OB-GYN-L Messages for September, 2003: Re: maternal hep B

Re: maternal hep B
From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com)
Tue Sep 30 15:36:31 2003

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In reply to: Charlie Chambers: "Re: maternal hep B"
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Do you think that neonatal vaccination would have made a difference? Or, by not recognizing the maternal Hep B did that prevent neonatal treatment with immunoglobulin, as Terry mentioned?

-- Richard Chudacoff, MD
640K ought to be enough for anybody. Bill Gates
-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Charlie Chambers Sent: Tuesday, September 30, 2003 12:34 PM To: Multiple recipients of list OB-GYN-L Subject: Re: maternal hep B
I think you have to look at this aside from the obvious liability risk. I'd take a systems approach to the issue. No single individual or entity's omission can lead to such an oversight. All involved share some duty to correct an obvious failure. If we rely simply on a notation or stamp on the prenatal record to carry out care on a 100% basis then failures are bound to occur.
On Monday, September 29, 2003, at 03:57 PM, Richard Chudacoff, MD wrote: <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Interesting discussion today in the doctors lounge: 6-month-old infant develops fulminate hepatitis and liver failure. Noted to have Hep B. Records reviewed noted that mother was Hep B positive, but this was not acted upon by OB. Aunts and grandmother are also Hep B positive-none with active hepatitis. Infant never received hep vaccine in hospital, or by pediatrician. Fingers have been pointed. Who, if anyone, has the majority of the responsibility, and why did the checks and balances (vaccination in hospital, review of records, pedi vaccination) fail?<?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Any comments?<?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Richard Chudacoff, MD, FACOG<?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Chudacoff Obstetrics & Gynecology, PLLC<?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>15200 Southwest Freeway, #270<?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Sugar Land, TX 77478<?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Tel: 281-277-3900<?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Fax: 281-277-3901<?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>rchudacoff@mylinuxisp.com<?/smaller><?/color><?/fon tfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Richard.Chudacoff@obgyn.net<?/smaller><?/color><?/f ontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>http://www.mdhub.com/281-277-3900<?/smaller><?/color><?/fo ntfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>http://www.chudacoffobgyn.yourmd.com<?/smaller><?/color><? /fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>*****HIPAA Confidentiality Notice*****<?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily>
<?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>The documents inside this electronic transmission contain confidential information belonging to the sender that is legally privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information to any other party and is required to destroy the information after its stated need has been fulfilled, unless otherwise required by law.<?/smaller><?/color><?/fontfamily>
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************************************************************************** Charlie Chambers Hood River, OR USA
-- cchamber@alumni. rice. edu
"I'm a goin fishin. Yeah, I'm goin fishin And my baby's goin fishin too!" Taj Mahal
************************************************************************
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<p class=MsoNormal><span class=EmailStyle15><font size=2 color=navy face=Arial><span style='font-size:10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial'>Do you think that neonatal vaccination would have made a difference? Or, by not recognizing the maternal Hep B did that prevent neonatal treatment with immunoglobulin, as Terry mentioned?<o:p></o:p></span></font></span></p>
<p class=MsoNormal><span class=EmailStyle15><font size=2 color=navy face=Arial><span style='font-size:10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial'><![if !supportEmptyParas]> <![endif]><o:p></o:p></span></font></span></p>
<p class=MsoAutoSig><font size=2 color=navy face=Arial><span style='font-size:10.0pt;mso-bidi-font-size: 12.0pt;font-family:Arial;color:navy'>Richard Chudacoff, MD</span></font><font size=2 color=navy face=Arial><span style='font-size:10.0pt;mso-bidi-font-size: 12.0pt;font-family:Arial;color:navy;mso-color-alt:windowtext'><o:p></o:p></span></font></p>
<p class=MsoAutoSig><font size=2 color=navy face=Arial><span style='font-size: 10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial;color:navy'><![if !supportEmptyParas]> <![endif]></span></font><font size=2 color=navy face=Arial><span style='font-size:10.0pt;mso-bidi-font-size: 12.0pt;font-family:Arial;color:navy;mso-color-alt:windowtext'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size: 10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial;color:navy'>640K ought to be enough for anybody. </span></font><font size=2 color=navy face=Arial><span style='font-size:10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial;color:navy; mso-color-alt:windowtext'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size: 10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial;color:navy'>Bill Gates</span></font><font color=navy><span style='color:navy;mso-color-alt:windowtext'><o:p></o:p></span></font></p>
<p class=MsoNormal><span class=EmailStyle15><font size=2 color=navy face=Arial><span style='font-size: 10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial'><![if !supportEmptyParas]> <![endif]><o:p></o:p></span></font></span></p>
<p class=MsoNormal style='margin-left:.5in'><font size=2 color=black face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma;color:black'>-----Original Message-----<br> <b><span style='font-weight:bold'>From:</span></b> ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]<b><span style='font-weight:bold'>On Behalf Of </span></b>Charlie Chambers<br> <b><span style='font-weight:bold'>Sent:</span></b> Tuesday, September 30, 2003 12:34 PM<br> <b><span style='font-weight:bold'>To:</span></b> Multiple recipients of list OB-GYN-L<br> <b><span style='font-weight:bold'>Subject:</span></b> Re: maternal hep B</span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=3 face="Times New Roman"><span style='font-size:12.0pt'><![if !supportEmptyParas]> <![endif]><o:p></o:p></span></font></p>
<p class=MsoNormal style='mso-margin-top-alt:0in;margin-right:0in;margin-bottom: 12.0pt;margin-left:.5in'><font size=3 color=black face="Times New Roman"><span style='font-size:12.0pt;color:black'>I think you have to look at this aside from the obvious liability risk. I'd take a systems approach to the issue. No single individual or entity's omission can lead to such an oversight. All involved share some duty to correct an obvious failure. If we rely simply on a notation or stamp on the prenatal record to carry out care on a 100% basis then failures are bound to occur. <br> <br> On Monday, September 29, 2003, at 03:57 PM, Richard Chudacoff, MD wrote:</span></font><font color=black><span style='color:black;mso-color-alt:windowtext'><o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-right:.5in;mso-margin-top-alt:auto;margin-bottom: 12.0pt;margin-left:1.0in'><font size=3 color=black face="Times New Roman"><span style='font-size:12.0pt;color:black'><?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Interesting discussion today in the doctors lounge: 6-month-old infant develops fulminate hepatitis and liver failure. Noted to have Hep B. Records reviewed noted that mother was Hep B positive, but this was not acted upon by OB. Aunts and grandmother are also Hep B positive-none with active hepatitis. Infant never received hep vaccine in hospital, or by pediatrician. Fingers have been pointed. Who, if anyone, has the majority of the responsibility, and why did the checks and balances (vaccination in hospital, review of records, pedi vaccination) fail?<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Any comments?<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Richard Chudacoff, MD, FACOG<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Chudacoff Obstetrics & Gynecology, PLLC<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>15200 Southwest Freeway, #270<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Sugar Land, TX 77478<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Tel: 281-277-3900<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Fax: 281-277-3901<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>rchudacoff@mylinuxisp.com<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>Richard.Chudacoff@obgyn.net<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>http://www.mdhub.com/281-277-3900<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>http://www.chudacoffobgyn.yourmd.com<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>*****HIPAA Confidentiality Notice*****<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>The documents inside this electronic transmission contain confidential information belonging to the sender that is legally privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information to any other party and is required to destroy the information after its stated need has been fulfilled, unless otherwise required by law.<?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller> <?/smaller><?/color><?/fontfamily><br> <br> <?fontfamily><?param Arial><?color><?param 0000,0000,0000><?smaller>If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of these documents is strictly prohibited. If you received this electronic transmission in error, please notify the sender immediately to arrange for return.<?/smaller><?/color><?/fontfamily><br> <br> <?color><?param 0000,0000,0000> <?/color><br style='mso-special-character: line-break'> <![if !supportLineBreakNewLine]><br style='mso-special-character:line-break'> <![endif]></span></font><font color=black><span style='color:black;mso-color-alt: windowtext'><o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in'><font size=3 color=black face="Times New Roman"><span style='font-size:12.0pt;color:black'>**************************************************************************<br> Charlie Chambers<br>
Hood River, OR USA<br> cchamber@alumni. rice. edu<br> <br> "I'm a goin fishin.<br> Yeah, I'm goin fishin<br> And my baby's goin fishin too!"<br> Taj Mahal<br> <br> ************************************************************************</span></font><font color=3Dblack><span =
style='color:black;mso-color-alt:windowtext'><o:p></o:p></span></font></p>
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