Re: OB: Malpractice Review--even more facts
From: art fougner, md (evsono@pipeline.com)
Mon Feb 10 06:51:45 2003
LOL - you think it's about truth and science? if so there'd still be Dow
implants and we'd be Rx'ing Bendectin. for some good thoughts on the
subject - check out Philip Howard's editorial in ObGyn News and the
OurCommonGood.com website.
art
At Sat, 8 Feb 2003, Richard Kaplan wrote:
>
>Forgive me for picking up an old thread but I just read a review article in
>Ob/Gyn V.101, no.2, p380 about screening and treating gestational diabetes.
>Wouldn't it be ironic and sad to convince a jury that this unfortunate
>stillbirth was due to malpractice and the failure to diagnose gestational
>diabetes mellitus when medical science cannot convincingly prove that we
>should even be screening for it.
>
>--
>Richard Kaplan
>Greensboro
>
> Original Message -----
>From: "Garry E. Siegel, M.D." <garrys@mindspring.com>
>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.medispecialty.com>
>Sent: Monday, January 06, 2003 12:57 PM
>Subject: Re: OB: Malpractice Review--even more facts
>
>> The fact that she was breech was not picked up until the ultrasound to
>> confirm the IUFD, as best that I can tell.
>>
>> I am not so certain that she wasn't diabetic:
>> 1. 9 pound, 10 ounce term baby, with a prior one 3 pounds less.
>> 2. Hemoglobin A1C was elevated on admission.
>>
>> While I agree that this may have just been an unexplained IUFD (tragic,
>> of course), I also think that the theory that this patient was an
>> undiagnosed, untreated gestational diabetic has validity.
>>
>> For those who disagee, how can you explain the elevated A1C?
>>
>> Garry
>>
>> At Mon, 6 Jan 2003, Larry Glazerman wrote:
>> >
>> >I agree that spontaneous version would have been a good possibility.
>> >Thinking as a plaintiff's lawyer (perish the thought), though, IF the
>> >discussion about version vs section vs awaiting labor (ie awaiting
>> >spontaneous version) didn't happen, the patient might have a case (far
>> >fetched as it seems), that IF she had been given those options, she
>> >would have chosen elective section at 39-40 weeks, and therefore this
>> >tragic outcome would have been avoided.
>> >
>> >I don't agree with this line of thought, but it could be used, and
>> >knowing the present jury situation, possibly could be successful.
>> >
>> >Just my $.02, FWIW
>> >
>> >-----Original Message-----
>> >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Jay
>> >Kulkin
>> >Sent: Monday, January 06, 2003 9:01 AM
>> >To: Multiple recipients of list OB-GYN-L
>> >Subject: Re: OB: Malpractice Review--even more facts
>> >
>> >Sponstaneous version would still need to be considered i.e may have
>> >been
>> >vertex at the last visit. I've seen fetuses vert spontaneously during
>> >labor----ultrasound proven!. I don't see any liability in this case
>> >based on
>> >falling below the standard of care. Certainly a tragic outcome which we
>> >regrettably see in our profession.
>> >
>> >JK
>> >
>> >Jay M. Kulkin, MD MBA FACOG
>> >Women's Institute For Health PC
>> >975 Johnson Ferry Road
>> >Suite 460
>> >Atlanta, Georgia 30342
>> >Ph: 404.832.0300
>> >Fax: 404-832-3777
>> >http://www.wifh.com
>> >
>
>>>> >>----- Original Message -----
>> >From: "Larry Glazerman" <l.glazerman@rcn.com>
>> >To: "Multiple recipients of list OB-GYN-L"
>> ><ob-gyn-l@mail.medispecialty.com>
>> >Sent: Monday, January 06, 2003 8:50 AM
>> >Subject: Re: OB: Malpractice Review--even more facts
>> >
>> >> After reading the additional information, I think the only thing I'd
>> >> address is if he knew it was breech. If so, then I think a discussion
>> >of
>> >> version vs elective section vs section when she's in labor would have
>> >> been indicated. If that discussion never took place, then there might
>> >be
>> >> some liability, although it's somewhat of a stretch.
>> >>
>> >> -----Original Message-----
>> >> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>> >Garry
>> >> E. Siegel, M.D.
>> >> Sent: Sunday, January 05, 2003 10:57 PM
>> >> To: Multiple recipients of list OB-GYN-L
>> >> Subject: Re: OB: Malpractice Review--even more facts
>> >>
>> >> >
>> >> >Can you give us a little insight into that?
>> >> >What was the mother's weight?
>> >> >What was her weight gain this pregancy? ( Trying to decide whether
>> >one
>> >> >abnormal glucose is significant)
>> >> >Is not mentioning induction below the standard of care?
>> >> >
>> >> >Robert Modugno MD MBA FACOG
>> >> >Marietta, GA
>> >> >http://www.novaobgyn.yourmd.com
>> >>
>> >> I'll post some weight data tomorrow (the file is put away and I'm lazy
>> >> :)).
>> >>
>> >> I'm not sure that her weight has bearing on the significance of one
>> >> abnormal value, however.
>> >>
>> >> IMHO, not mentioning induction is not below the standard, and last I
>> >> checked, elective induction is not at all the standard, and is even
>> >> denounced by many. In the provider's mind, this was a normal
>> >pregnancy
>> >> when last seen at 39 6/7--so no reason to induce, other than the
>> >> patient's request.
>> >>
>> >> Garry
>> >>
>> >> --
>> >> Garry E. Siegel, M.D.
>> >> Private Practice
>> >> Roswell, GA
>> >>
>>
>> --
>> Garry E. Siegel, M.D.
>> Private Practice
>> Roswell, GA
>>
--
art fougner, md
ich bin ein New Yorker
