Patient wants an apology, not money, after medical malpractice

by Tricia Pil, MD

This is the true story of a hospitalization as told from three points of view: first, the recollections of the patient (who happens to be a physician); second, events as recorded in the medical charts by doctors and nurses; and third, the version put forth by the hospital.

FRIDAY

Patient:
It is fall 2005, and I am nine months pregnant. A healthy 33-year-old pediatrician, I am a longtime patient of Doctor A and Doctor B, who delivered my two young children at this hospital. My husband and I are eagerly anticipating the birth of our third child.
One evening after dinner, the contractions start coming every five minutes. My husband and I pack our bags and drive to the hospital. I am nearly 4 cm dilated. After observation, Doctor C calls Doctor A, makes a diagnosis of false labor and sends us home.

Chart:
9:25 pm: 33 year old gravida 3, para 2, 38 5/7 week seen in office this AM almost 3 cm. Negative PMHx, c/o contractions q 5 min. Cervix 3+. Will ambulate 2 hours.
12:15 am: Continued contractions q 5 min. Spoke with Doctor A–home or stay–patient chooses to go home. Keep appointment Monday for induction.–Doctor C

Hospital:
Your presentation to Triage was discussed with Doctor A by the OB Triage Specialist. Since there was no change in cervical dilation, you were discharged.

SATURDAY

Patient:
My water breaks the following night, and I call Doctor B. After saying “Hold your horses,” he grudgingly tells me to return to the hospital. By the time we arrive, my contractions are coming every minute. No one is behind the emergency room desk. My husband finally finds an off-duty orderly willing to get a wheelchair to take me to the birthing center. There, the secretary refuses to call a nurse until I sign papers explaining the hospital’s privacy policies.

Chart:
Registration 10:45 pm. Triage admission 10:45 pm.

Hospital:
After 10:30 pm a call bell is present on the counter in case the triage nurse is not at the window. The “off duty orderly” who wheeled you upstairs to the birthing center may not have known the proper sequence to follow. Documented registration time is 10:45 pm and the time placed in the triage room is 10:45 pm which indicates swift placement into a triage room. There are some forms that must be signed for each admission.

Patient:
In triage, Doctor D prepares a fern test to determine whether the fluid that has soaked the bed and wheelchair has come from a ruptured amniotic sac, when that fact is clear even to my lay husband. Nurses are shouting at me not to push, but I am involuntarily bearing down with each contraction. By the time we rush towards the delivery room, the baby is crowning. He is born in the hallway.

Chart:
10:59 pm: Boy delivered 8 pounds, 1 ounce. Spontaneous vaginal delivery.–Nurse A

Hospital:
You delivered in the labor and delivery room 14 minutes after arrival by the OB Triage Specialist.

Patient:
I am left lying there, waiting for Doctor B. When he arrives I ask, “Where were you?” He answers, “I can’t come until they call me.” He yanks the placenta out, and I bite my lip. At one point, while he is sewing my laceration from the birth, I exclaim, “Ouch! I can feel that!” He replies, “Aww, that’s just the deepest one,” and keeps on going. He disappears as soon as he is done.

Chart:
11:25 pm: BP 136/76, HR 85. Hemoglobin 14.
Delivery Note: Precipitous labor, arrived at triage 8 cm, dilated and delivered on arrival by Doctor D. I arrived in room just after delivery. Placenta spontaneous and repair of second degree laceration under local. Group beta strep positive–no antibiotics given.–Doctor B

Hospital:
Doctor B was on-call for his practice that night and was physically on the premises. However, since your delivery progressed so quickly he did not make it from his prior location. He does not recall “yanking” your placenta.

SUNDAY

Patient:
We are moved to the postpartum floor. Seven hours later, I suddenly feel weak, dizzy and nauseated. I say, “Somebody help me, I don’t feel well.” The next minute, I’m hemorrhaging. There is blood spurting everywhere, clots the size of frying pans. I think I am going to die. Panicky nurses and residents crowd the room. The crash cart is wheeled in, my baby is wheeled out. My husband is shouting, “Somebody get Doctor B!” I am being stuck everywhere for an IV. Someone says that there will be a “procedure,” and then my underwear is cut off, injections slammed into my buttocks, my legs are forced open and somebody shoves an entire forearm into my uterus and pulls out clots. Three times. I scream and scream and scream. The pain is unbearable, and I feel brutally violated.

Chart:
7:30 am: Called to see patient passing clots. Passed two medium size clots. Blood pressure 110/67…100/60…90/58. Pulse 88…96. Patient uncomfortable, vomited x 2. Bimanual evacuation lower uterine segment with 3 large clots. Orders: IV, Pitocin IV, Methergine IM, Morphine IM, Zofran prn. Discussed with Doctor B.–Intern

Hospital:
Once again, we refer you back to your private physician for a detailed discussion about the hemorrhage you outlined.

Patient:
Everyone flees the room.
I am curled in a fetal position, crying and shaking. No one comes to explain why, how or what has just happened. When my husband stumbles down the hall afterwards, other new mothers stop him to ask if his wife is okay after what they have heard. They are the only ones who ever ask if I am all right.

Chart:
7:40 am: BP 90/58. Will continue to observe.–Night Nurse B
8:00 am: IV running. Patient medicated with Zofran for nausea. Resting comfortably. Will monitor.–Day Nurse C

Hospital: [no response]

Patient:
Doctor B makes rounds. “You doctors make the worst patients.” Then he asks if I am up for an early discharge. He stands in the doorway, making more eye contact with my chart than with me. I never see him again.

Chart:
8:40 am: Hemoglobin 11. BP 90/60.
Afebrile, vital signs stable. Fundus firm, lochia moderate, perineum ok. Doing well. Orders: Discontinue Pitocin at 12 noon if lochia normal. Heplock IV.–Doctor B

Hospital: [no response]

Patient:
My husband notices that the expiration date on the bag of Pitocin–the intravenous medication used to treat postpartum hemorrhage–is fourteen days overdue. A nurse quickly removes the bag and assures me that Pitocin is good for two weeks past its expiration date anyway.

Chart:
1:50 pm: IV infiltrate right forearm. Catheter discontinued.–Nurse D

Hospital:
Each unit where Pitocin is supplied is checked on a monthly basis. The Pitocin label has two dates on it. One date is the compound date, and the other is the expiration date. Is it possible you noticed the compound date?

Patient:
I lie dazed and in shock, unable to eat or drink. When my baby is brought in to nurse, I numbly put him to my breast and go through the motions. Patient-care assistants come in once per shift to chart my vital signs. Nurses avoid the room and act as if nothing happened.

Chart:
12 pm: BP 100/70. 4 pm: 90/60.
Intake: Regular diet. Quantity sufficient. Output: Voided. Quantity sufficient.
Infant weight 7 pounds, 10 ounces. Breastfeeding score 10/10. Assessment within normal limits.–Nursing notes

Hospital: [no response]

MONDAY

Patient:
Doctor A rounds. “I’m surprised you decided to leave that first night.” I am stunned. When I finally answer that we were discharged from the emergency room on his orders, he replies, “I thought you came in looking for a sneak induction.” He writes my discharge orders a day early and leaves, also never to be seen again.

Chart:
12 pm: BP 90/60. 8 pm: 96/58.
No complaints. Feeling better. Doing well breastfeeding. Orders: Home tomorrow AM.–Doctor A
Infant weight 7 pounds, 5 ounces.
Infant nursing well at frequent intervals. Exam significant for icterus [jaundice]…facial bruising…Precipitous delivery, maternal group beta strep positive without antibiotic treatment. Discharge planned for Day Five if course in hospital remains uneventful.– Doctor E

Hospital: [no response]

TUESDAY

Patient:
On the morning of discharge, I tell the nurses repeatedly that my baby is very sleepy, not nursing well and starting to vomit. He has lost 10 percent of his weight in the forty-eight hours since birth. The discharge nurse tells me to “stop worrying like a pediatrician mother,” his vomit is just spit-up, and he is not sleepy, just “content.” We are handed formula samples and hurried out the door.

Chart:
1:45 pm: Infant weight 7 pounds 3 ounces. Bilirubin 12.7. Report given to Doctor F via Nurse E. Patient discharged to home with infant after discharge instructions and supplemental nursing that patient requested in case she decided to supplement infant. Patient’s condition stable.–Nurse F
MD verbal order: Discharge home with mother. Cancel home health.

Hospital:
There was no emesis or spitting documented. Status reports were given to Doctor F and nursing notes indicate that Doctor F wanted your baby to be supplemented. The nursing notes indicate that you were informed of this and were provided instruction on supplemental nursing.

Patient:
Within one hour of getting home, my baby throws up again, drenching the bassinet. We rush him to the pediatrician’s office and are sent immediately to the emergency room of another hospital. He is jaundiced, lethargic and dehydrated. The ER staff struggles for IV access, sticking his arms, legs and scalp. He is admitted that evening, five hours after our hospital discharge, still wearing his hospital leg bands. It is my thirty-fourth birthday.

Chart:
6 pm: Infant weight 7 pounds, 3 ounces. Bilirubin 16.9. Sleepy, floppy, jaundice to umbilicus. Admit.–Emergency room notes

Hospital:
Once again your pediatrician can address your concern in this matter as well.

WEDNESDAY, THURSDAY, FRIDAY

Patient:
My son remains hospitalized, lying in an incubator receiving intravenous fluids and phototherapy. He doesn’t come home for good until he is nearly a week old, requiring yet another week of home phototherapy and daily home care visits before regaining his strength and weight.

Chart:
Diagnosis: Obstetrical Trauma Not Otherwise Specified.
Disposition: Return in approximately one year.–Doctor G

Hospital:
We are sorry that you were so unhappy with your stay. After a thorough investigation of your allegations, we have concluded that the care you received was appropriate. Thank you for taking the time to express your concerns.

***

In the months after my son’s delivery, it was as if a curtain had descended over my life. In addition to a terrible feeling of numbness, I was haunted by flashbacks and nightmares about what had happened. Billboards for the hospital where I’d delivered, people dressed in scrubs, pregnant women, a favorite red velvet cake that now resembled to me a large blood clot and, worst of all, my own baby–the sight of any of these could trigger flashbacks and bouts of heart-stopping, sweat-drenched panic.

For my postpartum checkup, I saw a new obstetrician, who listened uncomfortably to my tearful story and ultimately dismissed my symptoms as hormone-induced baby blues, “Mother Nature’s way of kicking women when they’re down.”

After five months of worsening symptoms, I finally self-referred to a psychologist who began treating me for post-traumatic stress disorder (PTSD). It was only then that I started bonding with my infant son.

On the eve of my son’s first birthday, the first anniversary of the event, I wrote a letter of complaint to the hospital and to the physicians who’d been involved in our care. It had taken me that whole year to verbalize what had transpired. Even as I mailed the letter, I struggled with feelings of disbelief, anger, shame and betrayal that something like this could have happened to me, a physician, “one of their own.”

I wrote the letter because I wanted the doctors and hospital staff to understand my perspective and to appreciate the devastating impact that this event had had on my life and family.

I also wanted them to consider the inept and unfeeling care we’d received from first to last–including the failure to get me into a delivery room quickly enough, the brutal response to the hemorrhage (which better care might have prevented in the first place) and the inappropriate discharge of my ill newborn.

I wanted them to change the way they conducted business so that no one else would have to endure what I did.

Naively enough, I wasn’t even thinking of a lawsuit–that is, until I received the hospital’s letter of reply three months later, the one extensively quoted above. In that infuriating moment I suddenly understood why patients sue. The response, with its defensive, denying, callous tone, was like a slap in the face–like being traumatized a second time.

The following week I called a malpractice lawyer and told him my story.

He listened sympathetically and then zeroed in on the key word–damages. Aside from my psychotherapy bills, it was hard to pinpoint a lasting physical injury to me or to my baby. “This case would be worth a lot more if we had three motherless children or a brain-dead baby in a wheelchair,” he said. That’s when I politely thanked him for his time.

I wanted an apology, answers and change–not money.

I never did receive a response from any of my physicians.

As someone who has been on the receiving end of care that felt both incompetent and uncaring, if not cruel, I’m sure that we medical professionals can do better. As someone who looked for explanations and received none, I’m hoping that we can change, getting beyond blame-shifting, defensiveness, denial and complicit silence–and moving instead towards transparency, disclosure, apology and healing.

As a physician, I hope that we can learn to more actively engage our patients in their own care. I hope that we can reexamine the ways in which we respond to our own errors and share the lessons we have learned with our medical students and residents.

If we can do this, perhaps then we could rise above the babble of Babel, our voices joined in a common language of human care and compassion.

Tricia Pil is a pediatrician. This piece was originally published in Pulse — voices from the heart of medicine, and is reprinted with the author’s permission.

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  • http://www.legalnurseconsultingofamerica.com Rochelle Saxon

    There are always three sides to every story. It is pitiful, the treatment that this patient received. Her being a physician has nothing to do with her care or complaints. Her being a physician should not have been considered as she was a PATIENT! As a medical professional I’ve seen too many times where we are treated differently because it’s assumed that we know everything. Many times we are ignored because as medical professionals we are considered a pain and staff feel that we will view what they do with more intent than most patients. This is true to a certain extent. As a nurse I know if someone is starting an IV incorrectly on me. But that doesn’t mean I shouldn’t receive appropriate care.
    Anyone thrusting their hand/arm into a vaginal canal the way it was described should be prosecuted for battery. I must admire this woman for not wanting to file a suit but an appology from the medical staff. It is terrible that the hospital and physicians responses and in some cases lack of responses were obviously due to their desire to cover their behinds. Medical professionals need to understand that they would be involved in less suits if they would take responsibility for their actions, take a moment to see things from the patient’s perspective and when appropriate admit to their mistakes. Listening to a patient in many cases is all that is needed. I’ve seen that many times a patient files a lawsuit out of frustration. In this situation I would request a copy of my medical records, go see several more attorney’s and file complaints against those physicians with the appropriate medical board.
    It is obvious that this patient would suffer from PTSD. It seems that a very good screening of the patient’s medical records is in order. Questions remaining are: What are the SOP’s for:
    1. patients coming into the hospital in her situation,
    2. medication review for out of date meds.
    3. delivery of a child
    4. contacting physicians and response time
    5. discharge criteria of mother and baby
    6. staffing
    There are numerous other questions that need to be answered. Unfortunately, all of this could have been taken care of by the staff, including the physicians listening to the patient and taking care of her and the baby in a professional manner. It sounds like most of the caregivers had an attitude that the patient was a pain and they didn’t want to be bothered. The patient was obviously scared, concerned and these issues among many others were not addressed by staff.

  • http://glasshospital.com John Schumann, M.D.

    How you were treated was appalling. And being a doc made things worse for you: people assumed you wanted special treatment, and that you ‘knew the score’ at every turn–and likely wouldn’t need adequate anesthesia during your lac repair, or that you wouldn’t actually need comforting, since as a doctor somehow you were ‘above’ needing that.

    My goodness.

    Beyond Insult to your injuries is the hospital’s defensive posturing. You deserve a hearing and validation and a genuine apology.

    Your story illustrates so much of what’s wrong with industrialized medicine.

  • Anonymous

    Thank you for sharing your story. While it sounds like you had horrifyingly dispassionate physicians who were unwilling or unable to display any empathy, I can’t help but view your story as yet another example of how the current malpractice environment can lead to such an adversarial relationship between patient and hospital or patient and physician the moment something goes wrong. Your reaction to your experience is understandable. What recourse, if any, are you left with? Name names? Go ahead with a lawsuit? You are left with no good options.

  • Jerry

    Why do you think that all seven of the doctors you met refused to respond to a person “who looked for explanations”? Why do you think that all seven doctors could not get “beyond blame-shifting, defensiveness, denial and complicit silence”? As a physician, why do you think all seven hesitated to engage the patient in her own care?

    Could there be a single answer to all three questions and could it be so obvious, but so politically incorrect that no one wants to mention it? Does that politically incorrect answer infuriate everyone on the forum?

  • Conniedl

    I can really relate to your story. I can’t imagine what you went through. It was so much worse than my experience, yet, I know that I had problems bonding to my son because of a traumatic delivery that I had dreams about on his first birthday. I had to have transfusions after the fact but I did not have near the inconsiderate care that you had. That is almost criminal, but I can certainly relate to wanting just an apology rather than any monetary damages. I was just asked recently by an acquaintance if they should seek a lawyer for a problem they perceived. I advised speaking with the physician first to see if they would give an apology first since there was little damages and the person did not want to sue, but didn’t see an alternative for justice. Hopefully, in this case the physician will see the right way to go.

  • Kim

    I have PTSD from a medical experience. I also contacted the hospital/clinic because I needed to understand what happened and an apology for my suffering. They seemed more concerned about defending their actions than my health. I still have nightmares and it affects my ability to get needed medical care.

    • http://www.legalnurseconsultingofamerica.com Rochelle

      Have you thought about meeting with the hospital administrator or the clinic manager? Perhaps you and that person can go over your medical records. By doing that you may see that either things were done correctly or if incorrectly perhaps the manager can talk to the people involved and help them see that discussing it with you and if appropriate, saying they’re sorry for what happened to you will enlighten them and help you.

      • Kim

        I talked to the clinic manager. She had no intention of helping me and neither did the doctors involved.

        When I changed doctors, told her about the PTSD, she defended her collegue.

        I ended up seeking care from a naturpathic physician.

        I have my medical records. I know what happened.

  • Anonymous

    My first child had a similar experience. I felt like it was completely my fault for naively thinking jaundice couldn’t be that bad if sunlight cures it and for failing to recognize some very obvious signs of dehydration. I still feel this way, 7 years later. He was in the hospital for a week, and in hindsight, I’m pretty sure he was close to death when we first brought him in.

    I got a spinal headache with my second, and I had no idea what that was until the doctor on rounds assured me it couldn’t be a spinal headache because the doctor who gave me the epidural was too good at his job. And, the fact that I waited until Saturday and spent 6 hours with a slightly jaundiced newborn waiting for a blood patch…that was my fault, too for waiting so long. I did feel the doctor on rounds was a jerk, but I shouldn’t have been so meek, and I should have questioned him better about “spinal headaches” while I was in the hospital.

    I’m not sure what my point is except that every patient is different even when faced with similar situations. That in itself is a challenge. And, maybe that challenge is enough to make it impossible for hospitals and doctors to do the right things all the time for every patient.

  • http://fastsurgeon.blogspot.com JF Sucher, MD FACS

    A very well told account of a terrible tragedy. It is humiliating from a professional perspective and greatly concerning from a personal one. Physicians and nurses are on the front lines, living on a tight rope. Some continue to struggle to maintain the balance, while others fall off one side or the other. The legal system has created such a fear amongst the medical profession that many aren’t willing or simply can’t maintain the balance of human empathy and openness against the jagged rocks of having your life destroyed by malpractice litigation.

    Unfortunately, the problem may lie more in our inability to police the profession and rid ourselves of unsafe or criminal healthcare providers. If we could do that, then we would have little need for the malpractice lawyers. At that point, I believe we would see less of this type of terrible story and more personal caring from our providers.
    JFS

    • Katie

      The callousness displayed by her caregivers in touching her without any sensitivity, failing to explain or give warning when they are about to cause her pain (even so much as a “I’m going to have to put my hand inside you to get clots out and stop your bleeding and this will hurt”) goes well beyond the malpractice issue. It takes next to no time to turn a terrifying occurrence to one in which you are in danger and in pain, but have confidence that you are in good hands. I say this as a provider and a patient.

      I doubt all these physicians and nurses are “bad” and need to be gotten rid of. They are the status quo. Their sense of compassion has been drilled out of them through their training and their work environment.

  • http://www.legalnurseconsultingofamerica.com Rochelle

    I have been a nurse for 20 years. I’ve had positions from staff nurse to administrator. I make it a point to try to educate my fellow peers as well as taking advise from them. We can all learn regardless of what our title. We all need to be aware of all medical personnel and work as a team. If someone needs help, give it. If someone is falling, stop and help them get on the right track. If someone is doing something wrong or giving sub standard care, it is our obligation to report that to the appropriate levels of administration. On the other hand, it is very easy in life to condem people. But most of the time people do not take the time to report good care, above standard care, etc. I always try to take the time to report to the administrator of whatever clinic/hospital I may receive superior care from. If we help one another it will help us personally and professionally. This will also help with lawsuits that are not necessary. We also need to police ourselves and if we do something wrong or give inferior care, step up and admit it. It doesn’t matter if it’s to your patient or superior. It starts with you as a person and spreads out.

  • Anonymous

    >>Perhaps you and that person can go over your medical records. By doing that you may see that either things were done correctly or if incorrectly>>

    Determining whether things were done correctly or incorrectly is meaningless to one who suffers from PTSD. In Dr. Pil’s case, there was minimal malpractice in caring for her medically but she was traumatized nonetheless. (Her son’s care was suboptimal, IMO.)

  • Anonymous

    >>I have PTSD from a medical experience. I also contacted the hospital/clinic because I needed to understand what happened and an apology for my suffering. They seemed more concerned about defending their actions than my health. I still have nightmares and it affects my ability to get needed medical care.>>

    I do, too. Like Dr. Pil, I’m also a clinician. In the aftermath of a surgical disaster, no one would talk to me except for the malpractice attorney I also consulted. Also like Dr. Pil, I didn’t want money, just an apology and some explanation of why my surgeon treated me like a leper once it became clear I had a poor outcome and it wasn’t because I’d failed to follow post-op instructions (!). The attorney told me I had no case because I wasn’t sufficiently damaged. Meeting with him, however, actually was therapeutic because he listened to me and believed what I was telling him – especially when we went through the records together. His was the one kind face I remember from that horrible time.

    I still have flashbacks. Like Kim, this experience has impacted my ability to seek medical care for myself.

  • http://www.lethachristinachamberlain.wordpress.com Letha Christina Chamberlain

    A forty year, graduate-educated psych nurse became a psych patient… and involuntarily-detained after multiple attempts to inform treating physicians the issues were the medication (including 150 mcg/qd levo-thyroxine–recently increased). Now, nine months free of all medicines (and thyroid profile “wnl” off all thyroid)… all offending sx gone, the nurse tried to inform hospitals, and was treated as a “terrorist”–after only wanting to educate and inform. A former colleague (who had once asked if this nurse was going to replace her in her assistant director role) told her to “talk to (her) provider.” Right! Will “old theories” never die? The medical records are damning and wrongful–and now she can’t even volunteer anywhere (or change the medical records).

  • Kelly

    As someone who also had a traumatic delivery, albeit less catastrophic than the one described above, I was also shocked at my treatment. I’m a health professional that worked in the hospital where I delivered but I also had a roomful of people take off my clothes and put a fist in me while starting an iv. All before looking at me or saying hello. After my delivery i was taken to a room alone for 8 hours and yelled at after I called for a nurse because I was bleeding everywhere.

    Like the author, I too wrote a letter but received no reply.

    This is a powerfully written piece. More of this needs to be shared. Perhaps then this kind of treatment will be unacceptable rather than explainable.

  • Romy

    Thank you for sharing this personal post. I liked how you juxtaposed your experiences with what appeared in your chart – powerful and unfortunately, I wonder if this doesn’t more often. Have providers gone so far in attempting to avoid legal issues that medical records/legal documents are too glossed over? Scarey thought.

    On a personal note, after a frightening c-section with my anaesthesia ‘not working’ (I believe it’s called a patchy epidural), me feeling everything from my ribs down, a lot of blood loss, and no memory of how my surgery ended, I also requested a copy of my records.

    On the OR report: patient tolerated the procedure well.

  • Anonymous

    After reading this piece, I am taking a video camera to my wife’s delivery. This is not because I want to make a touching home video of the birth of our child. This is because I want my own documentation as a buffer against the possibility of what can only be described as fraudulent medical record keeping that occurred in the case of the author.

    • Katie

      This is why the hospital staff will probably not allow you to record your child’s birth. That is a routine policy now in L&D units.

  • Vox Rusticus

    I suppose the OP will avoid that hospital in the future. If I felt as she did, i sure would.

    As for suing for “an apology” and not money, sorry, litigation does not work that way, unless you are making an offer to settle with no payment. That makes hiring counsel a problem unless you are willing to bear the costs of the prosecution of the plaintiff’s case.

    Unfortunately, defensiveness is the course to be expected whenever a sophisticated accuser–and a physician would certainly qualify–complains about care. Apologies are seen as admissions of failures and unfortunately that too often is re-drawn as an admission of failure to perform a duty and all that follows from that at litigation. Complaintants might say they want no money and only an apology, but they are permitted to change their minds at any time and litigate for anything they please, so a claim to “only want an apology” is not much assurance that you won’t later want money. (To make sure they “won’t do anything like they did to me to anyone else.”)

    As to the facts of the case, this is one side only we see here. The responses and citations are edited by the poster, and are not included in their full text. As compelling as the poster’s story may seem, it is not the whole story, nor is it the full and unedited account of all of the many people involved in the care of this patient and her baby. To be fair to them–and we should make that effort–we should not assume that there is no evidence available that contradicts this account.

    This might make a sympathetic story, but I don’t assume it is the whole truth.

    • Anonymous

      >>As for suing for “an apology” and not money, sorry, litigation does not work that way, unless you are making an offer to settle with no payment. That makes hiring counsel a problem unless you are willing to bear the costs of the prosecution of the plaintiff’s case.>>

      In my case, I actually considered suing without expectation of any payment to me. The attorney I consulted told me my case was as strong as several he’d won BUT in my case (unlike the others he’d taken to court) the only damage was psychological, not physical. The potential settlement wouldn’t have covered the cost of hiring a medical expert, never mind the attorney’s professional costs.

      The attorney told me not to go forward with the case. Again, he was very kind, though I paid him nothing for the phone calls and 90-minute in-person consultation.

      Physicians generally fear the filing of a lawsuit far more than the actual size of the lawsuit. That certainly explains my surgeon’s behavior; even with physical damages, my potential settlement would have been less than $30K.

      As for reporting my surgeon to the board of registration, that would be professionally embarrassing… to me. I’m torn in that I want the surgeon disciplined but don’t want the board (to which I also answer) to know about my PTSD. So other patients will probably have similar experiences with this surgeon. There’s no motive for change.

      • http://www.legalnurseconsultingofamerica.com Rochelle

        Your last paragraph just shows how this has impacted you. YOU are still putting all the blame on yourself. You shouldn’t do that. As to how you would be looked at if the board knew you’d been diagnosed with PTSD, I would make sure to read your practice acts. If you are on any medications, would that interfere with your practicing medicine? If the answer to that is no, then I would most certainly report the appropriate MD’s and nurses. That will wake them up.

        You keep forgetting that you were the patient. You were not a patient doctor. Just a patient who should have received the same quality of care that everyone else does. If this is an example of how everyone is treated at that facility, it needs to be made known. If you were a rarity because of your profession, they need to be spoken to by their boards.

        Regardless, unless you left out that you asked them to do all theses things to you, you were wronged.

        PTSD does not have the label that it once did. There are a lot of people out there who are getting treatment for that. Those people are in a lot of medical fields as well. I’ve taken care of a good number of medical professionals who have come back from war and they have been able to return to their practice despite that diagnosis.

        Go look in the mirror and remind yourself you were a patient. Then go do what you feel needs to be done. It sounds like you still need resolution and this may get you some.

        The other person who mentioned about charting; we are taught as nurses “if it wasn’t documented, it wasn’t done”. The opposite also is true. If it was documented, it did happen. Just because someone wrote down that you or your baby had an issue that was WNL doesn’t make it fact.

        The issue with this is that charting to cover yourself is just like a lie. And it is difficult to continue to do so without giving yourself away. When you check your medical records, do you see anything that doesn’t jive? Times, doctors orders, procedures, signature page. Every order and comment needs to be validated throughout the chart. I’ve had cases where a nurse has gone in the week after a patient died in an ER and inserted charting to cover everyone’s buttt. She messed up and actually put the current date on the notation. I’ve also been fired for refusing to falsify a patient’s chart.

        As I see it you have three options:
        1. Continue on the path you’re currently on and hope in the end, it helps you.
        2. Consult with another attorney. They may either review your chart themselves or get someone in that medical specialty to do so if they feel your case is potentially a good one. A malpractice attorney spends about $150,000 to bring a case to court. They will look at MR and the case and see if they can at least break even. Unfortunately at times it does come down to money.
        3. Report the appropriate people to their boards.

        • Anonymous

          >>YOU are still putting all the blame on yourself. You shouldn’t do that.>>

          You sound like my psychologist. And my husband, my best friend, and my sister. I’ll get there.

          >>If you are on any medications, would that interfere with your practicing medicine? If the answer to that is no, then I would most certainly report the appropriate MD’s and nurses. That will wake them up.>>

          No, I’m not on any medications. I self-paid cash for my counseling in order to avoid future problems with my insurance company. While I did scale back my practice radically for a while, I was more fortunate than Dr. Pil and have been able to return to full-time practice. But I’m not willing to make those counseling records public.

          >>You keep forgetting that you were the patient. You were not a patient doctor… Just a patient who should have received the same quality of care that everyone else does..>>

          At this time, confronting the surgeon is not a healthy option for me, though I feel guilt that others may experience the same hurt and down-the-rabbit-hole bewilderment I felt at her hands. As you said, I was the patient. I’m trying to remember I’m not responsible for that surgeon’s patients, too.

          >>If it was documented, it did happen. Just because someone wrote down that you or your baby had an issue that was WNL doesn’t make it fact.>>

          The other Anonymous posted once re: jaundice and a spinal headache. I don’t think she is a physician. My situation was a poor surgical outcome but did not involve childbirth.

          In my case, the situation is well-documented in the records and in e-mail communications with the surgeon, including numerous dated examples where the surgeon’s responses to my questions did not match the medical records (especially entries by her associates and staff). The attorney found a wealth of information.

          >>that charting to cover yourself is just like a lie. And it is difficult to continue to do so without giving yourself away.>>

          See above.

          >>As I see it you have three options:
          1. Continue on the path you’re currently on and hope in the end, it helps you.
          2. Consult with another attorney.
          3. Report the appropriate people to their boards.>>

          Re: 2. – I’ve spoken with several attorneys. The one who finally met with me was a referral by an attorney friend who works for a hospital. My case is worth about $15K (would be worth maybe $30K with physical harm), not $150K. I believe the attorney; we wouldn’t be able to pay the medical expert, even if the attorney worked pro bono. I don’t want any money for myself.

          At some point, I may report the surgeon to the board of registration, perhaps when I leave the area. I simply don’t have the energy for confrontation. I did report the surgeon’s behavior to the managing partners at the practice for which she was working. She has since joined another practice, but I doubt my case was the catalyst. In the meantime, I’ll continue to rebuild.

          • http://www.legalnurseconsultingofamerica.com Rochelle

            Well, I wish you well and just do what is in your comfort zone. Many people are going to the internet to check physicians. You are able to leave comments. Of course you don’t want to slander anyone regardless if they deserve it. But it’s your right to mark them and the facility at the lowest scores. That may prevent some patients experiencing what you did. I wish you much luck. PTSD is difficult and not fast to get to the point where you can lead a healthy mental life. I’m receiving tx for PTSD although thankfully not the same situation as yours. It’s a long road with a lot of potholes in the road. I learned not to wear makeup to my appointments as it usually ends us smeared all over my face. But, I do find the counseling helps. This back and forth is also good for you although at times I’m sure the responses are frustrating.

            Enjoy your family and make sure none of your patients you ever treat in the future don’t experience the same issues where you can help it.

            good luck.

  • http://www.brightonyourhealth.com Mary Brighton, MS, RD

    This is a shocking story…and I believe it is not as uncommon as people think. I am happy that you got yourself some pyschological treatment and you made steps to address your concerns with a letter to the hospital.
    I feel that WE all have had either some very positive or very negative experiences related to our interactions with health professionals. And as a health professional, we need to be fully aware that our actions, whether verbal or non verbal can affect that client or patient’s attitude toward their mental and physical health.
    In addition, through my work as a dietitian counseling new mothers, I have seen many cases of how a traumatic birth experience (for example emergency C-sections) has affected that initial bonding experience between a new mother and her baby. This also cannot be underestimated by medical personnel.
    Good luck to you,
    Mary Brighton MS, RD

  • Doc99

    Thank you for your thoughtful and poignant post. Does anyone here think the PPAHCA will make the scenario described more or less likely?

  • anon

    What is saddest to me about this post is not the possibility of substandard care, as it was the lack of human decency. The doctors and nurses most likely started off as bright-eyed, bushy-tailed idealists who got into medicine to help people. What about the curriculum or the practice leads to the loss of such decency? Is it worth it?

  • SarahW

    Jerry, the reason is they, to put it bluntly, screwed up and they knew they had. DENY DENY DENY. They go to sleep knowing how dishonest they are.

    The possibility of being sued is no excuse for poor care or the treatment of the patient. Everyone can be sued for screwing up. Man up.

  • SarahW

    The “sneak induction” comment was a jaw-dropper.

    The reason he suspected it is because he takes shortcuts, and is a sneak himself.

  • jsmith

    This was crappy impersonal care, but not malpractice. They diagnosed your hemorrhage and treated you appropriately. They treated your baby appropriately. You deserve an apology (which you will probably never get), but you do not deserve hundreds of thousands of dollars in compensation. The punishment should fit the crime.
    But eventually, if they keep this up, these docs and this hospital will combine impersonal care and a bad outcome and they will be nailed big-time. I wonder if they know it.

  • DWBennett

    As sad as this story is, you can only imagine the untold horror stories from the unsophiticated patient who isn’t connected, and can’t command the public bully pulpit to tell their story. Even if they could, I wonder if they would receive the same sympathy as expressed in the comments here. Could it be that when “one of our own” is violated with sub-standard care that the cries of indignation are justified?

  • http://www.linkedin.com/in/achievementstrategies Marie

    I am so sorry what should have been a joyous occurrence turned into such a traumatic one. I am glad you are doing better and I thank you for this lucid and telling chronology.

    As a patient with a chronic illness (MS) I can tell one horror story after another about practitioners who have lost sight of the fact they are treating human beings. Or perhaps they never held that concept from the beginning.

    On the other hand, I have received much wonderful and compassionate care.

    This goes back to what I have said before on these pages and will keep saying. What is wrong with medicine in America today, more than anything, is a tolerance of mediocrity. The good guys MUST stop looking the other way. A major problem with that is so many of them have revenue, they way they support themselves and their families, tied up with the same facilities that back up the unprincipled jerks. Unfortunately, callous and unprofessional behavior is just as often overlooked because people don’t like to rock the boat.

    Sharing your story may make some people think twice about ignoring what is flat out wrong.

    Thank you. I wish you a peaceful and thorough healing process.

    As an aside, the charting is appalling. In nursing school, our instructors would have had our guts for garters if we had written anything as stupid as ‘passed medium clots’. Medium?!?! What’s ‘medium’?! My medium and your medium could be light years apart. It should be ‘..patient passed 2 clots, each approx. 10 cm. in diameter; c/o weakness, nausea, sob. Per order, O2 started at 3 l. via nasal canula…’. You get the idea. Absolutely pathetic. And indefensible in court.

  • TrenchDoc

    My advice to you is to get some counselling,get over it and get back to work. Use this experience to make yourself a netter doctor. Then use this experience to hurt those that hurt you where they can be hurt – in their pocketbook. Influence the mothers of your patients to seek their OB care with anyone but this group. Revenge can be sweet if you are patient.

    • Anonymous

      >>Influence the mothers of your patients to seek their OB care with anyone but this group.>>

      That’s slander. Furthermore, Dr. Pil is no longer practicing medicine, as a result of PTSD triggers in the healthcare environment.

    • Revenge

      @Revenge can be sweet if you are patient.

      We patients that have been harmed by our doctor become “doctor bashers” as labeled by the readers of the Well Blog at the NY Times. Our voice has become the constant criticism of doctors. Those that receive compassionate care don’t complain about their doctors. Compassionate doctors don’t worry about RateMDs.com.

      I am glad you feel that revenge is sweet. I haven’t quite “gotten over” my traumatic, no apology medical experience. Off I go to the NYT to see what I can complain about.

  • Kim

    “Revenge can be sweet if you are patient.”

    I can’t believe you feel that quality medicine is acheived by vindictiveness.

  • SarahW

    Anonymous, it’s not slander.

    • Anonymous

      It may not be slander if it’s the truth, but the physicians involved could certainly sue for slander.

      As has been discussed many times on this site, anyone can sue, even without grounds.

  • SarahW

    Quality medicine is partly achieved through consequences applied to bad medicine.

  • Anonymous

    >>I wish you much luck. PTSD is difficult and not fast to get to the point where you can lead a healthy mental life.>>

    Thanks. I was relatively ignorant about PTSD prior to this experience. I thought I had major depression until I realized flashbacks and hypervigilance weren’t classic symptoms of depression. That’s when I sought help.

    >>I’m receiving tx for PTSD although thankfully not the same situation as yours.>>

    I’m sorry to hear that. PTSD is a miserable problem. I’d much prefer to forget this period of my life, but I still have flashbacks. When that happens, I’m back in the moment, and I feel that fight-or-flight fear for my life.

    And there’s still a tiny corner inside my head that believes I must be weak to have PTSD.

    >>This back and forth is also good for you although at times I’m sure the responses are frustrating.>>

    Still, I hope those who are “frustrating” never experience a medical mishap. Physicians and their families are not immune from poor care (I thought my degree and training would protect me). Patients who complain of poor care or even outright malpractice are not all cranks.

    >>Enjoy your family and make sure none of your patients you ever treat in the future don’t experience the same issues where you can help it>>

    Part of the betrayal by my surgeon was the growing realization that not every physician cares for her patients first… some care for themselves first. I don’t understand that kind of practice. That’s not why I became a doctor.

  • lady patient

    Kim, Telling the truth is not vindictiveness, I would expect no less than honesty from my doctor if I ask his opinion of, or recommendation for, another doctor, hospital, procedure, etc.

    Anonymous, If you ask your doctor if he himself would go to a particular doctor for a certain problem, and your doctor said ‘no’. Is that slander?

  • Anonymous

    >>If you ask your doctor if he himself would go to a particular doctor for a certain problem, and your doctor said ‘no’. Is that slander?>>

    Sometimes my patients ask me that very question, and I try to answer honestly and diplomatically. Usually, I say: “I recommend Dr. X” (emphasizing the positive qualities of the physician I do recommend).

    Answering a direct question is quite different, however, from “influencing” my patients NOT to use a physician.

    For example, the surgeon with whom I had a poor outcome is not a bad surgeon. She isn’t even a bad person. She’s an average, maybe above-average surgeon, and an average, maybe below-average human being. Not someone who ought to lose her license – not unlike Dr. Pil’s physicians.

  • TrenchDoc

    All she has to say when asked about that group is “They were once my doctors but I had a bad experience and now they are no longer my doctors”. The plain simple truth is always better than hyperbole and hysteria.

  • jennie

    I am also a physician and had very unpleasant delivery experiences with both of my daughters. To add insult to injury, I read my chart and found many completely unfounded and untrue statements about me and my behavior. A simple comment that “just wanted to let you know the shower in this room doesn’t work” turned into “patient complaining throughout delivery process”. I was spoken to rudely by staff at all levels. I think I have a milder form of PTSD as well. It is amazing to me that physicians will treat anyone, including another physician, this way. I’m glad you told your story. You are certainly not alone. I hope the joy you found with your baby eventually rises to the top of the memory, and you have a long and happy life without any other influence of this event.

  • Liz

    I’ve heard many women over the years talk about “medical births”. Birth is safer these days and not so many women or babies die, but boy, can it be a brutal experience?
    I have a friend who contributes to the BirthTrauma site…where women can support each other after brutal treatment during delivery.
    I sometimes wonder if men gave birth whether we’d have anything to talk about….
    One young Dr told me once that women can’t have dignity and privacy because they have babies.
    Wrong! Go back to medical school…
    I had a baby and because I have no trust in the medical profession, I left nothing to chance – interviewed three female gyn’s, toured and settled on a private hospital that allowed me to give birth in my own room privately or if a c-section was needed, private prepping and only required personnel in the room.(as few as possible)
    I didn’t want to give birth with an audience, I don’t consider birth a spectator sport. I firmly believe many women struggle to give birth with no privacy.
    My MIL had two babies at home with a midwife in the UK, in her own bedroom with the fire on and a pot of tea on the table…gas and air for pain.
    I wouldn’t be game to do that in case I got into trouble, but then there are many “surgical” vaginal births and other traumatic births in hospitals where women are treated like slabs of meat…and the damage is long-lasting.
    One woman told me her soul was bruised…her husband was so traumatized that he had a vasectomy a month later. (still no regrets 4 years later)
    That poor woman had three male medical students sewing her up and making uncomfortable jokes along the way. That woman said the human part of her died at that moment – it was deeply humiliating. Her husband suffered as well seeing the woman he loved being treated so insensitively.
    I think the medical profession needs a major shake-up and it needs to happen from the ground up.
    We need to let other women know about the hospitals that fall short.
    We need to let the profession know what we expect and get our husbands to support us…complain, refuse, report…don’t accept unsatisfactory treatment or attitudes! It’s time to fight back, these people and “hospitals” are the enemy.
    On another subject, all women need to demand the truth about breast and cervical screening. At the moment there is no informed consent for women…we’re over-screened, screened inappropriately, over-treated, harmed by unnecessary exams and treatment and the States leads the way…
    The annual gyn exam is unnecessary and risks your health – also look at the evidence and only have smears and mammograms if you’ve made an informed decision and if you have them, set the screening interval and start and finish dates to minimize the risk of harm.
    These awful tragedies make us all wake up….this was a disgusting way to treat a human being.
    I’d be naming and shaming, I know you have your career to think about but that “hospital” and those “doctors” and “nurses” need to know that sort of “care” carries serious consequences. If they can’t do better, they need to find other jobs…

  • Anonymous

    >>there are many “surgical” vaginal births and other traumatic births in hospitals where women are treated like slabs of meat>>

    One of my close friends, a large animal veterinarian, had two c-sections (the first for transverse presentation, the second scheduled). While she wasn’t traumatized, she described the experience as being treated like a slab of meat. As she performs c-sections in practice herself, on actual slabs-of-meat-to-be, I think she’s well-qualified to make that assessment!

  • anonymous

    I am a doctor in India and despite our system being not as good as the US system[!!!],we as doctors do get better care than this gruesome incidence.In fact my friends in US tell me that they spend more time in paperwork than in actual treatment.This is a consequence of the fear of malpractice.Have we ever thought that it is a fraud perpetrated by a combination of lawyers and judges who belong to the same proffession.

  • SarahW

    No, Trenchdoc, that’s wholly inadequate. The correct response is to tell what happened, not to hint at some vague unpleasantness.

  • http://www.TheWriteTreatment.com Barbara Hales

    The care and treatment discussed in this article is tragic and a travesty to us as human beings.

    Unfortunately, the dreaded behavior is on the rise and will continue to be on the rise, (as an obstetrician, I myself have witnessed the increase in such dispicable mannerisms) fostered by a few “advances” creating the “perfect storm”.

    While years ago there was a very strong bond between physician and patient, the relationship has been totally severed. Frequently I have heard patients state, “Doctor, you delivered all my children and saved my mother’s life but my insurance changed and so I am transferring my care”. Meanwhile, the doctor has poured all his/her emotion and care into that patient. With no patient loyalty, the physician is being trained to not care as much. (after all, they are only human)

    Add healthcare reform whereupon doctors now focus on the computer more than the patient and decreased reimbursements with rising expenses, and you can understand that physicians are under a tremendous strain and also need to see more patients in a shorter time to make ends meet.

    While all of this does not justify being inhumane, it does explain it.

  • Christina

    I currently work a large hospital and I am in nursing school. The key to nursing from what I have learned/seen is patient advocating. Someone should of spoke up for you and I am so sorry that someone didn’t. It seems that all these hospitals care about is get them in get them out. It is sad that care of patients isn’t allowed because of money.