OB-GYN-L Messages for August, 2000: Re: I Sympathize.....

Re: I Sympathize.....

From: Joanne Bulley, MD

jbulley@cheshire.net

Wed Aug 30 21:22:02 2000

Yes we have seen the cases of bad decisions/care with bad outcomes. Those are not the ones we are likely to be discussing here - they are "open and shut". We discuss the ones that make no sense to us - probably wondering if someone else can...

I have seen a patient who had an attempted hysteroscopic myomectomey. the OR - and doc never noticed that they were way off on the fluid I&O - they were off by a 9 liter excess before her Na got low enough for problems to show up. She was in a coma for quite a while. finally recovered enough to go back to work - took a lot of time and ReHab. The doc also dinked around for over 4 hours. Not much to say - the hospital and doc deserve what they have coming. To me - it is open & shut. Not too much to discuss, is there - Yes, I truly am empathetic with this patient, her sequelae and her suit. I recall quite vividly the course instructors going over in great detail and with dismal outcomes - the fact that IF you do H/S resections etc - THEN you must be absolutly COMPULSIVE on the fluid I&O.

So - Ann - what discussion would you have us have on the legit cases? How can we modify the system so only the negligent cases have their day? That is why many of us would rather see a poor outcomes compensation system. If you then went for malpractice - you would have to go to criminal court and prove above and beyond a doubt - rather than the preponderance of the evidence. the current 50.1% VS 49.9% rankels me the wrong way...

Joanne

At Tue, 29 Aug 2000, Ann Hillard wrote: >
>Wow,that is really something. There are alot of bogus lawsuits,and
>selfish litigation. What concerns me is that whenever there is
>malpractice discussed here on the board,I never hear accountability.Just
>horror stories of what crackpot called the ambulance-chasing attorney.
>(sorry-not to offend anyone) We have all seen mistakes in the delivery
>room,where patients,not doctors are victims. Sometimes Im afraid of the
>views and opinions that we as medical professionals adopt because of one
>or two bad expeiences with personal injury lawyers that twist the truth.
>What about the mom who is suffering from decelerations where the fhr
>monitor is showing distress during contractions,and the rn,do and other
>hospital staff waits until its as serious as bradycardia,and then vacuum
>exract while the c/s doctor is setting up iv's for what would have been
>a safer delivery,and then the child is brain damaged for life? Do we
>scoff at her for contacting a lawyer? (Example) I wouldnt. I respect
>medicine,and am God-fearing with my responsibility. We do make
>mistakes,We need to hold ourselves accountable,so that it doesnt happen
>again. Thats all. When we get too haughty to see our own
>mistakes,maybe its time to turn in the robe,or go back to school..just
>my opinion. Maybe if the stupid lawsuits like the one with the
>crackhead/smokaholic would get out of the court system,we could go back
>to keeping it real,and keeping mistakes when quick descions are to be
>made at a minimum,and when we do not,making amends for it legally and
>respectfully. No doctor would intentionally cause harm,but our degrees
>prove we know better in some circumstances.Hope not to offend anyone,Im
>sorry if I did. Sometimes for every 9 good actions we have 1 poor one.
>And sometimes we dont know that until its too late. Every
>patient/situation is unique,and we cant always rely on previous
>victories in the delivery room,etc...Every doctor/hospital is
>different,I can only judge by what goes on around me....Hope some of you
>out there agree with me....

-- Joanne Bulley, MD Keene, NH, USA

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