Friday, January 07, 2005

My Proposal for Birth Injury Malpractice Reform

Why not create a national compensation program for families/individuals with birth injuries and/or congenital disabilities?

I could imagine suing if I was faced with a lifetime of expensive treatments, medicines, and therapies for my child. It would be my only way to cover expenses. If, instead, I knew before birth that a federal program would provide not only medical care, but appropriate education and care for my child, most incentive to sue would go away.

The only other two motivations I could imagine for a lawsuit would be vengeance and trying to prevent the situation from occurring again.

Education could go a long way here. If women are given honest information before conception, during pregnancy, during labor, if they are consulted, made partners in their care, treated as intelligent people, then they may be more accepting of unforeseen outcomes. They could come to see that many "bad outcomes" are simple bad luck and unavoidable, rather than a reflection of negligence on the part of their caregivers.

When babies are born with problems (and without), parents should have access to their files, to honest information. I had a client whose son was born blue, limp and quiet. He was whisked to the warming cart and doctors "worked on him" for 15-20 minutes while everyone else sat in the most awful silence I've ever witnessed. After a while, a nurse wrapped the baby up, brought him over for the mother to hold briefly and said he was going to the NICU for observation.

By all observations and reports the baby is fine today. He was fine the next day. Apparently he was fine when he went to the NICU. But my client said nurse after nurse would come in and say "Boy, your little guy had a rough start!" Only after a visiting nurse repeated this phrase to her at home did she said, "What do you mean?" The nurse said "Do you have any idea what happened to your son in the hours after he was born?"

She only knew what I was had been able to report to her: that sometimes babies inhale meconium and it can irritate their lungs...That her baby was breathing on his own with only blow-by oxygen at five minutes...That a pediatrician friend thought it was great news that he went home after observation...

The nurse urged her to get her son's hospital file and ask her doctor about any part of it she didn't understand.

If there was this much confusion and silence with a "routine" complication (aspirated meconium) and an essentially well baby, imagine what happens when things truly dire.

An even farther step in reassuring patients that their caregivers are qualified, responsible, and not likely to repeat mistakes would be to open hospital and birth center files. Atul Gawande wrote a great New Yorker article last month about health centers sharing information. Imagine if you could know how your hospital's care stacked up nationally.

As for vengeance and wanting to bankrupt the bastards that ruined your life and your child's, I don't know what to say. Anger is a part of grief. Involving the care team in the family's grieving might mitigate those desires some...And if nothing works, there's still the lawsuit option.

[ed. I'm completely unsatisfied with this entry. It in no way matches what's in my head. But I really need to get to sleep!]


Anonymous Anonymous said...

Does anyone reading this have previous experience with making an accident claim? A friend of my mother recently had some complications when giving birth. It wasn’t her fault and there weren’t natural complications but were due to someone else. If seen companies that deal with compensation claims but don’t know if there are grounds for claim of medical negligencein a birth injury claim! Has anyone ever heard of anything like this?

10:01 AM  

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