, I will gladly determine that only, and at no charge to
>the facility. So after determining that the fetus is indeed breech,
>getting the patient to the waiting room and the next patient on the
>table, the doc then tells me that she needs to know if that breech baby
>has an anterior placenta, where the cord is (yes, is there a nuchal
>cord!), how much the baby weighs and if I think she can turn this baby!!
>
>Now, would you like to repeat that comment about how "sometimes our
>sonographers can set us up"?
>
>BTW: another physician just lost a term fetus due to a true cord knot;
>he wanted to know why I did not "see" it.
>
>--
>Scot
>
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
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