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An interesting medical malpractice lawsuit was filed in California. Well, interesting if you are not the defendant.
The plaintiff delivered a healthy baby girl. The allegation is that her C-section was performed without anesthesia forcing her to suffer horrific pain. More on that in just a bit.
The new mom was 41 weeks pregnant and was rushed to Tri-City Hospital in Oceanside, California for a C-section. The anesthesiologist allegedly did not arrive to administer anesthesia after several pages were sent.
The mother said:
“I was crying because I was scared, I didn’t know what was going on. I was laying there and the obstetrician was like, ‘We have to just do it.’ That’s when I felt them cut me open. Nurses were holding me down … I could feel her cutting me and, with her hands, opening me. That’s when I passed out.”
The patient’s boyfriend was outside the delivery room. He said he heard “the most horrific screams you could ever imagine” followed by silence.
The couple said the anesthesiologist finally entered the delivery room after the baby, named Cali, was born, telling the mom, “I’m gonna make you feel better now.” They also note that the hospital staff attempted to assuage the situation by offering the new mom a $25 gift card to the hospital gift shop.
Nice touch.
Baby is doing well. Patient and her boyfriend are suing for medical malpractice, loss of consortium, negligent infliction of emotional distress and assault and battery, and are seeking $5.75 million in damages.
Here’s where the story gets interesting.
The hospital denied the patient’s allegations. “The patient was administered anesthesia prior to the surgery.” The hospital adds that although they normally don’t comment to the press on pending litigation, they decided to release a statement due to the patient’s “outrageous allegation.”
Well, that’s not an insignificant detail.
Further, it’s a detail that could easily be checked by looking at the medical records. What did the patient receive and when?
Under Model Rules for the American Bar Association:
A lawyer shall not bring or defend a proceeding, or assert or controvert an issue therein, unless there is a basis in law and fact for doing so that is not frivolous, which includes a good faith argument for an extension, modification or reversal of existing law.
cannot just accept a client’s version of the events.
Thus, whether in a civil or criminal matter, a lawyer cannot be “intentionally ignorant.” This is not to say that counsel must satisfy herself beyond doubt that her client’s every claim is true; indeed, an attorney may “rely on…her client’s statements as to factual claims when those statements are objectively reasonable.” [Calloway v. Marvel Entertainment Group, 854 F.2d 1452, 1470 (1988)] But when asserting a client’s position, counsel cannot be indifferent or blindly rely on her client. She must make an “objectively reasonable inquiry” as to the facts.
While the anesthesiologist in the California case might not have been present; that does not mean no anesthesia was given. The fact that the hospital responded so quickly makes one wonder whether the plaintiff’s attorney even had someone eyeball the records before making such a bold claim.
We’ll find out soon enough.
What do you think? Let us know your thoughts in the comments.
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I have a feeling the patient is full of crap. However the anesthesia MD should at least answer their phone
They probably injected local to the incision line.
That would be my first guess. Still, obvious idiot.
Uh, at least consciously sedate her at that point. Or wait, obviously, if you can. What a fool. You can always narcan the baby. The difficult issue is because of the anesthesiologist not showing up in time — he probably should have been in house anyway — everybody is set up if there is any bad outcome at all. I once had a situation where I, as a pediatric hospitalist with a low census, was required to be in house but OB/GYN and anesthesiology weren’t. At 4:30 in the morning this woman comes in full breech and I rush down there and see the baby tanking on the monitor. So here I am when the OB/GYN finally gets there trying to turn the baby. I don’t think I’ve ever actually done that before.
I am aware of C sections being done by OB/GYNs when they rushed a patient to the OR BEFORE calling the OR crew, and started a Csection under local anesthesia. The anesthesia is always inadequate because it takes time for local anesthesia to take effect, and the OB in these cases typical injects local and immediately makes an incision.
Typically by the time the OR crew arrive the baby is already out.
While such cases are rare, they have happened. Typically review of the fetal strips reveals that the baby was in trouble long before the decision to do a Csection. So the decision to do the C section and call the OR crew were much later than they should have been.
Most anesthesiologists in hospitals doing OB, are required to be in the OR within 30 minutes of when the C section was called. So was the anesthesiologist in this case just late, or was this another one of the cases mentioned above, where the OB just called for help late.
Having done thousands of plastic surgery cases under local anesthesia with sedation, the issue here is likely inadequate dosing. This patient probably received a combination of a benzo and narcotic, followed by local anesthetic. Because the baby was in distress, the OB likely ‘went light’ on the 2. After giving the medications, the patient likely seemed well sedated (asleep and snoring) and the procedure began. The local was injected and the patient woke up, screaming in pain. After the injection, the anesthesia was sufficient to do the procedure and mom and baby were fine.
Benzodiazepines are a two edged sword. They have an amnestic effect but if the dosage is low, the patient will only have a partial amnesia, remembering the most stimulating part of the procedure (usually the local anesthesia). The problem is that this is the patient’s ONLY memory of the procedure. So the patient will state that ‘I felt everything’, or ‘I was screaming and the doctor did nothing’.
I learned this the hard way. Early on doing these procedures, this exact thing happened to me. Fortunately, I could show that the patient had undergone a 3 hour procedure and cooler heads prevailed in the end. The lesson is that if you are going to use a benzo for procedural sedation, make sure the dose is adequate. You may not get sued or have to defend your care but most certainly your reputation will be tarnished when your patient tells all of their friends about their ‘surgery without anesthesia’.
This case is a bunch of crap. Mother and baby are both fine. Who said birthing is painless? And the human brain has a difficult time remembering pain, otherwise women would only get PG once. They should have sued for an even $6mil so it could divide 3 ways…