Posted on 07/01/2010 6:17:01 PM PDT by Domandred
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That’s what I thought, but the parents here didn’t vehemnently deny treatment according to the story, but simply wanted a second opinion which seems totally justified since a spinal tap is quite a painful ordeal and if not necessary, i.e., your child merely has a cold which turned out to be the case, why subject them to the pain? I still say something’s missing here.
1. Any child under 2 months old with a fever has meningitis or sepsis until proven otherwise...their immune systems are not well developed so they must be treated quickly or they can die or be seriously disabled. That’s standard of care and not doing it is negligent.
2.Spinal taps in infants are easier than drawing blood.
3.The only alternative would have been for the child to be admitted and treated for meningitis/sepsis without a clear diagnosis...a 10 day or so course of IV antibiotics.
4.As an ER doc, I wouldn’t have let the mom take the baby out of the hospital, (I’ve done it, and I am legally obligated to do it if I think the child is in danger) but if she still refused the tap, I’d have started antibiotics and gotten the child admitted and let the pediatricians deal with the fallout.
5. This is why I cringe every time I see a teeny-tiny out in public when they are only a few weeks old, a random virus causing them to run fever can set this whole thing in motion.
O2
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Richard MacDonald, M.D. Emergency Medicine Emergency Medicine of Idaho- Boise 13960 W Wainwright Ste A Boise, ID 83713 (208) 384-9022 Fax: (208) 388-1683 |
| Medical School: | Tulane University, 1996 |
| Residency: | Johns Hopkins Hospital |
| Board Certification: | American Board of Emergency Medicine |
Police and Doctor Recording Transcripts
Start reading at the end of page 3. Discussion with the police and social services.
Police officer saying that they don't want to violate her rights and that she has done nothing criminally wrong.
Social services says basically they'll take the child knowing that the judge will release after tests (spinal tap) are complete.
Police go along with it, KNOWING FULL WELL the mother has done nothing criminally wrong.
That is some scary crap.
Illegal seizure anyone? Clear violation of the 4th in my opinion, yet the jury was unanimous.
I hope she stated that she would not pay for a spinal tap... then again, I guess that would only work in a country with free market competition in healthcare.
1. The baby was nine weeks and there was a flu going through the house
2. Are you seriously saying that a spinal has as little risk as drawing blood? Seriously?
3. The infant’s temperature was dropping after subcue fluid intake. Observation is the course that should have been taken. Admit the baby if need be, OR do as the mother said and get a second opinion. YOU would have done that, as you stated. This ER idiot called CPS.
4. I don’t like to see infants out either.
Reading this case from the links you gave me and it just gets worse and worse.
So what’s the point of consent forms when the hospital can just call the police, have the child yanked for a few days and have all the tests and procedures done that they can think of on the State’s consent instead of the parents.
So did she get her baby back?
Where is link to story???
I thought I posted that in the first followup post, but through editing it looks like I accidentally deleted that part (or didn’t close a tag properly so it’s there, just buried in html code)
She got her baby back a few days later after the little one was release from the hospital.
So the “plan” by the police and CPS worked just as they said. CPS took the baby on a neglect charges long enough for tests, then CPS judge released back to parents dropping the charges.
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Best Post of The Day!
Eric and Corissa Mueller have waited six years to get their say in court and allege that their constitutional rights as parents were violated simply because they preferred not to let a doctor stick a needle in their 5-week-old daughter's spine without more information.
If that's not true, then you can skip the rest of this post, because I have to admit the mortal sin of not reading the whole article...I stopped at the 5-week old part because that really is where the baby poop hits the fan.
I don't like 'set in stone' treatments, and I'm pretty comfortable with my clinical judgement, especially with kids, but even I won't break this one. A 5% chance of meningitis is 1 in 20. Meningitis is 'bad disease'...i.e. it kills. I'm not willing to bet my career or a child's life on those kinds of odds.
And yes, spinal taps really are that easy to do in infants, much easier and less painful than trying to find a tiny vein that can support an IV.
Observation is not at all supported in this case, infants are too fragile, and if you wait until they look bad, it may be too late. Admission would be for treatment, and once the antibiotics are started without the tap, you can't tell what you are treating anymore, so you are committed to a full hospital course of treatment. So now a baby who could have been discharged if the workup was negative is stuck in the hospital for 7-10+ days.
Armed with that information, I've been pretty successful with convincing parents about the LP when necessary...most just have a knee-jerk reaction to the idea or base it on their own experience. Once they are confident that we really do have the child's best interest at heart and are made aware of the potential dangers, they almost all will let us do what we need to do. I also wouldn't have a problem with a second opinion, but it would have to be quick and at our hospital, I wouldn't discharge or transfer the child for it (again...didn't read the article-itis :^))
O2
30 years ago my son had his tonsils removed, the doctor wanted to stick tubes in his ears, I told him no. I thought the doc was going to have a screaming hissy fit. (’I’m a doctor, I’m a doctor”)
My son was just fine without the tubes. I had just read about doctors doing this routinely and unnecessarily.
Thank you for your sane post. My daughter had meningitis at 8 weeks old and the cautious treatment she received saved her life.
My husband is a doc and I made him stay in the ER with her during the LP. I couldn’t stand it and stayed out taking care of my other child. But when she was admitted I didn’t leave her side for the entire week she remained for antibiotics and observation.
Other than some rotten baby teeth she came through completely unscathed.
100.8 is not even much of a fever...raised 5 and had emergency trips only twice...One was a temp 104. and pre epilepic (had seizure on way to hospital), the other was a high school foot ball injury, concussion...Any one that takes a child to the hospital for a 100.8 temp is nuts..unless there were other things wrong. 100.8 for inpatients when I worked in the hospital didn’t even get aspirin until 101. But you took the temp every 2 hours...
You have named it accurately.
There was a story in Reader's Digest in the late 90s where a mother went to social services (in Sweden, IIRC) just looking for a little assistance but wound up losing her children to the state.
Nanny-state uber alles in dem Welt, esp. you.
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