Here’s a twist: A doctor and hospital are sued for performing a C-section too early

“The suit, filed against Willow Creek Women’s Hospital in Johnson, among others, claims the baby suffered adverse health consequences from a premature birth because another defendant, Dr. George R. Cole, decided to perform a Caesarian section.

Cole, who was on call at the hospital when Hutchison went there, testified Monday that he determined the baby needed to be delivered via C-section after being told over the phone by a nurse at Willow Creek that Hutchison’s membrane had ruptured and there was a breach presentation of the baby.”

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  • Anonymous

    It’s really not as much of a “twist,” as some people might think. When you understand why these people sue, you’ll see it’s not a twist, merely the most convenient thing they could blame.

    The people who sue doctors and the lawyers who abet them are generally upset with outcomes. It does not matter to them if they had a wonderful, gifted doctor who did everything she could to help the patient. It would not matter if she was so smart she knew at her fingertips every paper ever written on the patient’s condition. It would not matter if she performed flawlessly.

    All that matters is outcome. They expect that nothing should ever happen to them, and if it did, someone must pay. It doesn’t matter if the poor doc did everything right: she must be blamed, and she must be found guilty – of something. Something must be found, some judgement must be identified where a hired gun can be brought in to say “she did wrong, this doc.”

    She must – will – be made to pay.

    And so it goes. The lawyer here will, without missing a beat, enter a court room the very next day and vilify some other poor sod for not doing a C-sec quick enough.

  • Curious JD

    Opinions are so easy to have when you’re not burdened by facts, aren’t they?

  • Anonymous

    “Opinions are so easy to have when you’re not burdened by facts, aren’t they?” Curious JD

    Due to HIPAA, I can’t prove this story is “factual”, but it is.

    Recently EMS brought in an emaciated, neglected, abused 13 year old. She weighed 70 pounds (30 kg.) She looked like one of the Holocaust victims you see in Newsreels. Her mother (the caretaker, and suspected abuser), came with her. In the trauma room, she had no blood pressure, was septic and unresponsive. My hospital has a policy to allow family members to be present in the resuscitation room. So as I attempted to keep this 13 year old from dying, (I am not exaggerating) I had to attend to the mother, the likely abuser. I left the resus. room to get a chair, so the mother wasn’t standing in the room. After all, there is a current lawsuit against a hospital where a family member fell and suffered an epidural while his wife delivered a baby. Basically according to lawyers I’m responsible for the patient, her family members, even her abusers. As if I didn’t have enough to worry about, I had to worry about this woman, who was extremely distressed, and I had to keep reminding her to stay seated. I felt she should be in the room,(after all, she’s still the child’s mother) but the last thing I needed was to worry about her welfare. You don’t want to think about these things when you’re trying to save a kid’s life. But this is the type of burden that lawyers have added to our ability to practice medicine

  • Anonymous

    Opinions are so easy to have when you’re not burdened by facts, aren’t they?

    Precisely, CJD – no human I know has demonstrated that more amply than you. Certainly not on this blog.

  • Curious JD

    Anonymous 8:06 – great story, but what does that have to do with the article? An article about a case you haven’t read a single record on?

    “. I left the resus. room to get a chair, so the mother wasn’t standing in the room. After all, there is a current lawsuit against a hospital where a family member fell and suffered an epidural while his wife delivered a baby.”

    If you based your actions on what you think you know about that case from a newspaper article, then you’re a fool. One, you didn’t even read the newspaper article correctly, and two, it was a NEWSPAPER ARTICLE about a case which you new nothing about.

  • Anonymous

    You doctors are nuts.

    RE: ” The people who sue doctors and the lawyers who abet them are generally upset with outcomes. . . .It would not matter if she performed flawlessly”

    WRONG! Doctors are only liable if they fail to meet local standards of care. Now, of course, bad outcomes often result from error–and sometimes no doubt doctors who did perform “flawlessly” are successfully sued. But no system is perfect–medicine or law. Given the difficulties consumers have in ensuring that health care providers do things right, I say err on the side on caution and let doctors worry constantly about being sued.

    Re: “You don’t want to think about these things when you’re trying to save a kid’s life. But this is the type of burden that lawyers have added to our ability to practice medicine”

    Oh, get out the hankies for you. This is precisely the sort of self-absorbed nonesense that makes doctors so ridiculous. Yes, society (and the law) make demands on people with power to observe certain rules (like allowing family members to witness resuscitations)–on teachers, cops, business, lawyers, i.e., people who have power and can abuse it. That these rules sometimes result in difficult situations is undoubtedly true, and these rules make the lives of teachers, cops, doctors, lawyers, etc. more difficult. But that difficulty must be weighed against society’s judgment that these protections are warranted. Being present at a loved one’s moment of death is very important for many people and thus the law guarantees it. That it sometimes results in difficult for the commenter–well, in the bigger scheme of things, who cares?

  • Anonymous

    I left the resus. room to get a chair, so the mother wasn’t standing in the room. After all, there is a current lawsuit against a hospital where a family member fell and suffered an epidural while his wife delivered a baby. Basically according to lawyers I’m responsible for the patient, her family members, even her abusers. As if I didn’t have enough to worry about…

    Dude. You are practising very dangerously. I’d be more careful if I were you. Did you determine that she was qualified to sit down on a chair? Did she have the appropriate certifications to stand in a resuscitation room when her daughter was being treated? Has she passed all her American Board of Standing in a Resuscitation Unit exams? After all, if she fainted at the sight of her daughter being tubed (after she insisted on being there and watching it), you .

    Also, did you ascertain that the chair was fully functional? Did you go over every inch to make sure there weren’t hairline cracks that had a higher than 50% chance of giving way under stress? If you didn’t, dude, you’re commiting malpractice. If that chair broke… man. How could you be so heartless?

    Don’t think I’m kidding here, dude. Never been more serious. Lawyers sue doctors over this. Go look at that thread Kevin put up about the husband fainting during wife’s delivery. People like CJD actually mounted a defense of the plaintiff, suggesting that doctors should have determined if the husband was qualified to let the sight of a needle pass into his visual field. Everyday, you think you’ve seen the limits of how low these people can sink – and everyday they show you you haven’t.

  • Curious JD

    “People like CJD actually mounted a defense of the plaintiff, suggesting that doctors should have determined if the husband was qualified to let the sight of a needle pass into his visual field. “

    Actually, I suggested possible theories. Not knowing all the facts (something that doesn’t hinder you from forming an opinion) I couldn’t state with any certainty.

    And it’s the litigant who is actually doing the suing, not the lawyer. The lawyer just acts on their behalf.

    The more you know.

  • Anonymous

    “The lawyer just acts on their behalf.”

    Now you’re making assumptions without any basis in fact.

  • Anonymous

    Ah yes, the doctors are “nuts.”

    WRONG! Doctors are only liable if they fail to meet local standards of care. Now, of course, bad outcomes often result from error–and sometimes no doubt doctors who did perform “flawlessly” are successfully sued. But no system is perfect–medicine or law. Given the difficulties consumers have in ensuring that health care providers do things right, I say err on the side on caution and let doctors worry constantly about being sued.

    Lolol. So you start off yelling that we are “wrong”, and then go on to make the point we are making. Where we disagree is with what the point means. To you, innocent doctors being ripped into like piranha fodder is nothing – a “small” price to pay for your comfort. For us, it is unconscionable, especially given the scale at which miscarriages of justice are happening. A doctor can be sued when he is completely innocent of malpractice, be dragged through the legal system, be forced to settle because his insurers don’t want to risk court, and be slapped with huge increases in pemiums through no fault of his own. He can practice the best evidence-based medicine, but be sued by a patient who was too irresponsible to keep an appointment to get a PSA checked – and has the gall to blame his cancer on the doc.

    Lawyers have set up an system that will eventually break because it is trying to do the economically impossible. They forget that there is no such thing as a free lunch; if you abuse a part of a system often enough, someday it will give. Right now, frivolous, shockingly unfair lawsuits like the Merenstein case can be filed with unbelievable ease. The doctor is then dragged through a nightmare, and at the end of it, he is asked to consider himself lucky if damages are not assessed. He does not get any compensation for his legal expenses (incurred through no fault of his own) if he hired privately. If he didn’t have his own lawyer and uses the insurer’s lawyer, they will pay him – but guess who is really footing the bill through increased premiums?

    He has no recourse to justice. He cannot take the plaintiff lawyer to court for irresponsible litigation. (The standard for “malicious prosecution” has been made to be unachievably high by the lawyers, who in any case never ever take a case like that against one of their own. Has anyone ever noticed how CJD never addresses this rank hypocrisy, even though he wails that docs do not testify against their own, a demonstrable falsehood?)

    The doctor cannot hope to countersue the plaintiff with much success – the odds are massively stacked against him, even when it has been shown in court that he was innocent.

    So what is he expected to do?

    Suck it up. And pray there’ll be no more piranhas. For a while.

    In this sick system, doctors are being forced to pay for the privilege of getting sued by unscrupulous patients and lawyers, when they are innocent.

    This is a system that does not make economic sense, and so it will falter and finally give. The signs are already there. Because the system is so unjust, measures taken to insulate oneself from entering the system in the first place will become widely used.

    So radiologists simply stop doing mammograms. Hundreds already have. It is simply not worth it.

    Neurosurgeons will stop doing traumas, decompressive craniectomies, high-risk vascular procedures, etc in ever increasing numbers. (From 2000-2002, the national average insurance premium hike for neurosurgeons was 63%. It is simply becoming increasingly unfeasable to continue practising in this insane scenario).

    OB Gyns will keep dropping the ob part of their practices; high-risk ob naturally will be completely abandoned by the overwhelming majority of providers.

    ER docs refuse to give RCT-proven therapies for stroke, because of patients who simply won’t get a clue about risks and benefits in medicine and simply sue docs when common, known complications, about which nothing can be done, arise.

    If society (more accurately appaling litigants and their selfish, astonishingly greedy lawyers) keep up such a concentrated abuse of one segment of society, eventually these professionals will draw up a wall to protect themselves or get out completely, no matter how altruistic they are.

    To paraphrase that old Indian saying: “When will lawyers realize that when their little daughter needs a craniectomy to save her, that they cannot do one?”

  • Anonymous

    It’s true, those 250,000 patients who die in the U.S. every year from preventable medical errors should just suck it up and get over their petty concerns.

    This whole idea of putting medical records on computers is ridiculous — who are you to tell me that it will make patient information more accessible, more reliable, and improve care? I opened up a patient file the other day and began to diagnose on the basis of test results in the file. The patient said he never had that test, but you know how clueless patients are — who knows better, the physician or the patient? Well, it turns out the test result was in the wrong patient file, so I ripped it out and threw it away. See? No problem. The other patient who DID have the test? We’re on top of the situation, don’t worry.

    [Identities disguised. I'm a patient, and this 'rip it out and throw it away' happened in front of my eyes. Saw it go into the trash myself.]

  • Curious JD

    “(From 2000-2002, the national average insurance premium hike for neurosurgeons was 63%. It is simply becoming increasingly unfeasable to continue practising in this insane scenario).”

    And yet you have no clue why, Chicken Little.

  • Anonymous

    CJD bloviates:

    “And yet you have no clue why, Chicken Little.”

    Apparently you don’t have a clue either. ;)

  • Anonymous

    Anon 1138 –

    Your story is intriguing and I believe that it happened. But it is an anecdote. Curious JD will tell you that anecdotes don’t count.

  • Anonymous

    “It’s true, those 250,000 patients who die in the U.S. every year from preventable medical errors should just suck it up and get over their petty concerns. “

    This is a discussion about malpractice lawsuits, which are almost always brought about because of bad outcomes. This topic has nothing to do with medical errors. My colleagues and I in an urban ER still don’t have any lawsuits based on medical errors, just bad outcomes.

  • Anonymous

    Curious JD: From 2000-2002, the national average insurance premium hike for neurosurgeons was 63%. It is simply becoming increasingly unfeasable to continue practising in this insane scenario).”

    And yet you have no clue why, Chicken Little. “

    That’s an easy one. Only the bottom of the medical school class goes into Neurosurgery (And OB-GYN, ER, insert high risk specialty). That’s why they get sued so often. We should stop wearing the t-shirts with the targets on them

  • Elliott

    So why would a doctor do a non-emergency c-section without a good idea of gestational age?

  • Rich, MD

    He might if there is evidence of chorioamnionitis.

  • Curious JD

    “That’s an easy one. Only the bottom of the medical school class goes into Neurosurgery (And OB-GYN, ER, insert high risk specialty). That’s why they get sued so often. We should stop wearing the t-shirts with the targets on them”

    How is it one who posts so much about malpractice rates can have so little understanding of the insurance industry?

  • Anonymous

    CJD

    There are multiple anons posting, and you’re getting confused by them. I made one of the earlier posts, not the rest.

    Regardless, it’s clear that your message wouldn’t change even if all the different posters were uniquely identified.

    You basically believe that the current malpractice insurance crisis (when you are in a mood to actually see that there is one) is entirely a creature of insurance business cycles and/or practices, coupled with the endless failings of physicians. In your eyes, misguided plaintiffs, unscrupulous lawyers, and a legal climate designed to be singularly condusive to extraordinary amounts of litigation play completely no role, at all.

    Your view is simply unsupported by the facts and the daily, unvarnished experience of doctors all around the US of A. Clearly, you have a similar ly poor opinion of our view.

    It’s odd that you keep posting with such fervour. May I ask why? It must be obvious to you by now that telling doctors stuff they know from their very own eyes to be untrue is unlikely to convince them of your remarkable claims. Presumably, our efforts to educate you meet with a similarly low opinion of our views.

    So why post? Nothing’s going to change. Posting here can be a bit fun, now and then. Yet every time I drop by, you are here posting away, with no break, no let up, the same talking points. What’s the motivation?

  • Anonymous

    “So why post? Nothing’s going to change. Posting here can be a bit fun, now and then. Yet every time I drop by, you are here posting away, with no break, no let up, the same talking points.”

    Yes, and his talking points are often flat out wrong but that won’t stop him, will it? ;)

  • Anonymous

    Anonymous 7:46,

    Let’s clear something up. I do not believe that there are no unscrupulous lawyers out there. I bet there are just as many unscrupulous lawyers out there as there are doctors, or CEOs, or plumbers. I would never dispute that.

    Nor do I believe that the current “crisis” has nothing to do with the fact that insurers have to pay claims. But the evidence indicates that lawsuits are not the primary cause. And I’ve posted multiple links from medical and insurer trade publications, insurance executives, and insurance lobbyists which support this. I’m not even citing plaintiff’s advocates. Even if you don’t believe me, how can you not believe them?

    My real objection, however, is to those who would limit the ability of people harmed by another’s negligence by virtue of an arbitrary cap which has no basis on the individual case. Particularly when THE INSURER’S THEMSELVES say it won’t affect rates. The best they’ll say it that maybe the rate of increase will slow.

    You say my view is unsupported by the facts? Again, I tell you what THE INSURERS say, when they have to say it under oath. I tell you what your own medical journals say. If anyone has the fact deficit here, it is your side. You rely solely on anecdotal evidence of cases you’ve never seen a bit of evidence in to come to these broad conclusions. How do you justify that as a scientist? Or is it merely a matter of faith that all lawyers are bad and every plaintiff is just a money-hungry liar?

    Why post? Because you’re not the only physician on here. And I believe that behind the hatred for lawyers, some of you really do care about the legitimately injured. And, maybe, just maybe, the next time we have a “crisis”, you’ll remember what I was saying, and realize you’re right back where you were during the last “crisis”, and perhaps not try to make your money back off those who are hurt the worst.

    Also, this blog is read by hundreds (maybe thousands with all the press Kevin has been getting) who don’t comment. And if all they ever read were your comments, they’d be getting at best 1/2 the picture, and they might not ask the questions about the logic behind your conclusions that I do.

    In short, I’m an irrepressible optimist.

    CJD

  • Anonymous

    You’re the optimist? Somehow, I believe the physicians are the optimists. We truly believe that someday, we will be able to do what’s best for the patient again, instead of just creating an airtight defense with every patient we see. The good thing is, your profession has taken it so far (ie medicine is now giving children cancer with all the radiation that is necesssitated by CYA CT scans) that it’s got to change.

  • Anonymous

    Very interesting thread. Curious JD, it sounds to me as if you are assuming that most (or all) docs want a cap and nothing else to fix the system. Having read through quite a bit of data myself on both sides, I doubt I would be the first to say that a cap (on non-economic damages only) would be merely a temporizing measure. Beyond that, there still needs to be a long discussion about the true goals of quality care and patient safety.

    I would be interested to know, from a lawyer’s POV, do you know anything about the National Patient Safety Foundation. My understanding of the organization is that it was founded, largely with funding from the AMA, to promote various patient safety programs, and despite an explicit invitation from the founders, has no participation from the trial bar.

    Yes, the insurers say that caps alone will not drop rates, but recent data from Texas’ comprehensive tort reform DID yield reduced rates, and hopefully will keep docs in the state as well as encourage them to practice safe and effective medicine.

  • Curious JD

    Anonymous 9:41,

    I assume that because that’s the only place that physicians have really flexed their legislative muscle.

    Tell me how recent tort reform in Texas could have dropped rates? Those cases haven’t even come to trial yet, and the nation’s largest insurer told the TX Dept. of Insurance that caps would affect at most 1% of their losses.

    What actually happened, just like what happened in the 90s, was that the economic climate improved, and more competition came in. It will turn, and some carriers will go under because they underpriced their product to get money for the float, just like what happened a couple of years ago.

    The TLMT, after increasing rates over 100%, reduced them 15%. They didn’t need to raise rates that high that fast, but they did so you guys would squawk. You did, you got your caps which, while not reducing their payouts much overall, gives them some certainty on the bigger cases, and so they gave a little back. Reserving the right, of course, to raise them at any time they see fit – like the next time the market crashes.

    Of course, those harmed by the caps, the people injured the worst, they don’t get to raise their cap. It becomes a little less every day with inflation.

  • Anonymous

    “those harmed by the caps, the people injured the worst”

    As you would likely say, “this is hearsay” Do you have any study that proves that the most injured are harmed the most by caps? After all, it’s accepted that very few people at all win anything in the current tort “lottery” climate. Also, the Wall Street Journal reported that one of the effect of the caps is that Texas lawyers are less likely to accept cases, due to the lower likelihood of huge payouts, leaving some of these “people injured the worst” without a lawyer to represent them.

  • Curious JD

    I think you don’t understand what hearsay is.

    Either way, one can assume that a case which has $250,000 in non-economic damages probably has some significant injury. I have never seen a case with those kind of pain and suffering damages that didn’t involve a life long problem.

    Interesting that you compare it to a lottery. A lottery is when you get something for nothing or for very little out of your pocket. I’d say the loss of brain function, one’s breasts, etc. would be quite a bit to bear. There are plenty of lottery winners who continue to buy tickets and look forward to winning again. Ever seen anyone with a malpractice claim that wouldn’t rather be healthy?

    But hey, I know thinking about the actual harm suffered isn’t really your thing.