Re: Sterilization
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Tue Mar 1 10:58:58 2005
Boy, it is quite a reach to sue for LACK of doing the TL. Furthermore,
there is a clause on Medicaid papers to do them AFTER the fact if an
emergency surgery is done.
The lack of papers shouldn't prevent a TL; the lack of confidence in
doing the right thing should, and only the MD on the spot can make that
judgment and have that discussion with the patient.
I have young women who ask/demand/cry for TLs at 22 and 23 after 2 or 3
children; right or wrong, I do not think that is the right thing to do,
and I tell them so. This is due to the high rate of regret, divorce,
etc.
Garry
At Tue, 1 Mar 2005, Richard Chudacoff, MD wrote:
>
>Well, just maybe, and I know this is a reach, but perhaps the office did
>send the informed consent and the hospital misplaced it. I know that never
>happens, but...
>
>--
>Richard Chudacoff, MD
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Seele,
>Mona
>Sent: Tuesday, March 01, 2005 10:24 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Sterilization
>
>Why the hospital? It is the attendings responsibility to give/get informed
>consent.
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Richard
>Chudacoff, MD
>Sent: Tuesday, March 01, 2005 9:30 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Sterilization
>
>Then the patient, office or hospital is culpable, not he attending physician
>
>Richard Chudacoff, MD
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of R. Daniel
>Braun
>Sent: Tuesday, March 01, 2005 9:22 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Sterilization
>
>The injury is $4000 and an extra anesthetic and the risk of a second
>procedure. The violation of the standard of care was in not having the
>papers available.
>
>On Tue, 1 Mar 2005 09:12:53 -0600, ainsron <ainsron@sbcglobal.net> wrote:
>> Where is the injury? The only way I can see the standard of care not being
>> met in this type of situation would be if the surgeon misled the patient
>> into thinking he would do the tubal prior to the cesarean section and then
>> decided not to perform it without informing the patient in advance. There
>> are plenty of options available to this patient to avoid future
>pregnancies
>> that would cost less, including vasectomy, continuation of Depo Provera
>and
>> IUDs.
>>
>> Ronald E. Ainsworth
>>
>> -----Original Message-----
>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Andrew
>> Folley
>> Sent: Tuesday, March 01, 2005 6:05 AM
>> To: Multiple recipients of list OB-GYN-L
>> Subject: RE: Sterilization
>>
>> I would have been inclined to tie her tubes originally at the time of
>> Csection with pts consent. As it turns out the patient has incurred an
>> "injury" in that she has to have a xecond operation and $4000 cost. the
>> question is whether or not there was a breach in the standard of
>care.Whose
>> responsibility was it to have the papers at the hospital at the time of
>the
>>
>> original c-section? it is sticky but I would not be surprised if they
>rule
>> for the defendant. Andrew
>>
>> >From: ainsron@sbcglobal.net (Dr. Ainsworth)
>> >Reply-To: ob-gyn-l@obgyn.net
>> >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>> >Subject: Sterilization
>> >Date: Mon, 28 Feb 2005 19:08:42 -0600
>> >
>> >I colleague of mine asked me a question that I wanted to pass on. She
>> >did a emergency cesarean section a year ago on a patient who had
>> >previously signed papers for sterilization. The papers weren't
>> >available in the hospital at the time of the surgery and she told the
>> >patient that could not do the tubal at that time. The patient appeared
>> >to understand, saw her postpartum and received two depo-provera
>> >injections for birth control. The patient saw another MD who did the
>> >tubal recently. My colleague recently received a letter from the
>> >patient's attorney demanding that she pay ~$4000 for the sterilization
>> >procedure because of the extra cost and inconvenience it had been to
>> >this patient. I told her to tell the attorney to stick it in his ear
>> >(actually it was another three letter orifice on the end of the
>> >alimentary tract) and do not see any liability she has in these
>> >circumstances. What do you think and what would you do??
>> >
>>
>--
>R. Daniel Braun
> Kinky for Governor
>
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--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
