Re: Malpractice questionairre
From: Efrain Ramirez (eramirezt@coqui.net)
Thu Jun 28 01:22:20 2007
Am I he only one in the list who happens to deliver a baby with APGAR
scores of 8/9 and was later told the next day that the baby had
seizures?
Ef
>At Wed, 27 Jun 2007, Henry Gregor wrote:
>
>Nothing at all to do with the treatment of mother and baby, if normal. But give it to the defense team if someone alleges years later that a poorly performing young schoolchild had been subjected to intrapartum obstetrical mismanagement. Without some objective proof of healthy status, it's not possible to disprove a negative....farfetched? Not, IMHO, in the USA. Some years ago I was witness to the subpoenaing (hey Joe, is that a word?) of the ob records re to a twin gestation patine and her management. The records had come my way through the years and various practice changes. The obstetric provider was a man whose name and stature as an academician, board examiner, etc. would be recognized by many on the list. The listed allegations were, as with all such summons and allegation processes, pretty horrendous. Some testing and documentation re the ABG status of the twins at birth would have been helpful. So perhaps one is only "treating" the capacity to continue practicing
> obstetrics with some protection from the stresses and damages potential litigation shadows much of what we do. Over the years we have all heard the advice to practice good medicine and not worry about litigation...well, with our theatrical system, with facts often overwhelmed by style, testing does get done, and will get done, secondary to those concerns. Its amusing to me to ponder the fervor and paranoia of my comments...I've never been charged in an ob suit....if and when, I'll probably really be over the top, lol.
>
> Hank
>
>"R. Daniel Braun" <rd.braun@gmail.com> wrote:
> What do you do diferent in the treatment of either the Mother or the baby based on the blood gas results? If nothing, the test is worthless and unwarranted.
>
> Dan
>
> On 6/27/07, Henry Gregor <henrygregor@yahoo.com> wrote: I agree with Ef...for all the stress and responsibility ob's bear for each delivery until that child reaches legal majority, it's money well spent. I've seen several cases of obs and peds getting stung with a suit seven to twelve years down the line, and in each instance that I interacted with any of the involved docs, there were regrets expressed about not having done some things that would have been to their advantage later down the line. It's sorta' like an automotive seatbelt...cars would cost less if that protective device weren't added to each one made, but when you need one and benefit from it, its pretty cheap equipment and money well spent. Placental path falls into the same category, IMO.
>
> Hank
>
>Efrain Ramirez <eramirezt@coqui.net> wrote:
>
> I totally disagree... they are an objective parameter of the baby's
>condition at birth... and cheap - for $20 you have a good information--
>not a waste of money at all. I do them to all my deliveries..I am sure
>it will, someday, become the standard of care.
>
>Ef
>
>> At Tue, 26 Jun 2007, R. Daniel Braun wrote:
>>
>>All cord gases do is cover the insurance comany's ass at the expense pf the
>>patient. They are of no value to the mother or the newborn and are a waste
>>of money.
>>I can say that since I am now retired and don't have to purchase Malpractice
>>insurance any longer.
>>
>>Dan
>>
>>On 6/26/07, Elrod, Darryl G Maj 48 MDOS/SGOBO <
>>Darryl.elrod@lakenheath.af.mil > wrote:
>>>
>>> Joe,
>>>
>>> Yeah! I know. There are a bunch of questions all like that.
>>> Thankfully, most I 'do' the right thing and don't have to explain
>>> myself. It just got me questioning if on this one I SHOULD be
>>> collecting a sample of cord for gases on each and every delivery. Did I
>>> miss some new policy statement that makes it standard of care? Of
>>> course the malpractice carrier will be the first ones to pick up on this
>>> for sure.
>>>
>>> Glen
>>>
>>> -----Original Message-----
>>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Joe
>>> Sent: Tuesday, June 26, 2007 1:34 AM
>>> To: Multiple recipients of list OB-GYN-L
>>> Subject: Re: Malpractice questionairre
>>>
>>> Elrod, Darryl G Maj 48 MDOS/SGOBO wrote:
>>> > I am filling out my first malpractice questionnaire. It read through
>>> a
>>> > list of questions and if you pick the 'wrong' answer (ie Do you apply
>>> > fundal pressure for relief of shoulder dystocia? If YES, then
>>> explain)
>>> > they make you explain the answers.
>>> >
>>> > One of the questions is 'Do you routinely collect cord blood at ALL
>>> > deliveries' If NO, then explain.
>>> >
>>> > Somehow, because I was trained that way, just doesn't seem salient.
>>> > What do you all do with regard to cord blood collection at delivery
>>> and why?
>>> >
>>> > Thanks,
>>> >
>>> > Glen
>>> >
>>> Is this for your own insurance carrier? From legal point of view
>>> whatever you put in print may come back to haunt you. Joe C
>>>
>>--
>>R. Daniel Braun, MD FACOG(L) CMT
>>Professor Emeritus
>>Dept. of Obstetrics and Gynecology
>>Indiana U. School of Medicine
>>
>>R. Daniel Braun
>>
>> "Science without Religion is LAME; Religion without Science is BLIND"
>> Einstein 1941
>>
>--
>" The greatest obstacle to knowledge is not ignorance,
>it is the illusion of knowledge." Daniel J. Boorstin - Historian
>
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>---------------------------------
>--
>---------------------------------
>R. Daniel Braun, MD FACOG(L) CMT
>Professor Emeritus
>Dept. of Obstetrics and Gynecology
>Indiana U. School of Medicine
>
>R. Daniel Braun
>
> "Science without Religion is LAME; Religion without Science is BLIND"
> Einstein 1941
>
--
“ The greatest obstacle to knowledge is not ignorance,
it is the illusion of knowledge.” Daniel J. Boorstin - Historian
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