Re: VBAC revisited

From: zygote@icsi.net
Mon Jul 7 11:11:22 2003

The data below in consent is excellent. Not only do the pts sign my form, but they are given the information verbally and are asked directly "Do you understand...." Then a separate dictation is done indicating visit, data etc. Often when pts learn that as little as 17 min may result in a brain damaged or dead fetus they decide that elective c/s may be best method. Often individuals will say: "Nothing is going to happen to me!" Statistically true until it is, then its 100%. It never hurts to be prudent! Sorry for the preaching!!!

On 3 Jul 2003 at 12:41, Dr. Ainsworth wrote:

> My consent form is pretty specific about the "bad things" that can
> happen:
> I understand that unsuccessful VBAC is associated with a higher risk of
> harm to my baby and to me.
> I understand that the risk of a uterine rupture during VBAC at least
> 0.2-1.5%, and possibly as high as 8%.
>
> If my uterus ruptures during attempted VBAC, I understand there may not
> be sufficient time to operate and prevent death or permanent brain
> injury to my baby.
>
> The exact frequency of death or permanent neurologic injury to the baby
> when the uterus ruptures is uncertain, but has been reported to be as
> high as 50%.
>
> The risks to me after rupture of the uterus include but are not limited
> to hysterectomy (loss of the uterus), blood transfusion, infection,
> injury to internal organs (bowel, bladder, ureter), blood coagulation
> problems or death
>
> >I agree that this is naive. If your lawyer asks in depositions or at
> >trial, did they sign the consent which said such and such, the patient
> >and family will say, we signed it, but we didn't read it, we had to sign
> >it because you always have to sign forms to get medical care. They will
> >also say nobody told them that whatever bad result they have could
> >happen--if they had just known, they would have chosen differently.
> >Gail Waldby, MD
> >Huron Clinic SD
> >
> >Douglas Krell wrote:
> >
> >> Am I naive to feel that
> >>
> >>> the patient has assumed most of the risk of her decision at this point?
> >>>
> >> Absolutely naive. Do you have any idea to what extent patients and
> >> their attorneys will go to lie, cheat, and steal their way into the
> >> financial assets of your insurance company? And if you're particularly
> >> unlucky they might come after you personally..civily...possibly even
> >> criminally. Then armed with nothing more than accusations. you risk
> >> becoming uninsurable, unemployable, or non-viable in business due
> >> excessive overhead expenses.
> >>
> >> If something bad were to happen, your patients, indoctrinated by 20
> >> years of managed care rhetoric probably wouldn't think twice about
> >> legally whooping your a...
> >>
> >> Douglas Krell MD
> >>
>

Robert J. Carpenter, Jr., M.D. St. Luke's Medical Tower # 2720 6624 Fannin, Houston, TX 77030 zygote@icsi.net 713-795-4600 FAX:713-795-4422



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