Comments on: C-section rates and its association with lawsuits

By: Cynthia

Cynthia — Wed, 05 May 2010 01:45:31 +0000

I had my last child in 2007 at the age of 42. She was delivered by c-section. I had 3 children previously all vaginal births. Any person that would opt for this delivery method when not medically required needs a mental evaluation. The recovery from natural birth is a million times easier and way less painful. Women should not be put through this hell unless it is actually needed. I am not saying some c-sections are not prudent. However, if the main reason is liability I consider this medically induced torture. Just wanted to let everyone know if there is an option- vaginal birth is definitely preferred. As for men speaking about their satisfaction with c-sections, I do not think they can conceive of what their wives actually experienced.

By: PJT

PJT — Thu, 29 Apr 2010 13:30:22 +0000

>>If this were true, you would be right. But alas, it’s not. Now, having a bad outcome is a necessary element, true, because you can’t have a malpractice suit without damages.>>

It is my understanding that in medicine there are many more bad outcomes than malpractice suits, including a number of bad outcomes that occurred as a result of actual malpractice.

By: Matt

Matt — Thu, 29 Apr 2010 12:38:35 +0000

“As long as malpractice equates to bad outcome,”

If this were true, you would be right. But alas, it’s not. Now, having a bad outcome is a necessary element, true, because you can’t have a malpractice suit without damages.

“So, you see, if the standard of care you implemented resulted in “damages”, you chose the wrong standard of care….in this particular case.”

Again, you’re still mistaken in your concepts.

As to your perception of reality, it remains purely your perception. Not the actual reality.

By: PAUL MD

PAUL MD — Tue, 27 Apr 2010 00:42:46 +0000

@Matt,
So sorry for mismatching my concepts. You are both right and wrong in your facts. The standard of care has horizontal measures of acceptable standards. In some, if not many, if not all decision tree circumstances in medicine there are other ways to skin the cat. So, you see, if the standard of care you implemented resulted in “damages”, you chose the wrong standard of care….in this particular case.

Result for physician is same. Call it what you want…lipstick on a pig and all that. I am just contributing my thoughts to a reality that many of us deal with on a daily basis.

Regarding the “caps” that you are so fond of. Maybe there should be no caps at all. Let’s be realistic about what Malpractice is in..legal practice. It is a bad outcome and a calculated cost to defend, percentage of risk to lose case and estimated risk of loss amounts. When malpractice is really a screw up or malice then we can talk about no caps. As long as malpractice equates to bad outcome, it is essentially “bad outcome insurance” and we cannot guarantee success, so then it is another day in the legal meat grinder.

By: Amy Tuteur, MD

Amy Tuteur, MD — Mon, 26 Apr 2010 21:36:10 +0000

What mystifies me is how people can accuse obstetricians of performing C-sections for extra money (a pittance, if anything) and saving time, while simultaneously insisting that obstetricians are not performing C-sections for fear of lawsuits potentially costing millions of dollars, consuming countless hours, and possibly ruining a professional reputation.

If you think an obstetrician would be inclined to perform a C-section to make an additional $250, why wouldn’t you think that he or she would be far more inclined to perform a C-section to save $5 million dollars?

By: PJT

PJT — Mon, 26 Apr 2010 21:27:57 +0000

>>So why arbitrarily cap the noneconomic damages if that doesn’t achieve the goal of reducing costs or reducing C-sections or increasing access?>>

What if the goal of those who advocate capping non-economic damages is NOT decreasing the number of C-sections or cost reduction? Certainly, there may be other possible motives for capping damages.

By: Matt

Matt — Mon, 26 Apr 2010 20:23:50 +0000

So why arbitrarily cap the noneconomic damages if that doesn’t achieve the goal of reducing costs or reducing C-sections or increasing access?

By: ls

ls — Mon, 26 Apr 2010 18:09:17 +0000

It won’t matter, because only the non-economic damages are capped. Even economic damages can still be well into the millions.

By: PJT

PJT — Mon, 26 Apr 2010 17:56:12 +0000

>>What matters is to obstetricians is the lifetime risk of being sued and that is approaching 100%.>>

Has the actual number of lawsuits in the U.S. risen over the last 20 years or not? If the actual number of lawsuits has not risen, is it spread more evenly amongst all OB/GYNs vs. 20 years ago?

It’s not possible to determine whether this fear of lawsuits is based in fact or not without further information.

By: Amy Tuteur, MD

Amy Tuteur, MD — Mon, 26 Apr 2010 17:39:24 +0000

“t no longer matters how many other suits are filed, how high the monetary judgments are, or even whether malpractice premiums are rising.”

What matters is to obstetricians is the lifetime risk of being sued and that is approaching 100%.

For obstetricians it is not a matter of IF you are sued, but how you will defend yourself WHEN you are sued. Even better, from the obstetrician’s point of view is to preempt the possibility of a lawsuit by performing a C-section at the drop of a hat. That deprives plaintiffs of the most common reason for obstetric malpractice suits.

You cannot say to an obstetrician: “Give me a perfect baby or I will claim that you should have performed a C-section, and then be surprised that obstetricians perform lots of C-sections.