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Re: Sterilization From: ainsron (ainsron@sbcglobal.net) Tue Mar 1 16:30:13 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: RModugno@aol.com: "Re: GEN: IUD and fibroids" Previous message: Joanne Bulley, MD: "Re: GEN: IUD and fibroids" In reply to: Joanne Bulley, MD: "Re: Sterilization" Next in thread: Geffrey Klein: "Re: Sterilization" She was the primary ob for this patient and did discuss it with her at the time of the emergency C/S, I'm not sure what the emergency was or if she told it was not being done because of the emergency, because the papers weren't there or a combination of the two. To me, it makes little difference, the patient knew ahead of time that it was not being done and didn't argue or complain about it at the time. Ronald E. Ainsworth -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Joanne Bulley, MD Sent: Tuesday, March 01, 2005 3:20 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Sterilization I disagree -- if it was an emergency C/S with unkown final status of the baby then not doing the TL is reasonable care. Was she the primary Ob provider for the patient (ie - was she the one who had the discussions when the patient was not in labor or in the emergency)? If she was and knew the patient wanted the TL and did not discuss it with her at the time as to why she was not doing it then there may be a case. However if the patient rolled in with a prolapsed cord and the ontire care had the sinuglar focus on getting the baby out pronto - then there may not have been a chance to have that discussion and then also not knowing what the outcome would be for the baby -- it is always best (in my judgement as well as how I was trained) to err on the side of doing the sterilization later. Joanne At Tue, 1 Mar 2005, R. Daniel Braun wrote: > >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: 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?? >> > >> -- Joanne Bulley, MD Keene, NH, USA Next message: RModugno@aol.com: "Re: GEN: IUD and fibroids" Previous message: Joanne Bulley, MD: "Re: GEN: IUD and fibroids" In reply to: Joanne Bulley, MD: "Re: Sterilization" Next in thread: Geffrey Klein: "Re: Sterilization"

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