Re: Preterm labor/transfer
From: art fougner, md (evsono@pipeline.com)
Tue Jan 30 20:51:12 2001
to which medical director replies - "Put this Dr. Emtala on the phone
right now!"
art
At Tue, 30 Jan 2001, Richard Chudacoff, MD wrote:
>
>EMTALA says you can't transfer her. I think greater than 4 cms is unstable
>for transport.
>
>--
>Richard Chudacoff, MD
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Garry
>Siegel
>Sent: Tuesday, January 30, 2001 9:08 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: OB: Preterm labor/transfer
>
>Speaking of CIGNA, dig this, and what would you do?
>
>25 YO P1001 with LMP mid July, making her about 26 weeks, presents to L
>and D with side pulling after being chased by a dog. PMH negative, and
>has only had one prenatal visit a few days ago, no ultrasound yet. She
>lives around 45 to 60 minutes away in a different part of town, but
>works nearby.
>
>Found not to be contracting, and while I was in a delivery, I asked the
>nurse to check her, and when her cervix was closed, to send her on.
>
>Well, she was 5 cm/80%, not ruptured! Ultrasound makes her 31.2 weeks on
>admission, vertex.
>
>Anyway, she was admitted, on mag then T pump, got steroids, and is
>sitting, some 7 days later.
>
>So, our plan is to have this multip with a premie with poor dates who is
>5 cm. sit in our hospital until she gets a good bit more pregnant, or
>even until delivery. The closest hospital that is in her network (ours
>isn't) is 30 minutes away in good conditions, a bit more via ambulance.
>We are also not on that plan.
>
>The medical director called yesterday and asked if we could transfer her
>to an in network facility. Today the same HMO was fined 300K!
>
>Garry
>
>Oh--what would you tell him?
>
>--
>Garry E. Siegel, M.D., F.A.C.O.G.
>Roswell, GA
>Private Practice
>
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
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