Posted on 07/01/2010 6:17:01 PM PDT by Domandred
Is there federal funding involved?
So this P$icks stole her baby?
I understand what you are saying but would it have mattered to wait for 30 minutes so the mother could call her husband and get another opinion from another doctor?
I’m going to bet probably not.
Texas CPS tried to take away my niece’s newborn son because she suffered from severe nausea with dehydration while pregnant, some stupid doctor accused her of being anorexic and demanded she go to a psych facility, which she refused, then the baby was born and the doctor called CPS who proceeded to take control of her life.. it took them two years before she could be alone with the child and at one point they were told by CPS if the filed charges against CPS she would never see her child again. I would have never believed this story if I didn’t know it to be true, all it took was one doctor who didn’t like a patient not doing what he demanded to almost ruin her and her husband’s life... for almost two years her MIL had to be present when she was with her son... oh, and to be clear, she was not having any post-partum issues and once the baby was born her nausea issues resolved.. if the doctor would have paid attention to what she and my sister tried to tell him he would know in our family this is quite normal as she and our mother all suffered the same thing as my niece...
No, I don’t think 30 minutes would have made that much difference, but (without reading the whole thing) I suspect that time was dragging on way beyond that and that communications had just completely broken down. I would think that the father would have known they were in the ER and it shouldn’t take 30 minutes to get him on the phone, let him talk to the mother and the ER doc, and get a decision made. Sometimes people just can’t get to a point where they can trust each other, and unfortunately in the ER you don’t get to pick your doctor, and we don’t get to pick our patients...so you just have to do the best you can.
You also have to consider that this wasn’t the only patient in the ER, and since a ‘2nd opinion’ wasn’t readily available, this doc may have been alone (our ER still has only single coverage for several hours every day) trying to manage other patients. Spending 30+ minutes negotiating to do a 5 minute (necessary) procedure is not something you always have the luxury to do.
O2
Your post helps make sense of the situation. And as a parent, it great information to have.
But, would you agree that the DR. was wrong to call social services and the police were wrong to allow social services to take custody of the child?
I livid reading the story starting with the dr. wanting to do a spinal tap and having a hissy fit when told NO. Reading your explanation, the DR’s demanded treatment wasn’t unreasonable, but his behavior afterwards was. It seems to me that he seriously failed here, because if he had presented the situation as clearly as you did, then there quite possibly would have been a different outcome.
Y’all are going to make me actually read the article aren’t you....
;^)
It really is a "damned if they do, damned if they don't" situation. We can probably find stories where children were misdiagnosed as having colds when they really had meningitis and malpractice suits were filed.
And it also appears that specific Idaho State law had much to do with this verdict.
Yes, I agree. Complete BS, as well.
I'll never forget the animal cry of agony that came out of our little baby's mouth while she received that tap. I had to relieve myself from her room once it was over.
While this procedure was awful, death by meningitis was NOT an option. Turns out she did not have it and no one to this day is sure what she had. Many theories of course.
Thank you and other good Doctors for taking care of our little ones. BTW, she's 15 now and thriving!
The parenthetical "necessary" bothers me. I fully understand your explanation of why it is necessary, but your verbiage here places primacy completely on the doctor's advice. Negotiating is not a luxury - it is a necessity. Otherwise "informed consent" is no more than "the doctor said so".
From the article, the baby's temp subsided after sub-q fluids were given, in the intervening time between Dr. Godzilla's edict and the actual tap. Does this observation mean nothing, medically? (I don't know the answer to that question, so please don't consider it rhetorical or inflammatory.)
Finally, when communications break down between ER doctor and patient/parent, do you believe that the patient/parent loses authority to the doctor in a case such as this?
In my case and the cases of friends/family that I know, it was private insurance. I think in all cases it was to rule out meningitis. I believe instead of watching the child in the E.R. for several hours to see if the condition worsens, it was a quick-answer to rule out a severe condition. The procedure is not without risk and my niece was put to sleep since she was an infant. You are suppose to stay very, very still. My neighbor’s eight year old had it done and the parents said it was obviously very painful. This case later proved to be strep throat. However, the child had pain at the sight and a headache for several days. Thanks.
I did misread the age of the child. However, the overreaction of the doctor in calling CPS is still unwarranted considering the temp was dropping after fluids. This child should have been admitted, NOT have CPS called. When the child’s temp dropped to normal for a 24 hour period, no spinal would be needed.
With that, if you think the risk of a spinal tap on an infant is the same as that of an IV, I’m REALLY glad you are not treating my children.
http://www.sciencedaily.com/releases/2009/03/090318113559.htm
It may be a whole lot easier to find spinal fluid than to find a vein, but it IS riskier.
You’re not talking to a lay person here.
>>Finally, when communications break down between ER doctor and patient/parent, do you believe that the patient/parent loses authority to the doctor in a case such as this? <<
Many doctors think it does.
I dealt with one of those last Oct. and I will never forget the telephone screaming match started BY the oncologist btw. In the end I would not back down and my mother achieved her dying wish which was to see my brother who was in the air on his way from Europe. That doctror met her brick wall when she met me.
I have little faith or trust in doctors now, certainly not with end of life issues.
PS. Mother did not die until Jan, but would have been gone that Oct night if the dr had had her way. Over medicated, suffering from pneumonia with a doctor who did not want to do anything further to treat.
>>I have little faith or trust in doctors now, certainly not with end of life issues.<<
I can tell you that working in the medical field makes one less caring than a family member. It takes a special person to remember that a patient is not a case in a book. They are each individual persons and the family are the people who will smack a healthcare worker back to humanity.
You did the right thing. We are our family’s advocates. Never stop being there for them. Because the healthcare worker, sometimes forgets the person and works on a “patient”.
Especially doctors, who have life and death decisions to make all the time. I worked for the best doctor in the world and he was caring ALWAYS. Not every one is like that.
The 'standard of care' for febrile infants includes LP. Not doing it would be like not doing an EKG in a 65 y/o who comes in with chest pain because they 'look ok'. The fact that LP is more invasive is irrelevant, it is still just as necessary. Here's an article from JAAPA (Physicians' Assistants, not evil doctors) that details the need for a septic workup which includes LP in all febrile infants with fever (100.4 by their definition).
http://www.jaapa.com/managing-the-febrile-infant-what-is-the-standard-of-care/article/124184/
What happens to the fever is irrelevant, once it is there it would be negligent not to do the proper workup, and no 'second opinion' will change that. I would have made reasonable accomodations for the mom to talk with the husband or her pediatrician about that need, but only for the mother's benefit...the child needs the LP and/or hospitalization, and at some point the delay in that decision is putting the child at risk.
As far as calling CPS, I don't know. I don't need them to do what I need to do in the ER, security takes care of that, but I have good pediatrician and nursing admin. support, so they'd have made those decisions based on the need to keep the child in the hospital. I don't know what was available in this ER, and at some point the emergency custody needs to be formalized.
This 'doofus' doc was educated in an American med school, residency trained at Johns Hopkins, and is board certified in Emergency Medicine...and he was doing exactly the right thing. Maybe he was impatient with the mother, maybe he was insensitive. Maybe he had an ER full of injuries, pneumonias and heart attacks. Maybe mom was a space cadet....don't know any of that. What it comes down to is the baby needed the workup he wanted to do, and he did what he had to do to get it done.
O2
I don’t think all the facts are here. Meningitis happens fast. In most cases, faster than what it would take to get a second opinion.
If the symptoms were there, the doctor’s right in trying to force a spinal tap. What’s odd, however, is that most of the time the doctor won’t get near a patient without a consent form being properly filled out first.
Believe me, when my kid went anaphylactic, Mom went in with my boy to the ER, but they kept my ass behind to get the docs in line.
There are facts missing here.
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