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Known Epidural Failure - Before Emergency C-Section Incision

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billy2009

Junior Member
My question involves medical malpractice in the state of: New York

Ok - sorry if this is not that clear I am not the best story teller, so I will try to articulate the situation with bullet points.



My questions are -
Is this case worthy? I just do not think writing a letter to the hospital to complain would really hold the people accountable for their mistakes. :wallbang:
Any recommendations of who I should call?



- Me and my wife were expecting a baby
- No major problems during prenatal care. Everything seemed normal
- My wife went to full term (38 weeks according to the hospital/midwifes that were advising us)
- My wife went to a regular weekly check-up @ 38 weeks
- At this check up we did standard blood work to test for preeclampsia
- Her test came back positive due a intermittent high-blood pressure result and high levels of protein
- Our midwife/nurse ordered a 24 hour urine test to confirm the results
- Results of the 24 urine test came back with very high levels of protein in her urine

Small tangent -
Later (during labor) we found out that the level of protein in my wife's urine was higher than anyone we talked to had ever seen. I am no expert, but In my mind it would raise the question of a false-positive result; As my wife was relatively A-symptomatic out side of one irregular high blood pressure result in combination with this "extrodoary high" level of protein in her urine. Probably unrelated as I am not really at odds why we needed an induction. I just think this adds some context.

*As my understanding of diagnosing preeclampsia you need to have high blood pressure and high protein content in urine
-
-My wife called our midwife/nurse to confirm a follow up appointment for the results of our 24 hour urine test
-We were told that we to check into the hospital immediately for an induction
-We arrive at the hospital to be admitted for an induction into labor
-Every thing is pretty standard in-terms of the induction

-The hospital staff is comprised of:
-Our midwifes who work out of the medical clinic from where we receive our prenatal care and hospital staff.

-Our midwife's main goals are basically ensure that everything happens natural up into the point that ether my wife's safety or our child's safety is compromised.
-And to help us stay informed about all of the procedures that may need to be done and to explain the "technical" side of the birthing process at our level. or in other words to help the hospital establish informed consent.

The hospital staff i.e Resident nurses / Doctors / Anestigologist / Surgeons ect... are there to do what they do.

Anther small tangent.
Also there seemed to be a lot of tension between our midwifes and hospital staff. In terms of who can do what, and what everything meant. And it was very apparent.

- ok on to the labor -

-We (nurses and midwifes) start induction by administering my wife poticin
-Contractions go on for about an hour
-Midwifes and Nurse's ask us if they can break my wife's water
-Me and My wife talk about this and agree.
-We tell the midwifes and nurses that we are scared of things escalating to a c-section and also we are not doctors and we will trust what they think if they acknowledge that this is the best thing to do.
- They say that this is standard practice when they are inducing labor
- Next my wife requests and epidural and it is administered
- Contractions increase but my wife never dilates past 7cm and we need to be at ten
- At this point it seems like a downhill battle
- They use another monitor internal monitor to check for contractions and administer fluid to the baby as the water was broke and a slight decrease in hart rate started to be noticed and the fluid is meant to help with decreases in the babies heart beat

- this goes on for over and hour or two with slight decreases in the babies hart beat when the contractions - they say what we are seeing is normal but it needs to be monitored
-during this time my wife was asked to change positions constantly for and hour or two with each contraction to find a "sweet spot" for the baby during each contraction
- We seemed to find a good spot then shortly after the close monitoring ended
- Soon after it seemed that the epidural was no longer working
- Their still were drugs in the epidermal machine and it was still pumping but it seemed my wife was not getting any relief from them as my wife was really feeling pain during these contractions -
- we asked to have some one help us fix this
- the nurse called for the Anestigologist to "top her off"
- I think the nurse assumed she needed a different type/additional drug
- we waited 20-30 minutes for the Anestigologist
-called the nurse again
- a different nurse came in with our nurse who came in right behind her and told the new nurse that she called the Anestigologist and he is coming down to top her off.
- Our then nurse explained the same thing to us and that she was on her break and thats why the other nurse came in.

- Then she assured us that Anestigologist is on his way down in about 15 minutes or so.
- 15-20 minutes later team of doctors and nurses come in the room and hook up a more accurate monitor for the babies heart beat

In less than one contraction monitor is in
The next contraction comes and the baby heart beat is dropping to about halfway down from a good 150 bpm


Last tangent
Looking back one of my regrets is... I did not interrupt a room full of doctors in a critical situation to point out the obvious. I just did think I would be helping. Only if I had know... I digress

-I did not mention anything to them as it seemed to a very urgent situation
-I felt like I would be interrupting a critical process
-It was obvious that my wife was in pain.
-The nurse we told that there was an issue with an epidural was in the room
-There were at least 2 doctors 1 surgeon and many other people in the room.
-I thought one of these people in the room is the Anestigologist


From delivery room to Or table takes no more than 5 minutes and I would even say that is actually longer - I could of been closer to 3 or 2 minutes. But everything at this point seemed to slow down for me.
.. and the next part is really hard for me to read or write. As this is painful for me to even think of.

- I get this blue suit to put on in the delivery room and my wife has already been pushed out of the room while im trying to put it on
- The midwife helps me gather our belongings and tells me she will take care of our stuff
- A nurse walks me down the hall to the front of the operating room door where my wife is
- The nurse is helping put on my mask and making sure I am not going to faint
- I see them start to prep my wife thew small opening in the door by throwing iodine on her getting the blue curtain up that I am going to stand behind
-The door closes
-I hear my wife scream in pain
-Are waiting to be let in
- Some on comes out and says this is now a "stat c-section" and I can't come in
-I hear my wife a little more after this saying no no no!!
- in about 20 minutes
- The baby is born healthy :)
- In About 15 get to come in a see the baby and take a pic ;)

- I wait for my wife as my baby is in the nursery
- I think the Anestigologist (some one from the operating room) comes out and tells me
1. My wifes epidural was not working
2. So they had to put her under
3. Thats why you couldn't come in
4. Your wife is ok and your baby is healthy

- my wife is rolled out and and is now waking up from being under and is still saying no no no... no no no... as she was when she went under. only now she is incoherent and waking up from medication
-after my wife wakes up and can talk she told me
- in the operating room
-she told them that the idodine was cold when they poured it on to her stomach
-she told them that she could feel her legs and
-she tells me she felt the c-section incision and thats when she screamed
-she then told me they said the epidural was not working ( the Anestigologist confirmed this with me earlier but left out the detail that my wife went under the scalpel and felt it)
- the room became very chaotic
- people began to re-try to administer drugs by epidural and test to see if was NOW working by prodding her with the scalpel
- she told them it still hurt
- then she said they started to administer drugs via her gas mask to knock her out except she felt like she was choking and fought them because she felt there was no O2 coming threw her mask.


ok - emotionally that was really hard for me to write towards the end of this
sorry if It is hard to read. I did not think it would be this long.

Thanks in advance -
 


ecmst12

Senior Member
Your wife experienced complications with her delivery. That can happen. And different people react differently to anesthesia - it's not always possible to predict exactly whether and epidural will work or what dose is needed. Some people are naturally resistent to anesthesia.

Your wife and baby are both ok. Isn't that what's REALLY important?
 

lya

Senior Member
Other than the lengthy epistle, I don't see anything wrong, unless the epidural catheter had dislodged and nobody checked to see. If it had dislodged, I'm not sure what action would have been taken except maybe to do another epidural procedure or a spinal or go with general anesthesia as was done.

Once it was determined that the patient was able to feel the procedure, general anesthesia was given and the baby was delivered without problem.

The OP's wife is not the only person I've heard of suffering this type of epidural failure; my niece suffered the same failure of the epidural. This time, my niece is receiving a spinal as the MD believes epidural placement does not work for her.

Bad results do not equal medical negligence or medical malpractice.
 

billy2009

Junior Member
Your wife experienced complications with her delivery. That can happen. And different people react differently to anesthesia - it's not always possible to predict exactly whether and epidural will work or what dose is needed. Some people are naturally resistent to anesthesia.

Your wife and baby are both ok. Isn't that what's REALLY important?
OK, I am torn between trying to be candid, with out sounding defensive or offend you.
I do not think you really understand the big picture here, what I am talking about, or you just failed to read my post. What is it?
-Your wife experienced complications with her delivery-
I do not see how this applies according to this.
http://en.wikipedia.org/wiki/Complication_(medicine)
when I am talking about this
We told them the epidural was not working about 45 minutes before the situation became critical -
-she told them that the idodine was cold when they poured it on to her stomach
-she told them that she could feel her legs
- Then they cut her open for the c-section and she felt the entire cut to stomach

-That can happen.
well I understand "that can happen" beacuse it did. Now is that ok?
I think not. That was a huge mistake we told them it wan not working.
And they could of put her under BEFORE they sliced her belly open.

Have you ever seen what it looks like? A c-section incision?

- it's not always possible to predict exactly whether and epidural will work or what dose is needed. - ok that is a generalization that would work for just about anything I can think of.
That is unacceptable.
Think about it - It was working - She was told to move in 20 different positions once every minute or so - then it stopped working and we told them almost an hour before she went under the knife. It was ASSUMED that everything was working by the surgeon and the anesthesiologist until they cut her. WHEN WE TOLD THEM, MORE 40 MINS BEFORE SHE WENT UNDER THE KNIFE.

Thats a complication ? How? Why?

-Some people are naturally resistent to anesthesia.-
This is irrelevant - and a generalization
It was working - It stopped working - We told them - They failed to act on this until they cut her open - they had the option to put her to sleep in the same amount of time. They did not.


Your wife and baby are both ok. Isn't that what's REALLY important?
Yes we a ok - but what happened was unprofessional and grossly wrong.

Thanks.
 

billy2009

Junior Member
-Other than the lengthy epistle, I don't see anything wrong -
Funny... lets try to bring it down to earth so I do not have google that epistle means letter:cool:

- unless the epidural catheter had dislodged and nobody checked to see. -

Very likely


-If it had dislodged, I'm not sure what action would have been taken except maybe to do another epidural procedure or a spinal or go with general anesthesia as was done.-

Well the action ( whatever it should of been ) should of been taken BEFORE they cut open her entire midsection.


Once it was determined that the patient was able to feel the procedure, general anesthesia was given and the baby was delivered without problem.
t
- Right. But - Do you think that should excuse the fact THAT THEY SHOULD OF KNOWN. I mean that is their job right? And we did tell them 40 minutes before it was a critical situation

The OP's wife is not the only person I've heard of suffering this type of epidural failure; my niece suffered the same failure of the epidural. This time, my niece is receiving a spinal as the MD believes epidural placement does not work for her.
-no comment

Bad results do not equal medical negligence or medical malpractice
- Bad results?? Im not too sure about that.
 

ecmst12

Senior Member
Your wife experienced complications when she was diagnosed with preeclampsia, and when her labor failed to progress. causing her to need a c-section. The complications are separate from the anesthesia problem.

Anesthesia failure does happen sometimes even in the absence of negligence. The patient having some sensation in the area does not necessarily mean they will totally feel everything. When they discovered she COULD feel it, they took the best and quickest steps they could to stop the pain and get her under for the surgery. The end result was a successful surgery, healthy mom and healthy baby. I'm sure it was very scary for both of you but there were no actual damages done to anyone.
 

billy2009

Junior Member
Your wife experienced complications when she was diagnosed with preeclampsia, and when her labor failed to progress. causing her to need a c-section. The complications are separate from the anesthesia problem.

Anesthesia failure does happen sometimes even in the absence of negligence. The patient having some sensation in the area does not necessarily mean they will totally feel everything. When they discovered she COULD feel it, they took the best and quickest steps they could to stop the pain and get her under for the surgery. The end result was a successful surgery, healthy mom and healthy baby. I'm sure it was very scary for both of you but there were no actual damages done to anyone.
Do you have background in law? I mean professionally? If so is it your practice malpractice/negligence suits? Or do you just troll? No offense. But you seem to be making assumptions that are way outside of what you really know. Also you are really not addressing any of my direct questions/statements/arguments towards you.
 

lya

Senior Member
I don't know the standards of care for all situations pertaining to an epidural; but, I do know the site has to be checked for bleeding, swelling, and wetness (which indicates a dislodged catheter). We check the site every two hours and more often if the patient is restless or complaining of unrelieved pain.

My advice is to ignore all of the other aspects in this event except for whether or not the standard of care was met as relates to checking the site and assessing for dislodging of the catheter.

Run this by a medmal attorney. Be prepared to hear that because no permanent damage or significant damage resulted, there is no viable medmal claim.

You may want to report this to JCAHO and the appropriate state licensing boards, as well as to the hospital administrator. Then, be prepared to find a new physician and a new hospital, which wouldn't be a problem for me if I had lost confidence in my healthcare providers.
 

billy2009

Junior Member
I don't know the standards of care for all situations pertaining to an epidural; but, I do know the site has to be checked for bleeding, swelling, and wetness (which indicates a dislodged catheter). We check the site every two hours and more often if the patient is restless or complaining of unrelieved pain.

My advice is to ignore all of the other aspects in this event except for whether or not the standard of care was met as relates to checking the site and assessing for dislodging of the catheter.

Run this by a medmal attorney. Be prepared to hear that because no permanent damage or significant damage resulted, there is no viable medmal claim.

You may want to report this to JCAHO and the appropriate state licensing boards, as well as to the hospital administrator. Then, be prepared to find a new physician and a new hospital, which wouldn't be a problem for me if I had lost confidence in my healthcare providers.
Thank you -
That is helpful

One thing that is perplexing still is what is the best way to find a lawyer
I wonder if there is a www.yelp.com for law... I might just try yelp. Other than that... I see billboard ads.. but I want to try and avoid "slezz ball" lawyers the best I can. I got one resource that looks promising. Just wanted to see if anyone knows of grass roots type org that can refer me. Thanks again!
 

lealea1005

Senior Member
Do you have background in law? I mean professionally? If so is it your practice malpractice/negligence suits? Or do you just troll? No offense. But you seem to be making assumptions that are way outside of what you really know. Also you are really not addressing any of my direct questions/statements/arguments towards you.

billy...no offense :rolleyes:, but do YOU have a background in medicine? Wikipedia does NOT take the place of years of medical education and hands on experience. Ecmst and Lya are knowledgable senior members who give out accurate information/advice.

From, both professional and first hand experience delivering my own child, I can tell you what happened to your wife's epidural was unfortunate, but it happens. It would seem that the staff would have made more of an effort to check the catheter placement, especially given your wife's repositioning herself so often. As Lya already advised, you can contact the hospital administrator and/or JACHO to file a complaint. You can also run it by a med/mal attorney, but I wouldn't hold your breath for a big payout. From everything you describe, I do not see a lack in the standard of care.

Congratulations on your new, healthy, baby.

ETA: Just wanted to add one more thing. It is not unusual to wait for an Anesthesiologist. It was not considered an emergent situation. The Anesthesiologist may have been attending another surgery.
 
Last edited:

ecmst12

Senior Member
The main thing that I see is that even if there was a deviation from the standard of care, there were no tangible permanent damages suffered by mom, dad, OR baby. Damages are required to make a lawsuit worthwhile. Pain and suffering is compensable in most cases, but only when it can be substantiated by actual injury/disability. I don't think I'm being insensitive for reminding OP that while their experience was not ideal (and really, I've only heard a few birth stories where everything went exactly as expected), no one was seriously hurt.
 

billy2009

Junior Member
billy...no offense :rolleyes:, but do YOU have a background in medicine? Wikipedia does NOT take the place of years of medical education and hands on experience. Ecmst and Lya are knowledgable senior members who give out accurate information/advice.

From, both professional and first hand experience delivering my own child, I can tell you what happened to your wife's epidural was unfortunate, but it happens. It would seem that the staff would have made more of an effort to check the catheter placement, especially given your wife's repositioning herself so often. As Lya already advised, you can contact the hospital administrator and/or JACHO to file a complaint. You can also run it by a med/mal attorney, but I wouldn't hold your breath for a big payout. From everything you describe, I do not see a lack in the standard of care.

Congratulations on your new, healthy, baby.

ETA: Just wanted to add one more thing. It is not unusual to wait for an Anesthesiologist. It was not considered an emergent situation. The Anesthesiologist may have been attending another surgery.
...no offense :rolleyes:, but do YOU have a background in medicine?
Wow - those comments were not directed at you. I guess this is underlining why this forum is tilted "free advice"

Wikipedia does NOT take the place of years of medical education and hands on experience.

Never said it did - but just to entertain you. To whom are you inferring to when you state "hands on experience" ? It seems you would be talking about the doctors/nurses AND NOT the person that I was responding within the context of what I was asking.

Ecmst and Lya are knowledgable senior members who give out accurate information/advice.

Never said they are not. I simply was asking what experience Ecmst has. It seems strange to me that - Ecmst has 12,090 posts since feb 06 - I so thats an average of 11 posts per day over three years. That makes me think a few things -
He is a great lawyer - so he has that kind of time on his hands
or
He is not a great lawyer - so he has that kind of time on his hands
or
He has a an personal interest in law - so he spends his free time on the boards
I could go on..

I just wanted to assume positive intent on his behalf.
However I find it interesting that you feel you should defend him.
Bit of groupthink do you think?

And as for Lya -
she actually was helpful -
However she did drop a sarcastic comment in her first post at me that I thought was funny.

Interns of the accuracy. I could not say that I know law. I do not think I know medicine . So your guess is as good as mine in terms of Ecmst's "accuracy" right?
I agree it was unfortunate. But what do you mean it happens? Epidurals or by mistake being able to completely feel being sliced open in the or?

I learned on another forum - much more helpful thus far.
Before she could get "top off" on the epidural the doctors need to examine her progress. That is what happened.
And in that process it was determined we needed a c-sectoin. IT WAS NEVER COMMUNICATED THAT THERE WAS AN ISSUE WITH THE EPIDURAL AMONG THE STAFF. Even if they checked it and it looked good we are still telling them it is not working. That is how anastasia presents its self right? . They only realized or I would say believed there was a problem when my wife was strapped down screaming in pain. Only then they stopped to listen.
That is standard? I really do not think so. If you say it is. THEN HOW? Where is your information coming from? How do you know? Im not claiming to know. I am asking. You are pronouncing the "accuracy" of people here. By who's authority ? There post count? I am not being unreasonable am I?
 

billy2009

Junior Member
The main thing that I see is that even if there was a deviation from the standard of care, there were no tangible permanent damages suffered by mom, dad, OR baby.
Damages are required to make a lawsuit worthwhile. Pain and suffering is compensable in most cases, but only when it can be substantiated by actual injury/disability. I don't think I'm being insensitive for reminding OP that while their experience was not ideal (and really, I've only heard a few birth stories where everything went exactly as expected), no one was seriously hurt.
Wrong - me and my wife were planing to have at least 2 more before this happened.
This damaged our life's forever.
 

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