Death and negligence

[rmet4nzkx]

I'm sorry for your loss, no parent should watch their child die in their arms.

In terms of medical malpractice, standard of care, however, emotions are not factors in determining whether the burden of proof is meet and you must be prepared for whay may seem to be an unjust or unfair outcome.

Medicine has come a long way and years ago there would have been nothing to be done other than watch your child die. Unfortunately, what happened is a conbination of a natural process excabertating the congenital defect so that the defect wasn't apparent at birth sometimes it is not apparent for years and in your case it was a matter of hours, which is very rare. Were there any other defects found on autopsy? It is not unusual for there to be more than one defect, which together might decrease the chances of survival and even if initial treatment is successful, the child requires continued monitoring and potentially more treatment in the future. It is not as simple as if baby received prostaglandins, baby would have surived long enough to avoid end organ damage.

The attorney will not only have to have the baby's medical records from the three facilities reviewed, but also your wife's prenatal care for factors contributing to the outcome.

For example, was this a full term birth, if not, what week?
Was the labor induced, if so, how?
Were there any signs of fetal distress during labor and delivery?
Did your wife have prenatal ultrasounds, if so, at what week and who interpreted the results?
Did your wife have any problems during either pregnancy?
While you have had genetic counseling and a previous healthy child, has your healthy child been examined by a pediactric cardiologist?

http://www.americanheart.org/presenter.jhtml?identifier=1667 As you will notice in the last sentence of the first paragraph, that symptoms can develop as early as the first week of life, but that is not the nore and usually it is after discharge from the hospital, the signs may not have been present upon examination. Your baby was examined in the nursery out of your sight many times so just because a pediatrician was not available or only looked at your child a mnute doesn't mean there was negligence, that will be revealed in the record.

I mentioned ultrasound (U/S) it is possible, especially if your child's symptoms were as severe as you indicate that there may have been a clue upon prenatal U/S, much has to do with the quality of the U/S and the objective clinical findings and how they comare to the post mortum findings, there may or not have been any warning. In addition to genetic counseling, if you decide to have another child, the prenatal testing and care will be very important and even U/S is not without risks.

It is possible that you preceive the hospital as being negligent whereas there may have been clues in prenatal care and even these might not rise to the level of negligence if they were within the standard of care. www.jultrasoundmed.org/cgi/content/abstract/8/2/65
www.jultrasoundmed.org/cgi/content/abstract/16/2/95

If all you want is for this not to happen to anyone else, make complaints to JCAHCO, hospital and professional boards who will investigate and make reccommendations to improve patient care.

 

[sam4u99]

A little saddened.

I am reading this thread and am a bit shocked at the replies. I am a new nurse, 1 year out of school. I am not working in OB or Peds. But, I am a nurse and I do remember everything I was taught about assesment skills and PARENTAL INSTINCT. This man is obviously not a new parent, having a 5 year old, and this was their 3rd day with the new baby, so obviously he is not oblivious as to what to expect. Yes, a coarc can be missed upon assesment, as there are not always preceeding s/sx but as he stated many times, he believed there was something wrong with the baby, as did others. He was ignored by two different nurses stating that "newborns do that". I believe that as a nurse the entire family is my patient and not just the baby. Being that I know that babies breathe hard does not mean that a parent does. Even if out of sheer respect for others, these nurses could of examined this baby, mabye there would of been s/sx, mabye not, either way I can't imagine shrugging a parent off and minimizing their feelings with regard to their child. Any nurse who does is in the wrong profession, she/he should've been a doctor. I agree with the majority of healthcare professionals with regard to frivilous lawsuits, as the general public doesn't have the knowledge to understand that sometimes no matter what you do their loved one could not be saved. But to suggest that they "are out to get" someone is ludacris. Nothing they do will bring that child back, so mabye, just mabye, they really want to prevent this tragedy from hurting another family!!!

 

[jackryan]

Ok..I sincerely thank you for all of your input.

I was looking more for legal info and not medical. I understand that med professionals feel victomized at times too but I dont think that justifies the lack of compassion and sympathy by some "medical professionals" here. We learned more than we wanted about congenital heart defects when our son was sick. We know and understand the facts of his illness and dealt with many professionals along the way. They were all great people and did there best. If we were wanting some kind of sick revenge we would be after the surgeons and others that took care of him for a month. When we went to the second hospital it took very little time to diagnose and treat him. The same could have been true at the origonal hospital. I believe that there was a negligent lack of care for my son and the hospital did not live up to it's advertised claims of being the best birthing center around. After all there slogan is expect the best. Well we did, but didn't recieve it. After all what kind of hospital doesn't have a pediatrician on staff to treat a child at a parents request? We just want the truth to be known. Again thank you all.

Sincerely,

Joe

 

[rmet4nzkx]

Ok..I sincerely thank you for all of your input.

I was looking more for legal info and not medical. I understand that med professionals feel victomized at times too but I dont think that justifies the lack of compassion and sympathy by some "medical professionals" here. We learned more than we wanted about congenital heart defects when our son was sick. We know and understand the facts of his illness and dealt with many professionals along the way. They were all great people and did there best. If we were wanting some kind of sick revenge we would be after the surgeons and others that took care of him for a month. When we went to the second hospital it took very little time to diagnose and treat him. The same could have been true at the origonal hospital. I believe that there was a negligent lack of care for my son and the hospital did not live up to it's advertised claims of being the best birthing center around. After all there slogan is expect the best. Well we did, but didn't recieve it. After all what kind of hospital doesn't have a pediatrician on staff to treat a child at a parents request? We just want the truth to be known. Again thank you all.

Sincerely,

Joe

Joe,
Could you answer some of my questions?

 

[jackryan]

Sure...I would be glad to.

 

[seniorjudge]

Sure...I would be glad to.

We are waiting, Jack/Joe....

 

[rmet4nzkx]

Sure...I would be glad to.

Perhaps I should repeat them?

The attorney will not only have to have the baby's medical records from the three facilities reviewed, but also your wife's prenatal care for factors contributing to the outcome.

For example, was this a full term birth, if not, what week?

Was the labor induced, if so, how?

Were there any signs of fetal distress during labor and delivery?

Did your wife have prenatal ultrasounds, if so, at what week and who interpreted the results?

Did your wife have any problems during either pregnancy?

While you have had genetic counseling and a previous healthy child, has your healthy child been examined by a pediactric cardiologist?

 

[jackryan]

Sorry I didnt realize you meant the ones you origonally asked.

For example, was this a full term birth, if not, what week?
Full Term C section...

Was the labor induced, if so, how?
She had diet controlled Gest. Diabetes They didnt want her to have a vback
The last non stress test our son was not moving. The Doc was concerned so he gave my wife some juice. She had several contractions during the test. The doctor did have some concern but our son began to move a little. They scheduled the section that day.

Were there any signs of fetal distress during labor and delivery?
No

Did your wife have prenatal ultrasounds, if so, at what week and who
interpreted the results?
Yes she had approx 12 ultra sounds and 10 non stress test. I dont know who went over the results. We will find out about that soon. As far as we knew all test were ok. My wife did have low amniotic fluid five weeks before delivery. They thought she might have been leaking fluid but decided she was ok. Now I think it might have been congestive heart failure. Like I said ...that is strictly my conclusion.

Did your wife have any problems during either pregnancy?
No real issues or problems. First child was 9lb c sec. but healthy. Our son was 7lb 12 oz 20 in long. Diet controlled gest diabetes on second pregnancy.

While you have had genetic counseling and a previous healthy child, has your healthy child been examined by a pediactric cardiologist?
Yes the cardiologist that treated our son and diagnosed him did ekg...ultrasound of heart and some other test....She was good.

Jack inherited a chromosome translocation from my wife. My wife has a bundle branch blockage, murmur, and mitral valve prolapse.

Jack had a coarctation of aorta....and after open heart we found out that he also had hypoplastic transverse aortic arch and mitral valve stenosis.

The surgeon who I consider to be one of the best said he may have had a fatal reaction to protomine. His heart and lungs quit once administered after surgery. He came back from surgery on ecmo w/o a heart beat.

We were told the coloring of his lungs and heart were very poor (pale grey)before surgery began. His lungs had scar tissue from hypoxia and escemia from his origonal insult. We were origonally told that treatment a few hours before he recieved it would have spared him alot of this organ damage. When prostaglandins were administered the watched his pda open on the echo.

 

[jackryan]

Also three days before his surgery jack excabated himself. They left him off the vent because they thought he was doing well. His heart rate was 180/200for three days straight. I dont think that was normal but maybe for his condition it was expected. He also had trouble expelling co2

 

[rmet4nzkx]

Sorry I didnt realize you meant the ones you origonally asked.

For example, was this a full term birth, if not, what week?
Full Term C section...

Was the labor induced, if so, how?
She had diet controlled Gest. Diabetes They didnt want her to have a vback
The last non stress test our son was not moving. The Doc was concerned so he gave my wife some juice. She had several contractions during the test. The doctor did have some concern but our son began to move a little. They scheduled the section that day.

Were there any signs of fetal distress during labor and delivery?
No

Did your wife have prenatal ultrasounds, if so, at what week and who
interpreted the results?
Yes she had approx 12 ultra sounds and 10 non stress test. I dont know who went over the results. We will find out about that soon. As far as we knew all test were ok. My wife did have low amniotic fluid five weeks before delivery. They thought she might have been leaking fluid but decided she was ok. Now I think it might have been congestive heart failure. Like I said ...that is strictly my conclusion.

Did your wife have any problems during either pregnancy?
No real issues or problems. First child was 9lb c sec. but healthy. Our son was 7lb 12 oz 20 in long. Diet controlled gest diabetes on second pregnancy.

While you have had genetic counseling and a previous healthy child, has your healthy child been examined by a pediactric cardiologist?
Yes the cardiologist that treated our son and diagnosed him did ekg...ultrasound of heart and some other test....She was good.

Jack inherited a chromosome translocation from my wife. My wife has a bundle branch blockage, murmur, and mitral valve prolapse.

Jack had a coarctation of aorta....and after open heart we found out that he also had hypoplastic transverse aortic arch and mitral valve stenosis.

The surgeon who I consider to be one of the best said he may have had a fatal reaction to protomine. His heart and lungs quit once administered after surgery. He came back from surgery on ecmo w/o a heart beat.

We were told the coloring of his lungs and heart were very poor (pale grey)before surgery began. His lungs had scar tissue from hypoxia and escemia from his origonal insult. We were origonally told that treatment a few hours before he recieved it would have spared him alot of this organ damage. When prostaglandins were administered the watched his pda open on the echo.

Thank you for answering the questions I know it was difficult and while they seem separate the legal and medical issues are very much linked.

This was a high risk pregnancy, one in which your wife was closely monitored. I'm sure he was monitored and examined at the hospital prior to release especially because of the lack of movement prior to birth, but was apparnetly healthy enough to be released and these defects most often don't appear until several days after birth at the earliest can quite literally appear suddenly hours later, otherwise your son would have been in the NICU.

The risk from a VBAC was too great so it was appropriate to do a C section. Remember the anesthesia can affect baby's respirations and baby's breathing can seem strange.

Doing a C Section interrupts both mother and child's natural systemic response to labor and delivery and the endocrine system plays a major role.

You wife had a number of U/S and stress tests, none of which detected a serious defect. If you read the articles I linked re U/S you would have seen that a difference between the right and left sides of the heart may in a significant % of cases indicate this problem, at the same time, who reads the U/S may also be a factor. Here is a similar case study for comparison, although lacks the diabetes and maternal cardiac defects. In this case PCDA was associated to severe oligohydramnios. ... Coarctation of the aorta. This can be ascertained by evaluating the size of the ascending ...
http://www.thefetus.net/page.php?id=1071

There was however a concern because of no movement and Oligohydramnios, Amniotic Fluid that is too low, this can be caused by the GD, furthermore, it may cause damage to the various systems including the kindeys and lungs. Here is a March of Dimes article.
http://www.marchofdimes.com/professionals/14332_4536.asp.

Then add to this an adverse drug reaction. It is going to be difficult to meet the burden of proof to blame the nurses or peditrican at the 1st hospital for your child's death as many factors contributed to it. Now it is possible that the review will yeild some negligence which may or not be mitigated depending on the standard of care for that provider. For example, let's say because this was a high risk pregnancy your wife was treated by a provider specializing in high risk pregnancies and all her U/S were done at a lab and reviewed by a radiologist specializing in U/S and there were signs of the defect on the actual U/S but not recognized or noted, there there might be a cause of action, but not if the providers were operaitng within their scope of practice and standard of care. This is a rare defect and it is not clear that there is one specific cause of death but multiple organ failure that may be more likely caused by the diabetes than negligence. An adverse drug reaction is unpredictable, which may be what they are trying to tell you.

Please update us on the results of the review.

If you and your wife plan on another pregnancy, you might consider consulting a high risk OB and a perinatologist prior to conception and during pregnancy and plan on C section at a hospital with a NICU.

 

[jackryan]

Thank you very much for your time. We are not pursuing the hospital for some huge monetary settlement but rather for the sake of preventing any wrongdoing to anyone else. ( if it is evident ) We know that our sons case is difficult and complicated however we did not want to ignore any opportunity to try and change the attitude of the post pardom nursing staff (IF negligence was a factor in the beginning.) I don't blame his death on anyone but cant help but wonder what if, when I know how abnormal his behavior was early on.

Thank you again for your consideration and kindness.

 

[rmet4nzkx]

Thank you very much for your time. We are not pursuing the hospital for some huge monetary settlement but rather for the sake of preventing any wrongdoing to anyone else. ( if it is evident ) We know that our sons case is difficult and complicated however we did not want to ignore any opportunity to try and change the attitude of the post pardom nursing staff (IF negligence was a factor in the beginning.) I don't blame his death on anyone but cant help but wonder what if, when I know how abnormal his behavior was early on.

Thank you again for your consideration and kindness.

Lawsuits are about money.

If you want something else, save the time and effort and make an administrative complaint, that is the best way to accomplish an investigaiton and some reform, neither will replace your child.

 

[ellencee]

What can I say. I really do value other professional opinions but to me the facts are clear. It is no different that someone going to a hospital requesting treatment only to be told nothing is wrong with you without getting an examination, only to suffer a serious life threatning illness shortly after. If it was clear to us that something was wrong it should have been somewhat obvious to the staff of the hospital. We were told time and again that if treatment were administered earlier that his outcome may have been different. I do have little knowledge but the fact remains that the administration of prostaglandins is what ultimately prevented his death that evening. Had they been administered earlier when he had symptoms he would not have suffered such a large insult to the organs. Again i am not out to get anyone but when the nurse is more interested in smoking than treating her patients it would anger any partent. I only want to prevent another parent from having to endure what we and our son endured. Until you take your child off life support and hold them in your arms while they die, until you spend every waking moment at the hospital with them hoping for improvement then maybe you would understand how I feel that the two nurses ignored our concerns when he was origonally having difficulty breathing.

You will have to find a way to work through your grief. Understandably, you are nowhere near a healthy resolution to your grief. You are angry, which is a step in the grief process. You are seeking to blame someone (one or more nurses and a pediatrician). You are seeking to hurt someone as much or more than you have been hurt. You are not selflessly motivated to save others. You are full of the desire to hurt others and to hurt them deeply.

The laws of our nation are not based on emotion and your claim of medical malpractice/professional negligence will not be evaluated for whether or not emotions were disturbed. If and only if you win a medmal lawsuit will your emotions have any value; then, your emotions will be considered in an award for punitive damages. Your chances of collecting $.001 are slim to none.
Your chances of having a valid medmal claim are equally slim.

(Obviously, you had reason to suspect any child you had would/could have genetic abnormalities as you stated you have already received genetic counseling and that you have a 5 year-old daughter. You can bet the defense will review your genetic counseling.)

EC

 

[ellencee]

Lawsuits are about money.

If you want something else, save the time and effort and make an administrative complaint, that is the best way to accomplish an investigaiton and some reform, neither will replace your child.

Reform? Like what? Recognition of signs and symptoms of neonatal distress are requisite, yearly education requirements for all who care for neonates. There is nothing to reform but perhaps that which really needs reform: the public consensus that nothing bad happens to people in healthcare need unless a medical professional is negligent and money is to be made by suing. Capping punitive damages is a reform to medical malpractice lawsuits; more are forthcoming.

The only son I ever had died as a premature neonate. That's why I always say I never raised a son instead of saying I never had a son. I FEEL these parents' pain but it doesn't change my professional opinion as a clinical expert and expert witness, expert consultant. I reaffirm: more likely than not, there is no viable claim of medmal as there are no damages that would not have occurred if everyone had done everything more perfect than perfect can be.

EC

 

[rmet4nzkx]

Reform? Like what? Recognition of signs and symptoms of neonatal distress are requisite, yearly education requirements for all who care for neonates. There is nothing to reform but perhaps that which really needs reform: the public consensus that nothing bad happens to people in healthcare need unless a medical professional is negligent and money is to be made by suing. Capping punitive damages is a reform to medical malpractice lawsuits; more are forthcoming.

The only son I ever had died as a premature neonate. That's why I always say I never raised a son instead of saying I never had a son. I FEEL these parents' pain but it doesn't change my professional opinion as a clinical expert and expert witness, expert consultant. I reaffirm: more likely than not, there is no viable claim of medmal as there are no damages that would not have occurred if everyone had done everything more perfect than perfect can be.

EC

Ellen,
I'm sorry for your loss and have long wondered what was the issue you had in this area because of some of your responses in the past. You like OP are still grieving. When do we stop grieving following the loss of a child? I know I haven't, yet as professionals we must still look objectively at the situation. You and I both said the same things in different ways. I never said what reform might be, perhaps only a heightened awarness, I also said that nothing would bring their baby back.

I asked questions because I knew there was more to the story and that OP's grief was the motovating factor behind his anger, giving him knowledge as preparation for what ever the attorney finds in the review. You and I both know what the prognosis was for this child without the intervention of modern medicine, that doesn't alter OP's grief. I also made suggetions should they consider conceiving another child.