Turned down for a C section & baby dies

[August]

Oh, no way will the doctor lose his license over this, but he will most definitely lose the lawsuit, if he doesn't settle (and I'm sure his malpractice insurer will insist that he settle).

OB have one of-if not THE-highest malpractice insurance premiums for that very reason--if something goes wrong with mother or baby, they're getting sued, and more often then not they'll lose. Tell a jury how much it costs for the lifelong care that a brain damaged baby will need and that's it. There was an awful case in Maryland not that long ago, where the mother was a home birth transfer. The midwife did absolutely everything wrong, they get to the hospital and by the time they got the baby out via c-section he was severely brain damaged. The parents sued the hospital, claiming they didn't act quickly enough when in fact the hospital followed protocol. The hospital refused to settle because they were sure they'd win. The judge declared any mention of the midwife's actions was inadmissible, and boom, payday. And the real kicker, those parents still have a great relationship with the midwife. I swear, those parents make me wish there was a hell.

And there have been other cases of mothers who are so insistent on vaginal births that they refuse c-sections when they're babies are in distress, and when baby was born dead or brain damaged they sue and win. All they have to say is, "But I didn't really understand that my baby could die. The doctor wasn't clear enough," and that's it.

I'm actually all for lawsuits, because there's nothing like the threat of losing money to keep people careful, but for that very reason I have no problem with high c-section rates. We can't have it both ways.

Yes, you can. Cradle to grave welfare state removes the need to sue and/or settle a suit, then institute strictly evidence based care.

[cindyluvs24]

That was my next question. In countries with Government-paid healthcare, future medical bills and care would already be covered so would they only be able to sue for pain/suffering/emotional distress? In the US there's so much talk of tort reform and how we should have limits on suits and how that would help bring down medical costs via lower malpractice premiums and less defensive medicine. Sounds like socialized medicine would do that.

[So Many Lies]

In Australia at least it is getting harder to sue since tort regorm. For medical malpractice it is very hard unless there was "gross negligence". That means mere causation won't work like it used to. Gross negligence is much harder to meet the requirements of that's for sure. It basically means a doctor had to deviate a lot from accepted standard practice. I think tort reform is good. It takes things back to basics. Sometimes bad things happen and you can't sue for situations that are inherently/obviously risky. I understand the American point of view but the "tort lottery" in Australia was starting to get out of hand.

[Aggie2145]

Oh this is America. They'll sue. And rightly so.

This is Texas, they can only bring suit if they can find a licensed physician practicing in Texas who will swear in an affidavit that the doctor was negligent. There is a reason why Texas Malpractice suits are short-lived. Doctors are handcuffed by their malpractice insurance and will lose coverage should they sign this type of affidavit.

[lascuba]

I'm really not ok with tort reform. I know it's not perfect, but I think it's right and fair that if a doctor is responsible for permanent damage, they should pay. And that's not to say that doctors don't make mistakes or they're evil if they do...that's why they have malpractice insurance, to protect their patients in case they make a mistake. Even with socialized medicine, there's only so may resources available. A severely disabled child can be financially ruinous, and considering that child will never be independent, there needs to be a big enough cushion to ensure their needs are met.

And, seriously, it takes messing up on a grand scale, several times, in a short period of time, for a doctor to experience any major professional consequences. I WANT my doctors to fear astronomical malpractice premiums--or even losing their coverage altogether, which effectively leaves them without ability to practice--if they're not careful. Money, and the possibility of losing it, is a great motivator.

(And on a slightly related note, I recommend the documentary "Hot Coffee." It talks about civil litigation and opens with the infamous McDonald's hot coffee case. That's sort of where I'm coming from with this.)

[susanread]

When I studied Torts at university (three~ years ago so fairly recent plus there haven't been huge reforms since then) my lecturers were actually critical of the Australian tort reform. Before tort reform in cases of medical malpractice about 1% would sue. So the numbers weren't huge. Plus the insurance companies heavily lobbied for the change and they were the ones that were putting out the information that the system was under huge stress from too many people suing. Despite that, premiums didn't really go down...

So I think it is good to have those avenues open (even if they can be fiendishly expensive).

[So Many Lies]

Lascuba, I'd agree there isn't a lot of resources in the public purse for carers of those with disabilities. It's a major failing in the system. And unfortunately, insurance premiums didn't actually go down as much as hoped.

[2xx1xy1JD]

That was my next question. In countries with Government-paid healthcare, future medical bills and care would already be covered so would they only be able to sue for pain/suffering/emotional distress? In the US there's so much talk of tort reform and how we should have limits on suits and how that would help bring down medical costs via lower malpractice premiums and less defensive medicine. Sounds like socialized medicine would do that.

Canadian here (not giving legal advice, just giving basic info and observations).

Future medical bills would be covered - but not home care, medications, rehab, special medical equipment and adaptations needed for the home, parental time off work, etc. [some coverage exists in places for some of these expenses, but they aren't part of the basic universal health care coverage.] Yes, costs will be lower, but they are not eliminated.

Our malpractice insurance set-up is a bit different here. There is one basic provider of medical insurance/medical-legal services for doctors, and coverage is mandatory. The fees are partially reimbursed by the government. This provider (the Canadian Medical Protective Association) NEVER settles unless there is clear liability.

Medical malpractice suits still happen, but they are not easy to win and do not get settled quickly for nuisance value. As I said, you can't judge a case on hindsight, but need to show that the doctor's actions fell below the standard of care for their training and look at what a doctor with similar training in a similar location would have done at each step with the information that was available at that time. Expert evidence is required to determine if the treatment fell below the standard of care.

As far as losing a license - in most of the cases here, it happens in cases where a doctor (1) got sexually involved with a patient, (2) refused to cooperate with an investigation or altered records, or (3) was dealing narcotics. Basically, these are the cases where a doctor is doing stuff that's just bad, and can't really be helped with some more training. Concerns about the actual quality of the care provided usually go to a different department. They can recommend more training or even restrictions on practice, but it's pretty rare to lose a license unless a doctor is really reckless and dangerous. Most doctors aren't deliberately evil or even reckless, but bad outcomes can happen to anyone. The ideal is to deal with the truly bad apples, but otherwise to use bad outcomes for case studies and rounds and make sure that doctors can use the experience to learn and make changes in the future.

[Stynjen]

This story sends chills down my spine. I had my first child 2 weeks ago, and the doctor ended up using forceps. Luckily, everything went ok with the forceps and I ended up with a healthy 9lb 4oz baby. I was never asked at any point if I was ok with forceps--or an episiotomy for that matter, and I tore more after the cut was made and ended up with a 4th degree tear. I didn't think forceps or episiotomies were very common anymore, so I didn't think to address either one ahead of time (and for my OB, they weren't common--she has only done one episiotomy in her career, but her partner was the one who delivered). The L&D nurses said afterwards that they were surprised that the doctor didn't opt for a c-section, and that they had started to prep for one.

I ended up losing a lot of blood and had to have a transfusion. The doctor I saw after delivery described it as a "traumatic delivery" that was "basically like a c-section in a more inconvenient place".

We want to have more children, but I will have a lot of questions for my OB at my 6 week check up. The blood loss and transfusion made for an awful recovery and I'm just now starting to feel normal again. I had hoped to avoid a c-section, but in hindsight, I think I would have preferred it over the experience I had.

What a scary traumatic experience for you. I'm glad your baby had a healthy outcome, and I hope you are healed soon. Take care!

[mags]

I'm really not ok with tort reform. I know it's not perfect, but I think it's right and fair that if a doctor is responsible for permanent damage, they should pay. And that's not to say that doctors don't make mistakes or they're evil if they do...that's why they have malpractice insurance, to protect their patients in case they make a mistake. Even with socialized medicine, there's only so may resources available. A severely disabled child can be financially ruinous, and considering that child will never be independent, there needs to be a big enough cushion to ensure their needs are met.

And, seriously, it takes messing up on a grand scale, several times, in a short period of time, for a doctor to experience any major professional consequences. I WANT my doctors to fear astronomical malpractice premiums--or even losing their coverage altogether, which effectively leaves them without ability to practice--if they're not careful. Money, and the possibility of losing it, is a great motivator.

(And on a slightly related note, I recommend the documentary "Hot Coffee." It talks about civil litigation and opens with the infamous McDonald's hot coffee case. That's sort of where I'm coming from with this.)

This is a pretty simplistic view of a complex issue.

The uncontrolled healthcare spending in the US is due in part to excessive unnecessary tests and procedures ordered because of fear of lawsuits. The payouts are decided by juries made up of the general public who may not be able to allow logic (the doctor is not responsible for the patient ignoring advice) to overcome compassion (for the disabled patient) when confronted with the choice. I do think that patients should be compensated for legit cases of physician negligence but I don't think the general public should make those decisions. I think a good compromise would be to set up something similar to vaccine court where payouts are based on evidence not emotion. In fact, the vaccine court was set up by the government because juries were awarding large settlements to people who claimed they were vaccine-injured despite lack of evidence that the vaccine cause the injury/disability. Juries felt bad for the disabled child and wanted him/her to have the money necessary for care. The vaccine manufacturers stopped making certain vaccines and there was a shortage. The government stepped in and agreed to set up the vaccine court if the manufacturers would start making vaccines again.

I'm afraid there is a big doctor shortage on the horizon and this is one of the driving forces. My husband and I are both doctors and we are hoping that none of our children become doctors. We may even be actively discouraging it at times. The 80 hour weeks + education debt burden (for in-state med school only, no undergrad debt) + constant fear of making a mistake just isn't worth the money (doctors can live a comfortable life but, as a group, haven't had a raise in years, possibly decades) and is no way to live. There are other professions where putting in the same amount of time is more lucrative and less stressful.

[scc12]

Isn't Obamacare one of the driving forces causing many to rethink becoming a Dr,and many to retire soon? I know my husb.'s neuro said it was a major factor for him.

[TheJewAmongUs]

We snark on fundies for begging for donations for medical expenses, but this couple is trying to crowd fund their expenses too. I'm sorry for their loss and the whole situation is awful, but really not any less tragic than the situations other families (even fundie families) find themselves in.

And from the description on the gofundme site, it looks like they started collecting donations before they even shared what they were going to use the money for. Personally, I don't agree with posting this link on FJ.