This is a true story as told to me by one of my OB/GYN colleagues who now works non-clinically in the health care industry. The sad thing is that she really was very good at treating sick patients in an inner-city hospital (for low pay), but this case (as well as lesser input from other small annoyances and inefficiencies) basically forced her out of clinical medicine. She was just too upset and disenchanted after getting through the aftermath.
So she was on-call for the Labour floor one night. She really was sort of a black cloud since she had more than her fair share of disasters come her way. This particular night, she was called to assist a resident in a vaginal full term delivery in a 17 year old illegal immigrant who by the way, already had another healthy child. The delivery was supposed to be routine although she had not really had much prenatal care. Nothing seemed particularly abnormal. In fact, the child came out fine with good apgars. Then the trouble began. After delivery of the placenta, she would just not stop haemorrhaging. This is called a post-partum haemorrhage and can range from a minor annoyance to a complete disaster. At first it did not seem so bad but the standard fundal pressure and vaginal packing did not work. Next she tried Oxytocin and just about this time it was evident she was losing too much blood so a transfusion was ordered. This would turn out to be the first of about THIRTY units of packed red cells she would receive!!!! An emergency D and C to try to remove placental remnants also did not help. Finally the decision was made to take the patient to the OR. She was semi conscious and had to be intubated and received wide open fluids in addition to the blood, fresh frozen plasma, and eventually platelets. While in the OR my colleague emergently opened this girl up and after unsuccessfully trying to massage the uterus manually, injected epinepherine and methergine directly into the uterus! Still blood poured out! Finally with no other options left, the girl had a hysterectomy which took out the offending bleeding site. The girl was still in rough shape and it was touch and go if she would survive. Pressors, fluids,blood products all keeping her alive. Finally after a few hours, she seemed to stabilise. By now about 5 hours had passed since the onset of the bleeding. The docter went out to find the family and tell them what had happened, feeling pretty good that the patient was still alive and now was improving. As soon as she told the family about the situation through a translator, they all at once had one response: “YOU TOOK OUT HER UTERUS!?!?!?!?!”, “SHE IS ONLY 17!!!”. Never mind that the girl was ALIVE! Never mind that the baby was fine, and that she already had one other one! Never mind the she explained how she came to have to do the hysterectomy as a last resort. Never mind that the girl made a full recovery and was discharged from the hospital in about two weeks! What was my colleague rewarded with for her life-saving efforts? You guessed it,
A Lawsuit
Now as you may have read in one of my previous posts, this city hospital system has a tendency to just pay settlements to make the cases go away. However, this one they decided to fight, Thank God. Turns out the only damages the patient could claim were for lost wages (which I can’t imagine was more than minimum wage) and the loss of the uterus. The whole mess dragged on for about a year and eventually the case was thrown out of court! This was due in no small part to my colleague’s excellent documentation, and the RN’s and anaethesiologists involved all gave depositions supporting her care. The whole process just wiped out this doctor’s will to treat patients again. She was so upset just thinking that she had tried so hard to save this poor girl – and was successful, only to be rewarded with an angry letter signed by “Money Grubbing Loser, Esq”! She went to work briefly in an outpatient GYN clinic (no OB) but then went back to school, got a MPH, and now works nonclinically. She says she now tries to “Help people from behind a desk”. Too bad, because she is much better at dealing with cases when the Sh** hits the fan, than many other GYN’s that I know. When all the good doctors leave clinical practise, what is left?
OK – I think there was a conflict with the add that was below this post – appears to be fine now.
That just Sux!
[...] ER Stories tells about a doctor leaving practice after being sued for saving someone’s life. [...]
And if she’d died, the doc would have been sued for not performing the hysterectomy soon enough.
I was talking to my lab partner in my organic chemistry class the other day. We were talking about medical school, and she said that she didn’t really want to practice medicine, just have the degree in her background in preparation for law school. “Oh,” I replied, “so instead of practicing medicine, you’ll be putting the people who practice medicine out of business.”
It is possible to be guilty of serious error (or one of your support staff under your supervisionmay be guilty), AND try to heroically save your patient.
Glossed over here, since there are no facts shared to shed light on the actual allegations, and this a sketchy anecdote, is the potential to bring about this kind of obstetric catastrophe with impatience and one tug too enthusiastic on the cord. If it didn’t happen here, it does happen.
There was no settlement at all, so known facts did not support one.
But I suggest to you, perhaps the doctor’s distress stemmed from lack of full confidence in her monitoring of this patient immediately after delivery, or her
suspicion that an ob nurse had tried to hurry things up. Because I can’t see her doubting for one moment the ultimate necessity of hysterectomy.
Well, I can tell you – regardless of whether the cord was pulled too hard (which I don’t see how it could cause the uterus to become atonic), the fact is, she tried for over several hours to prevent the hysterectomy. There was not a shred of doubt in the support staffs’ support of the final decision. And besides, the girl and baby lived.
That’s a shame that the OB doc decided to get out of the field because of this incident (I’m sure this probably was not the only one…I hope…..that caused him/her to want to get out of the business entirely!). But, kudos to him/her for saving that 17 yr old’s LIFE!
many times this is what drives people from the industry.
personally I think that we need to be able to tell people we can’t take care of them.
I went to the attorney’s office and said I’m getting sued for a car accident, he said that will be $10,000, I don’t have it, so I left.
It doesn’t work the same for the doctor, they have no choice, and they typically don’t get paid for the work they do.
Was she Latina?
I don’t want to sound like I’m stereotyping here, but Latino culture puts a very high premium on families and children. So for this very young woman, to lose her uterus and no longer be able to have children would be pretty devastating.
Sometimes when you save lives, it comes at a cost to the patient. And you can get so caught up in the adrenalin that you never acknowledge the price the patient and family might be paying. Instead, the attitude can be, “We saved your life; how dare you be ungrateful!”
Not saying it’s right or wrong, or that this situation wasn’t unfair. But it might help explain the family’s reaction. Our own prism of beliefs and values and culture and life experiences isn’t the only way to see the world.
Regardless of the race – I can’t imagine that they would rather have had the girl die with her uterus intact. Also, even if the loss of the uterus was distressing to the family, a lawsuit is not a reasonable way to settle such a loss when the alternative was death. I bet had she died they would have sued just the same however.
Wow, that is a powerful story. I can only say that I’m glad you could save the girls life, regardless of what had to be done. The fact that a lawsuit ensued is completely asinine. I compliment the fact that she still does try to help. Hats off to ya’.
I agree the fact that a lawsuit ensued is completely asinine, but, all medical facts & opinions on the case aside, it is SUPREMELY asinine that an illegal immigrant have any rights to even sue!! If I were to rob a bank, could I keep the money I took after I was caught? Of course not! The money would be returned as I obtained it illegally and we are not allowed to benefit and/or profit in America from illegal activity. Well, after we get past the fact that she’s an illegal immigrant, anything that does or benefits from is due to an illegal activity. Different setting, same principle. I mention this because near where I live several illegal immigrants cross over the Mexican/American border just to come here to have their children here, it is paid for with by SCHIP dollar(funded by U.S. taxpayers through a program in my state called Phase IV), and then, having their baby here illegally, gives the illegal immigrant legal rights that should not be. This not only is a strain on taxpayers(through U.S. tax dollars & state tax dollars-generally on a 70%-30% ratio), but also, as in this case, on our medical professionals with not only having to worry about being sued, but also with their malpractice insurance. This wrong to have to put this extra strain on our medical professionals. There are now 300 million people in America legally. They do not need the added worry about people who come here specifically for their help, but illegally, having the right to sue them.
People wether legal or illegal have rights. Just becasue they are illegal does not mean that they should be disregarded. A medical health professional should be a medical humanitist. The fact that the girl was Mexican, European, African, Asian, American, Arabian, Australian etc should not be the focal point of this case. The problem is that people form all back grounds want to be secure- as it is a basic human need. People will grab money if it’s available, may be with the original intention of thinking that have been wronged. Not every one is priveledged with god education and money.