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Re: VBAC From: Myer S. Bornstein, MD, CPE, FACOG (mborn@massmed.org) Wed Aug 9 20:00:18 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: K Dew: "VBAC" Previous message: Jim Connerth: "Re: construction surgery for newborn mothers vaginal canal area" In reply to: art fougner, md: "Re: VBAC" Some comments from ACOG list re VBAC: Look at ACOG Reply. I wrote to Efrain this comment: we need to put our replies and ACOG Message on OBGYN-List. that should stir something up. Maybe start a telephone call-in into ACOG and swamp them Myer Topic: VBAC Guidelines (1 of 9), Read 41 times Conf: Professional Liability From: Kenneth Raskin (kraskin@usa.net) Date: Thursday, August 03, 2000 03:50 PM With ACOG's stance on VBAC's going from readily available to immediately available for cesarean deliveries, has anyone defined what immediately available means. We are a hospital that has 5 OB's that are almost all in solo practices. Does this new policy mean that the OB needs to be in labor and delivery, in the hospital, on the medical campus or what? If anyone has any input on what ACOG was trying to mean please let me know. With this type of change I think they should have been very explicit with location or duration to get to the hospital. TOP | Post | Reply | Reply/Quote | Email Reply | Delete | Edit Previous | Next | Previous Topic | Next Topic Topic: VBAC Guidelines (2 of 9), Read 26 times Conf: Professional Liability From: Ed Baker (dlivryboy@aol.com) Date: Saturday, August 05, 2000 02:51 AM I agree with you Dr. Raskin. Unfortunately, I don't think it matters what any individual or group of individuals think. As long as ACOG doesn't formally clarify this the interpretation will be left to the persuasiveness of the plaintiff's attorney. Will he be able to convince a jury that immediately doesn't mean downstairs? in your office? TOP | Post | Reply | Reply/Quote | Email Reply | Delete | Edit Previous | Next | Previous Topic | Next Topic Topic: VBAC Guidelines (3 of 9), Read 25 times Conf: Professional Liability From: Efrain Ramirez-Torres (eramirez@icepr.com) Date: Saturday, August 05, 2000 01:48 PM The answer is on Time magazine July 17,2000 , pages 22-27. TOP | Post | Reply | Reply/Quote | Email Reply | Delete | Edit Previous | Next | Previous Topic | Next Topic Topic: VBAC Guidelines (4 of 9), Read 18 times Conf: Professional Liability From: Ed Baker (dlivryboy@aol.com) Date: Tuesday, August 08, 2000 02:55 AM Efrain, stop being so mysterious. Please give us a synopsis of the Times Magazine article. I want to know what the answer is, but I don't have time to make it to the library to find out. TOP | Post | Reply | Reply/Quote | Email Reply | Delete | Edit Previous | Next | Previous Topic | Next Topic Topic: VBAC Guidelines (5 of 9), Read 9 times Conf: Professional Liability From: Efrain Ramirez-Torres (eramirez@icepr.com) Date: Wednesday, August 09, 2000 12:13 AM :-) http://www.time.com/time/magazine/articles/0,3266,49415,00.html TOP | Post | Reply | Reply/Quote | Email Reply | Delete | Edit Previous | Next | Previous Topic | Next Topic Topic: VBAC Guidelines (6 of 9), Read 20 times Conf: Professional Liability From: Susannah Frazier (sfrazier@acog.org) Date: Monday, August 07, 2000 02:51 PM The staff of the ACOG Practice Activities Division has offered clarification of "immediately available" as it appears in the VBAC practice bulletin. You can contact the Practice Bulletins staff by calling (202) 638-5577, or write to them at ACOG, P.O Box 96920, Washington, DC 20090-6920, to request this information. TOP | Post | Reply | Reply/Quote | Email Reply | Delete | Edit Previous | Next | Previous Topic | Next Topic Topic: VBAC Guidelines (7 of 9), Read 8 times Conf: Professional Liability From: Myer Bornstein (mborn@massmed.org) Date: Wednesday, August 09, 2000 04:47 PM Why doesn't ACOG just post their reply . Should every OB call ACOG to find out what is meant by immediately available Myer S. Bornstein, MD, CPE,FACOG TOP | Post | Reply | Reply/Quote | Email Reply | Delete | Edit Previous | Next | Previous Topic | Next Topic Topic: VBAC Guidelines (8 of 9), Read 6 times Conf: Professional Liability From: james connerth (babydoc@apex.net) Date: Wednesday, August 09, 2000 05:17 PM I should think--they owe it to the active membership-I believe we pay their salaries??? TOP | Post | Reply | Reply/Quote | Email Reply | Delete | Edit Previous | Next | Previous Topic | Next Topic Topic: VBAC Guidelines (9 of 9), Read 4 times Conf: Professional Liability From: Efrain Ramirez-Torres (eramirez@icepr.com) Date: Wednesday, August 09, 2000 07:41 PM They will look it at the Webster's Dictionary then they will ask for a "legal opinion" on the definition. Immediate is immediate -- period- to say that each institution should set their standard for that word is absurd - But I agree with you and Jim -- there should be a statement from ACOG saying that they agree or disagree with the dictionary. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of art fougner, md Sent: Wednesday, August 09, 2000 11:58 To: Multiple recipients of list OB-GYN-L Subject: Re: VBAC seems to me the whole issue hinges on the time it takes from onset of the problem to the time that all hell breaks loose. since this is so hard to quantitate, would it not make sense to err on the side of caution? art At Tue, 8 Aug 2000, Richard Chudacoff, MD wrote: > >Well, it seems that most OBs (at least in my community) do not agree with >the ACOG guidelines that they must be immediately available for VBACs. Hence >strong liability-intestinal fortitude is created if they can stand laboring >a VBAC patient at a distance without dyspepsia, and are willing to accept >the medico-legal risks of losing a lawsuit if any untoward event occurs and >they are not present at the initial occurrence of this event. They will >continue to practice as if the ACOG guideline never existed, setting a >community standard opposed to the ACOG guideline. On the other hand, since I >cannot stomach the acidic environment of self-imposed anxiety, nor do I wish >to take the stand that OUR college has left me hanging with this restrictive >edict (yes, I am ashamed that I have no calcium in my spine,) I would stay >in the hospital during the entire labor of a VBAC, and set the standard for >my practice guideline. As a solo practitioner, I cannot afford the close the >office, so I do not do VBACs except under very restricted conditions. > >Rick > >>-----Original Message----- >>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of >>RModugno@aol.com >>Sent: Monday, August 07, 2000 9:56 PM >>To: Multiple recipients of list OB-GYN-L >>Subject: Re: VBAC >> >>In a message dated 8/7/00 6:13:24 PM Eastern Daylight Time, >>rchudacoff@mylinuxisp.com writes: >> >><< No, the national standard is being set by liability-intestinal fortitude >> (how much will the pocket/stomach bear.) >> >> >>Can you elaborate a little more on this, Rick? >> >>Robert Modugno MD MBA FACOG >>Marietta, GA >> -- art fougner, md A series of 1000 cases begins with but a single anecdote. Next message: K Dew: "VBAC" Previous message: Jim Connerth: "Re: construction surgery for newborn mothers vaginal canal area" In reply to: art fougner, md: "Re: VBAC"

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