News-Medical.net also reports on the trial confirming the neuro protective effect of magnesium sulfate I earlier discussed in “If Mother Only Knew.” This report misses the point that many physicians still think the standard of practice still does not require that magnesium sulfate be administered to mothers threatening preterm delivery prior to 32 weeks. Rouse was the lead author for the published study findings N-M.net reports. However, Rouse wrote an opinion piece in the same issue of the New England Journal of Medicine lamenting that the beneficial effects of magnesium sulfate have not, for some authorities, been sufficiently established to recommend its use. Rouse opines that the neuroprotective effects of magnesium sulfate could spare 1000 children a year from suffering cerebral palsy.
The first study to demonstrate the beneficial effects of magnesium in this setting was published in 1995. The Rouse trial first reported upon in 2008 was the largest to date and those findings were again confirmed by Constantine and Weiner in their impressive meta-analysis “Effects of Antenatal Exposure to Magnesium Sulfate on Neuroprotection and Mortality in Preterm Infants” (Obstet Gynecol 2009; 114:354-64).
Weiner and Constantine, though concluding “magnesium sulfate…significantly reduces the risk of cerebral palsy without increasing the risk of death,” still fall short of insisting upon its use. This vacillation evades the the kind of pronouncement that assures obstetricians of the need to change their practices.
How many further children must needlessly suffer until a new standard of practice is pronounced? I think a new standard of practice has been announced and if obstetricians choose otherwise and cerebral palsy results, those obstetricians will suffer consequences.
The mother heard speaking in the above ad was present when a teenage driver recklessly careened down a quiet street striking her young son. The teen pulled into the nearby driveway of his home not even having realized he had hit and dragged the child. Miraculously, the child had only suffered severe scrapes and bruises.
The child was promptly taken to an emergency department of a large teaching hospital where a thorough survey confirmed the child had suffered no head injury or internal injury and the family was relieved. During the course of the various studies that were performed an endotracheal tube was inserted through the child’s mouth and into his airway to assure control over the child’s breathing should an, as yet, undetected injury to the lung or the space surrounding the lung be present. Because the child naturally resisted having a tube in his throat and respirator breathing for him, the child was chemically paralyzed so that he could not interfere with the respirator breathing for him. Though by end of day the tests were all negative the tube and respirator were left in place.
The child was transferred out of the emergency department to a monitored unit with the plan being that the tube and ventilator be removed the next morning.
That night, while a physician was teaching a less experienced resident physician to perform a procedure on the child the tubing connecting the respirator to the endotracheal tube in the child was unintentionally bumped by the doctors and the endotracheal tube was displaced such that the respirator was no longer ventilating the child. This event went unrecognized because alarms on the ventilator designed to warn immediately and loudly of the occurrence of such an event had been turned off. The disconnect was not therefore discovered until the child was virtually in cardiac arrest. Though the child survived following resuscitation, brain injury which resulted from the tube displacement and ensuing respiratory failure left him initially comatose.
The child’s mom and dad though present in the hospital were not in their child’s room when this catastrophe occurred. When they saw their son the next day they weren’t alarmed that he wasn’t moving because they knew he was chemically paralyzed. Excuses were given for why the child wasn’t removed from the ventilator that day and required continuation of the paralytic drugs for another day or so. Then the paralytic drugs were removed and the child was successfully able to be removed from the ventilator and have his endotracheal tube removed and he breathed on his own. He did not however wake up until much later.
Doctors provided the family with no explanation for why their child who had been admitted for bumps and bruises was now in coma. The delayed resuscitation of their child and the physicians’ role in unintentionally displacing the endotracheal tube was not disclosed.
These unique circumstances led the parents to contact a lawyer. I had the privilege of being the lawyer who was contacted. My investigation revealed that the child had an unexplained need for a resuscitation because of an allegedly sudden drop of oxygen levels in his blood which coincidentally occurred at the same time that the child’s endotracheal tube suddenly became displaced for no particular reason. Being a former respiratory therapist who had worked with respirator-dependent patients for many years, I was well aware that, in this child who had no lung disease or lung injury, there would not have been any sudden drop in his oxygen level from a displacement of an endotracheal tube because such a displacement would be immediately recognized if the alarms were properly set.
Eventually, I was able to discover and establish that the airway accident was easily avoided and that improper monitoring had led to such a delay in the recognition that a tube displacement had occurred. The child was needlessly suffocated and anoxic brain damage had occurred.
Because of requirements of confidentiality imposed by a state agency on all medical malpractice cases, I am unable to report the means by which I was able to discover and prove the truth. Similar confidentially requirements also prevent me from reporting the method or means by which Paul Giuffre and I and other lawyers of Meyers Giuffre Evans & Schwarzwaelder were able to help this child and his family meet the many economic and other challenges they faced.
This story is just one of many such stories untold. Regrettably, because so many of these stories are untold, many victims of malpractice are unaware of what happens and where it happens and that it happens in every hospital.
When unexpected tragedies occur and doctors have inadequate or suspicious explanations, an experienced lawyer may be the only way victims can ever discover the truth. By then taking action victims are no longer powerless. Indeed, they help make the healthcare system better. After all, you cannot fix something you don’t think is broken.
I believe the public at large has for decades laboured under the impression that here we enjoy the best medical care available (Untrue. By most measures both Germany and France do better). Perhaps this is the reason that despite the real problems Americans have faced because of the increasing cost of health care the [...]
