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Re: OB: Preterm labor/transfer From: Efrain Ramirez (eramirez@icepr.com) Wed Jan 31 19:16:03 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: OB: AFP triple re-calculations" Previous message: Joanne Bulley: "Re: Woolley/Constitution/Here & Now - Long" In reply to: Garry Siegel: "OB: Preterm labor/transfer" Tell Medical Director to read "The EMTALA Answer Book" by Mark M.Moy or go to http://www.medlaw.com/. At Tue, 30 Jan 2001, Garry Siegel wrote: > >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 > -- "Life is neither the notes nor the silence between the notes, but the music that arises out of sound and silence felt as a living whole. Stop choosing...between chaos and order, and live at the boundary between them, where rest and action move together..." David Whyte Next message: Efrain Ramirez: "Re: OB: AFP triple re-calculations" Previous message: Joanne Bulley: "Re: Woolley/Constitution/Here & Now - Long" In reply to: Garry Siegel: "OB: Preterm labor/transfer"

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