|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Interesting D&E lawsuit Two more cents, and I'll raise you 2 more...From: Brickster0@aol.comSat Mar 12 13:32:14 2005
In a message dated 3/12/2005 2:28:15 PM Eastern Standard Time, tdrcaste@yahoo.com writes: I know, I am stepping out. Please correct me if I am wrong, I'm in it to learn. Was there an obligation? was the obligation breached? Did the patient suffer an injury? and can the injury be directly attributed to the breached duty? The obligation in my eyes is the Standard of Care. Does standard of care require ultrasound? Physicians doing thier own U/S is very scary. Just to think about it: I encouraged a Co-worker of mine (hirsute, obese, with irregular menses) to get eval for PCOS. The doctor was from out of town who actually works up PCOS. She ordered lab and tests, which she had done locally (mid size town). the Ultrasonographer found uterine stripe...but didn't note size. DID NOT FIND THE OVARIES. The physician re-ordered and had done near her office. She underwent evaluation received dx and tx PCOS. The woman could not afford to continue travelling out of town for treatment, asked the doctors locally if they would follow her while on treatment with Avandia....nobody would. One time she was actually hospitalized and the doctor did q 2 hr blood sugars just to prove to this woman, she didn't have diabetes. 2 years later she just couldn't stand it anymore, and had a Hyst. She never stopped bleeding after surgery, they went back in. She had two tumors. and what the physicia! n called Primary peritoneal cancer. She went to Tx. it is Primary ovarian cancer. Do you really want to do ultrasounds in your office? So, back to the original question...Was it standard of care to perform an ultrasound in this situation? Isn't Standard of Care, the minimum requirements for safe care, that all practitioners can do in any size town? Are all physicians SAFE in ultrasonography? Diane Castellanos RN,C/WHNP Ms Castellanos The physician you're describing is not necessarily an idiot for doing sonography, but may be an idiot for missing an ovarian cancer intraoperativily. A patient being treated with Avandia for insulin resistance leading to PCOS is well within acceptable clinical standards (and yes she will have normal BG and HgbA1C's which leads me to question the clinical fund of knowledge of physicians in you community). The Standard of Care is location dependent. It is the standard of care in your community. A family practice doc in Wyoming is held to a lower standard than a physician practicing at the largest ob hospital in the country if they encounter something like an amniotic fluid embolism. The response in both situations is maternal stabilization and fetal delivery (usually at the same time). In a rural hospital I would expect both mother and child would die and that would be within the standard of care. At Northside the standard of care would include intubation by the anesthesiologist assigned to L&D (and nowhere else) immediate delivery. Support by a pulmonlogist and perinatologist and/or hematologist for the ensuing DIC. (If I failed to do any of those things Tuesday, I would be ripe for a lawsuit) Brick Bills MD Atlanta, GA
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Jul 2 04:39:11 2008 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.