Re: 17 Minute Rule
From: Efrain Ramirez (eramirez@icepr.com)
Sat Apr 21 21:52:26 2001
Legally or medically, there is *nothing* written except outcomes -- if
you happen to have a ruptured uterus and delivered a healthy baby in 35
minutes you are ok - if you delivered a dead fetus in 16 minutes you
will find *experts* making a Disney line. Don't fool ourselfs -- IMHO
ACOG should make a strong statement -as it did on Misoprostol - very
well done BTW - addressing that issue.--- "With a little help from my
friends"
At Sat, 21 Apr 2001, Dean Huffman wrote:
>
>.
>
>Legally, there is no "17 minute rule" that I can find. I have searched all
>the appellate courts, state and federal, and cannot find any mention of
>such rule. If and when an appellate court wishes to issue such a rule, then
>there WILL be a "17 minute rule". At that point, it will make no difference
>whatsoever whether the medical literature accepts such a rule, or not, or
>whetherer such a rule is reasonable, or not. It will be a legal fact of
>life, at least in that jurisdiction, unless it is changed by a higher court
>or by a subsequent case.
>
>Medically, the 17 minute rule is mentioned in the American Journal of
>Obstetrics & Gynecology about five or six years ago. I have a copy of the
>article on file and can provide it for you if you wish.
>
>In sum, there are two sets of rules. One is a legal rule, which, as best I
>can tell, has not yet been established. The other is a medical rule which,
>as best I can determine, has been mentioned only once in a peer reviewed
>journal, about five or six years ago. It may well have been mentioned in
>other journals such as Contemporary OB/GYN.
>
>--
>Dean Huffman
>
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>
>Re: 17 Minute Rule
>From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com)
>Wed, 14 Feb 2001 15:38:06 -0600
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>There is not '17-minute rule.' There is only with or without perinatal
>
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>morbidity.
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>Richard Chudacoff, MD
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Dean
>Huffman
>Sent: Wednesday, February 14, 2001 2:27 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: 17 Minute Rule
>
>.
>
>Regarding the "17 minute rule", I have searched the entire federal and
>state legal database in WestLaw and I can find no mention of the "17 minute
>rule" in any appellate cases. The search was done about two months ago. If
>anybody has a more recent search and has found an appellate reference to
>the 17 minute rule, please let me know.
>
>Dean Huffman, M.D.
>Perinatl@bigfoot.com
>
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>
>Re: VBAC, immediate availabilty and change in hospital policy
>From: ainsron@msn.com
>Sun, 11 Feb 2001 19:23:51 -0600 (CST)
>
>Several posts dating back to 1997 regarding this topic, here is the most
>concise one: The "17 minute rule" is mentioned in Bruce Flamm's excellent
>editorial "Once a Cesarean, Always a Controversy" in Aug 97 Green Journal
>(Obstet Gynecol 1997;90:312-5). He states, "A large study (19) on uterine
>rupture found that no infants had significant perinatal morbidity when
>delivered within 17 minutes of the onset of a prolonged deceleration." The
>reference on this large study is Leung et al, Am J Obstet Gynecol
>1993;169:945-50.
>One further note is needed, apparently this study only had seven patients
>and the only one that had problems was outside of the 17 minute cut-off,
>ergo what some have called the 17 minute rule. I doubt you are truly brain
>dead, but if we aren't careful and speedy, apparently our patients might be.
>
>>Must have been brain dead at the time - but what is the 17 minutes about?
>>
>>Robert Modugno MD MBA FACOG
>>Marietta, GA
>
>--
>Ronald E. Ainsworth, MD
>
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--
"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
