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Re: Questions about a med legal case From: Dr. Ainsworth (ainsron@sbcglobal.net) Sat Oct 18 12:43:01 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Joanne Bulley, MD: "Re: Questions about a med legal case" Previous message: DoctorJoe@aol.com: "Re: Questions about a med legal case" In reply to: GIN11153@aol.com: "Questions about a med legal case" Next in thread: Braun, R. Daniel: "Re: Questions about a med legal case" The rise in WBCs is a "red herring," anyone who receives an course of steroids will have elevation of WBCs, it is a normal response. The only clinical indicator of value you have in this circumstance is the slight elevation in temperature and fetal tachycardia. Even without chorioamnionitis, the mortality rate for an infant at this gestational age is daunting, and the morbidity if it survived would be very high. I don't like being the devil's advocate, but in view of the tragic circumstances, the parents are probably lucky the baby did not survive. >Need help on a case I'm helping a fellow legal nurse consultiant with. > >Patient was 25 weeks-in a car accident with no apparent injuries(not checked >out at a hospital) Three hours later at home, membranes rupture. Goes to >hospital and is admitted. Given antibiotics for 7 days. Repeat c/section was done >on the 10th day for apparent chorioamnionitis(fluid was milky) Apparently only >2 CBCs were done in the 10 days. Her temps were under 99 until the 10th day >when it went up to 99.4 with a pulse of 134 and some contractions. CBC showed >WBCs were 21.0 so they started ampi and gent but monitoring showed fetal >tachycardia so they decided to do a repeat c/section that day(head was high). She >received 2 doses of betamethasone on days 1 and 2. Had fetal monitoring done >once a shift and intermittent BPP's. Baby died in the NICU 4 days later. Attorney > wants to prove that the seat belt injury caused the PPROM but we can't find >anything online to prove this, as most studies are about placental abruption >from the seat belt. > >Any ideas to help us would be greatly appreciated. > >Gail Neuman RNC CPHW LNC >certified high risk OB/legal consultant >listowner of LegalNurseConsulting@yahoogroups.com >Tustin, CA Next message: Joanne Bulley, MD: "Re: Questions about a med legal case" Previous message: DoctorJoe@aol.com: "Re: Questions about a med legal case" In reply to: GIN11153@aol.com: "Questions about a med legal case" Next in thread: Braun, R. Daniel: "Re: Questions about a med legal case"

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