Comments on: http://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html Tue, 14 Feb 2012 20:59:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html#comment-61398 Anonymous Sat, 01 Apr 2006 06:14:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20325.html#comment-61398 "What a prince you are. So, what would your net income before taxes be if you saw, say, 3 patients an hour?"<br/><br/><br/>I'm An ER Doc. I get paid the same whether I see 1 patient or 50. The way things have been going I'll be all that's left in a few years. I agree, that's scary. “What a prince you are. So, what would your net income before taxes be if you saw, say, 3 patients an hour?”

I’m An ER Doc. I get paid the same whether I see 1 patient or 50. The way things have been going I’ll be all that’s left in a few years. I agree, that’s scary.

]]> By: jbhttp://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html#comment-61396 jb Sat, 01 Apr 2006 05:14:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20325.html#comment-61396 Seeing three patients per hour might cover his overhead. Maybe. And then the other 1-2 ladies would have to go on itching. Seeing three patients per hour might cover his overhead. Maybe. And then the other 1-2 ladies would have to go on itching.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html#comment-61394 Anonymous Sat, 01 Apr 2006 05:07:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20325.html#comment-61394 "I should have just let her itch."<br/><br/>What a prince you are. So, what would your net income before taxes be if you saw, say, 3 patients an hour? “I should have just let her itch.”

What a prince you are. So, what would your net income before taxes be if you saw, say, 3 patients an hour?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html#comment-61332 Anonymous Fri, 31 Mar 2006 00:59:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20325.html#comment-61332 They were probably bust and overlooked her medication list....I once had a woman come in complaining of vag itch, I gave her flagyl for bacterial vaginosis (class C). She told me she had no medical problems and Only that night when I was writing my charts did I realize the nurse had documented she was on "prenatal vitamins". Hard to know everything when I see 4-5 patients an hour. I should have just let her itch. They were probably bust and overlooked her medication list….I once had a woman come in complaining of vag itch, I gave her flagyl for bacterial vaginosis (class C). She told me she had no medical problems and Only that night when I was writing my charts did I realize the nurse had documented she was on “prenatal vitamins”. Hard to know everything when I see 4-5 patients an hour. I should have just let her itch.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html#comment-61329 Anonymous Fri, 31 Mar 2006 00:27:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20325.html#comment-61329 It seems like the woman was taking the propranolol before the pregnancy...so the docs did not make a point of telling her to stop taking it. I'm pretty sure most docs would be hesitant to prescribe anything new to a pregnant woman because of the litigious society we are in...but I think it's an easier blunder to make to overlook telling someone to stop something they have been taking already for a while...I wonder if this was the case. It seems like the woman was taking the propranolol before the pregnancy…so the docs did not make a point of telling her to stop taking it. I’m pretty sure most docs would be hesitant to prescribe anything new to a pregnant woman because of the litigious society we are in…but I think it’s an easier blunder to make to overlook telling someone to stop something they have been taking already for a while…I wonder if this was the case.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html#comment-61321 Anonymous Thu, 30 Mar 2006 22:38:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20325.html#comment-61321 I'm an OB. With HTN and pregnancy the preferred drug is aldomet. For beta blockers the preferred drug is labetalol, which although class c, seems to have fever problems than propranolol or atenolol. <br/><br/>This pregnancy, from the article seemed to be high risk, with bleeding and HTN. Htn patients are at risk for unexplained stillbirth, even with close supervision such as twice weekly NST's or weekly BPP's. This surveillence will reduce the risk from the chronic effects of HTN. But nothing can predict abruption which can occur at any time with HTN. If the fetal death was from abruption, this is an unpredictable event that can't be screened for....But since I don't know the case I can only speculate.... I’m an OB. With HTN and pregnancy the preferred drug is aldomet. For beta blockers the preferred drug is labetalol, which although class c, seems to have fever problems than propranolol or atenolol.

This pregnancy, from the article seemed to be high risk, with bleeding and HTN. Htn patients are at risk for unexplained stillbirth, even with close supervision such as twice weekly NST’s or weekly BPP’s. This surveillence will reduce the risk from the chronic effects of HTN. But nothing can predict abruption which can occur at any time with HTN. If the fetal death was from abruption, this is an unpredictable event that can’t be screened for….But since I don’t know the case I can only speculate….

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html#comment-61320 Anonymous Thu, 30 Mar 2006 22:14:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20325.html#comment-61320 " most of the time can't collect as their claim was dubious in the first place "<br/><br/>What percent of all claims are "dubious"? ” most of the time can’t collect as their claim was dubious in the first place “

What percent of all claims are “dubious”?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html#comment-61317 Anonymous Thu, 30 Mar 2006 22:05:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20325.html#comment-61317 "-> Guess rest of the world practice it ->->-> LOSER PAYS"<br/><br/>We already have that. <br/><br/>But hey, while we're getting what the rest of the world has, can we get some universal health care? “-> Guess rest of the world practice it ->->-> LOSER PAYS”

We already have that.

But hey, while we’re getting what the rest of the world has, can we get some universal health care?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html#comment-61316 Anonymous Thu, 30 Mar 2006 22:03:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20325.html#comment-61316 I don't think people really understand what the categories say. Here's a version for lay persons.<br/><br/>A: means that drug has been tested in pregnant humans. Get real! For practical purposes, there are no A drugs. No one would test an unknown drug on a pregnant woman.<br/><br/>B: means tested on pregnant mammals and studied, not tested, in pregnant women. No increased risks noted.<br/><br/>C: means neither tested on pregnant mammals nor formally studied in pregnant humans. So judgment is called for.<br/><br/>D: means it has been studied and there are known risks in pregnant women; in selected cases, benefits may outweigh the risks, but use very cautiously. The classics are anti-seizure meds. <br/><br/>X - banned. I don’t think people really understand what the categories say. Here’s a version for lay persons.

A: means that drug has been tested in pregnant humans. Get real! For practical purposes, there are no A drugs. No one would test an unknown drug on a pregnant woman.

B: means tested on pregnant mammals and studied, not tested, in pregnant women. No increased risks noted.

C: means neither tested on pregnant mammals nor formally studied in pregnant humans. So judgment is called for.

D: means it has been studied and there are known risks in pregnant women; in selected cases, benefits may outweigh the risks, but use very cautiously. The classics are anti-seizure meds.

X – banned.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/heres-case-where-obs-were-sued-for.html#comment-61315 Anonymous Thu, 30 Mar 2006 21:19:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20325.html#comment-61315 Elliot is right. This is a news release, one sided, direct from the lawyers office. Especially in small towns, it creates tremendous pressure on the practitioner to settle. It's a favorite tactic.<br/><br/>A colleague of mine (not the OB) was involved in a bad outcome from a cesarean delivery. He received in the mail 8 X 10 glossy photos of the mom holding the infant in the NICU, with all the iv's and monitor wires prominently shown. The accompanying note from the attorney asked the doc if he thought he could fight this case in court and suggested settlement.<br/><br/>When the baby died a few days later, those same photos appeared on the front page of one of our local papers. Elliot is right. This is a news release, one sided, direct from the lawyers office. Especially in small towns, it creates tremendous pressure on the practitioner to settle. It’s a favorite tactic.

A colleague of mine (not the OB) was involved in a bad outcome from a cesarean delivery. He received in the mail 8 X 10 glossy photos of the mom holding the infant in the NICU, with all the iv’s and monitor wires prominently shown. The accompanying note from the attorney asked the doc if he thought he could fight this case in court and suggested settlement.

When the baby died a few days later, those same photos appeared on the front page of one of our local papers.

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