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-   -   Violation of patient rights (https://www.askmehelpdesk.com/showthread.php?t=318659)

  • Feb 19, 2009, 01:21 PM
    this8384

    Pitocin didn't artificially begin your labor:
    Quote:

    Originally Posted by rikkifarkas
    I have the right to refuse any drug that will artificially begin my labor

    As you stated that you were already dilated to 5cm when you were given pitocin.
    Quote:

    Originally Posted by rikkifarkas
    Can you imagine he only gave my body 5 hrs to dilate I was already 5 cm dilated

    If you're dilating, then labor has already begun.

    The question still remains: was there a legitimate reason to speed up your delivery? Maybe there was an issue with the your and/or the baby's health and pitocin needed to be given; I don't know for sure because I wasn't there.
  • Feb 19, 2009, 01:21 PM
    rikkifarkas

    Dear scott,

    The wrong doing is the fact that the dr did not get informed consent from me in a non emergency situation( speeding up labor because it is standard of care).

    The doctrine of informed consent/refusal is upheld by common law; case law; Constitutional law (the right to privacy and self determination protected by the 1st and 14th amendments); federal law (The Emergency Medical Treatment and Active Labor Act and The Patient Self-Determination Act); international tort law (which US courts sometimes cite); state law; state mandated medical ethics; and the ethical guidelines of the American Medical Association (AMA) and the American College of Obstetricians and Gynecologists (ACOG). The doctrine of informed consent/refusal upheld by these laws provides all patients, pregnant or not, with certain fundamental rights:
  • Feb 19, 2009, 01:23 PM
    JudyKayTee
    Quote:

    Originally Posted by rikkifarkas View Post
    It is aleady nine months since my last c-section and I can't begin to tell you the mental pain and feelings of being violated that My informed consent rights were abused. If you never have gone through a c-sectio you can not comprehend the mental pain a woman goes through.



    You've already received lots of very good, to the point legal advice here. I see no violation of your rights. I see a Doctor making the best decision under the circumstances (which can range from your health to the baby's health to staffing problems). If you don't want "this" to happen to any other woman, then write a letter to the head of OB/GYN at that particular hospital.

    I choose my Doctors based on their education, experience - expertise, if you will. I don't tell them what the best course of treatment is. They tell me. I'm not medically educated and I don't think you are, either.

    What "mental pain" does a woman go through because of a c-section? If you feel like less than a woman because you didn't give birth vaginally you have more problems than simply being administered a drug you did not want or chose.

    This is turning into a message board with "Dear so and so" as the heading.
  • Feb 19, 2009, 01:41 PM
    rikkifarkas
    The question still remains: was there a legitimate reason to speed up your delivery? Maybe there was an issue with the your and/or the baby's health and pitocin needed to be given; I don't know for sure because I wasn't there.[/QUOTE]


    Yes, I was 5cm dilated and not dilating fast enough for him ( it was only 3 hours that I was there) I spoke with my dr afterwards he said that he gave me pitocin because that is his standard method of care. Pitocin is not only used to start labor its used to speed up labor if the woman is not dilating fast enough. A woman by choice can allow herself 72 hours to labor and get her cervix ready for dilation.

    If My dr would have had the decency to consult with me and uphold my rights of informed consent then I would have chosen not to try to speed up my dilation with drugs and rather let my body naturally labor to decrease any extra stress on the baby(pitocin causes stress on the baby) . My dr did apologize that he did not ask me if this was the direction I wanted to go. Remember not everybody wants to speed up their labor because with medical intervention there is always a risk ex: fetal distress.e . His apoloogy is no consolation for me because he still robbed me of my right of informed consent and he took me down the path of medical interventions that I so desperatly wanted to avoid. The reason he performed the c-section Quote" I wasnt going anywhere".
  • Feb 19, 2009, 01:42 PM
    JudyKayTee
    Quote:

    Originally Posted by rikkifarkas View Post
    If My dr would have had the decency to consult with me and uphold my rights of informed consent then I would have chosen not to try to speed up my dilation with drugs and rather let my body naturally labor to decrease any extra stress on the baby(pitocin causes stress on the baby) . My dr did apologize that he did not ask me if this was the direction I wanted to go. Remember not everybody wants to speed up their labor because with medical intervention there is always a risk ex: fetal distress.e . His apoloogy is no consolation for me becuase he still robbed me of my right of informed consent and he took me down the path of medical interventions that I so desperatly wanted to avoid. The reason he performed the c-section Quote" I wasnt going anywhere".


    You are not a trained medical professional. He is. You are going to lose this argument.

    You have asked additional questions, stated additional "defenses" without answering questions already asked.

    This has turned into a discussion board and I think it's time to close or move to family and children.
  • Feb 19, 2009, 01:45 PM
    this8384

    Quote:

    Originally Posted by rikkifarkas
    The reason he performed the c-section Quote" I wasnt going anywhere".

    I'm sorry, but that doesn't make sense whatsoever. What does "you not going anywhere" have to do with a c-section?

    Also, you keep arguing that you shouldn't have been given this drug without answering the question, so I'll ask it again: was there a legitimate reason for speeding up delivery?
  • Feb 19, 2009, 02:30 PM
    Curlyben
    >Moved from Other Law<
  • Feb 19, 2009, 03:19 PM
    ScottGem

    The question here is what do YOU want? You already got an apology from the doctor. So what more do you want? If you want to sue the doctor, then consult an attorney. If you want to make sure the doctor doesn't do it again, then talk to the hospital's head of OB/Gyn.
  • Feb 20, 2009, 06:46 AM
    J_9
    As a labor and delivery nurse I am going to re-open this thread to clear a few things up.

    Okay, what pregnancy was this for you? First? Second? etc.

    What was your complaint when you went to the hospital, by this I mean were you admitted because you were in labor? How far dilated were you when you went to the hospital? What was your due date?

    Pitocin is a manmade form of a naturally occurring hormone in your body called oxytocin. It is routinely used in labor and delivery and does not need a signed consent from the patient as it is non-invasive.

    Quote:

    A woman by choice can allow herself 72 hours to labor and get her cervix ready for dilation.
    This is partially incorrect. If the membranes are ruptured the fetus needs to be delivered within a 24 hour time. You never, I don't think, mentioned that your water broke.

    Yes, there are risks with pitocin, there are risks with labor and delivery. I don't know your pregnancy health history, but things like PIH, gestational diabetes, etc can increase the risk for ceserean section.

    Again, the use of pitocin does not necessitate the need for a signed informed consent. There is risk for C-Section ANY TIME a woman is in labor.

    Quote:

    Originally Posted by Gernald View Post
    how you wouldn't notice the IV that they put in your arm or the needle is beyond me :-)

    All laboring women get an IV for fluids, usually Lactated Ringers (LR). A second needle, or IV, is not necessary for pitocin.

    Quote:

    Originally Posted by this8384 View Post
    I'm sorry, but that doesn't make sense whatsoever. What does "you not going anywhere" have to do with a c-section?

    This means that she is not dilating at the proper rate and is causing the baby to become distressed. It's called failure to progress and is a very common cause of ceserean sections.

    Quote:

    Originally Posted by rikkifarkas View Post
    my first child resulted in a c-section

    You are very LUCKY that your doctor allowed you to even labor. VBAC's are very uncommon and very dangerous to mother and baby. Once a section, always a section is a common phrase. Why? Because once a mother has a section she is at risk for uterine rupture during the labor process, putting both the mother and child at risk. The mother will be at risk of profuse bleeding, causing something called DIC (Disseminated intravascular coagulation), which in and of itself is extremely dangerous and possibly deadly. It places the fetus at risk for hypoxia, hypovolemia, and possibly death.

    Again, you are very lucky you had a doctor who at least let you try to deliver vaginally.

    Things could have been worse you know. At least both you and the baby are alive.

    Quote:

    he gave me the pitocin just to speed things up for no reason other than its 3:00 in the morning and he is tired.
    I'm sorry to be the bearer of bad news. But this is not why the pitocin was given to you. The doc does not need to be present until you are dilated 10 centimeters, 100% effaced and at 0 station or even 1+ station (depending on how far he is from the hospital). I frequently PIT women when the doctor is at home sleeping and there is no need to call and wake him until labor is imminent.

    In all honesty, the doctor was looking out for your best interests.
  • Feb 20, 2009, 07:07 AM
    ScottGem
    Quote:

    Originally Posted by J_9 View Post
    As a labor and delivery nurse I am going to re-open this thread to clear a few things up.

    Pitocin is a manmade form of a naturally occurring hormone in your body called oxytocin. It is routinely used in labor and delivery and does not need a signed consent from the patient as it is non-invasive.

    That's good info, and it, essentially, negates any chance of a malpractice suit.

    So lets summarize the issue here. The OP was aware of the use of Pitocin and had made her doctor aware that she did not want it used. The doctor decided to overrule her request, probably in the name of medical necessity. The child was delivered and mother and child are doing OK.

    So, the OP is unhappy because of this. But the question remains as to what she wants to do now.
  • Feb 20, 2009, 07:18 AM
    J_9
    Quote:

    Originally Posted by ScottGem View Post
    The doctor decided to overrule her request, probably in the name of medical necessity.

    He did not overrule the request out of medical necessity, rather, the OPs choice to attempt a vaginal delivery. Had the doctor been prudent, he would have scheduled her for a repeat C-Section rather than letting her labor due to the inherent risks of a VBAC delivery.

    He was simply trying to satisfy her desire to have a vaginal delivery.

    Quote:

    Originally Posted by ScottGem View Post
    That's good info, and it, essentially, negates any chance of a malpractice suit.

    Yes it does. If the OP had a VBAC and had suffered the negative consequences I have outlined above, she would then have a chance for malpractice. The doctor was simply looking out for the well being of the mother and the fetus.
  • Feb 20, 2009, 07:37 AM
    this8384
    Quote:

    Originally Posted by J_9 View Post
    The doctor was simply looking out for the well being of the mother and the fetus.

    That was my guess, which is why I was continually asking the OP if there was a valid reason for speeding up delivery. She constantly side-stepped the question, claiming that her doctor only did so because he was impatient. I personally found that quite hard to believe, as my OB/GYN wasn't even working the day I delivered; she was going to her kid's soccer game. I had a brand-new doctor that I had never seen before deliver my daughter, so I don't see why a doctor would rush any woman into labor.
  • Feb 20, 2009, 07:45 AM
    J_9
    Quote:

    Originally Posted by this8384 View Post
    That was my guess, which is why I was continually asking the OP if there was a valid reason for speeding up delivery. She constantly side-stepped the question, claiming that her doctor only did so because he was impatient. I personally found that quite hard to believe, as my OB/GYN wasn't even working the day I delivered; she was going to her kid's soccer game. I had a brand-new doctor that I had never seen before deliver my daughter, so I don't see why a doctor would rush any woman into labor.

    We don't rush anyone into labor. Pitocin is delivered at what is called milliunits per minute. If delivered too fast it is called "pit to distress" which means that we pit the mother until the baby is distressed. Do we want that? NO!! It places our licenses as nurses and doctors at risk.

    Pit is increase in 15 to 30 minute increments. Slower depending on the individual. It can be turned off at any time if the fetus is in distress ( I did this twice last night).

    Pitocin is on a pump, which means that it is delivered at a constant rate per hour.

    We NEVER rush a woman into labor as we don't want to put that baby into the NICU.
  • Feb 20, 2009, 07:49 AM
    this8384

    Oh, I wasn't implying that you would; I hope it didn't come off that way! The OP seems to think that her doctor did, though. That's why I mentioned it, as well as my own experience. If the doctor was in such a hurry, as the OP implies, he could have just taken off and let another doctor deliver... I really don't believe he just wanted to get the baby out for his own personal satisfaction.
  • Feb 20, 2009, 07:55 AM
    J_9
    Quote:

    Originally Posted by this8384 View Post
    Oh, I wasn't implying that you would; I hope it didn't come off that way! The OP seems to think that her doctor did, though. That's why I mentioned it, as well as my own experience. If the doctor was in such a hurry, as the OP implies, he could have just taken off and let another doctor deliver....I really don't believe he just wanted to get the baby out for his own personal satisfaction.

    No, you did not come off that way at all. I was simply trying to explain how things work in an L&D. We call the doc frequently through the night, but we don't need him/her until the baby crowning, of course depending on her Gs and Ps (meaning how many times she has been pregnant and how many living children she has).

    For instance... I am a G5P4. Which means I was pregnant 5 times and have 4 living children.
  • Feb 20, 2009, 09:05 AM
    DoulaLC

    IF things occurred as the OP said, and her doctor told her his use of pitocin was standard, then it very well could have been a case of his wanting to move things along.

    Pitocin, and rupturing membranes, are often used to speed things up. If there was a true concern for baby's well being, a c-section would have been done in the first place. Introducing pitocin increases the possibility of distress for baby, hence the need for continuous monitoring of baby's heartrate to be sure there are no adverse effects. The use of pitocin in this case only increased the possibility of uterine rupture because of the previous c-section. VBACS are far less of a concern until pitocin gets used.
    Pitocin should only be used when truly medically warranted. However, along with rupturing membranes, it is currently one of the more commonly used interventions in childbirth.

    It is important to keep in mind that just because something can be done, doesn't mean that it should be done.

    If nothing else, since it was not an emergency situation, the OP should have been made more aware of what was going on. It is when women feel things are just done to them in childbirth that they come away with a poor birth experience. Even when things don't go how you had hoped, being part of the decision making process and having your questions answered go a long way in helping women come away with positive feelings about the experience.
  • Feb 20, 2009, 12:11 PM
    ScottGem

    We have established that the doctor was within his medical rights. So any further discussion of that part is moot.

    The only further help we can give the OP is if she explains what she wants to do now.
  • Feb 20, 2009, 04:02 PM
    DoulaLC
    Quote:

    Originally Posted by ScottGem View Post
    We have established that the doctor was within his medical rights. So any further discussion of that part is moot.

    The only further help we can give the OP is if she explains what she wants to do now.

    I won't revisit the issue of medical rights, however since the OP has already spoken to her doctor, and has heard his reasoning for the use of the intervention, she can file a complaint with the practice and/or with the medical board of her state. However, other than perhaps some personal satisfaction of taking some sort of action, nothing will be done is this type of situation. If, by chance, it is a managed group practice, there may be some sort of discussion about how to better handle similar situations in the future.

    She can share her experience with other women so that they can be better informed about their role in their labor and birth. They should know that they have a say so in what goes on, they should be asking questions, they should have the use of interventions discussed with them, and they should be part of the decision making process.

    I hope she is able to come to terms with how her birth went and find some peace in knowing that she may be able to help other women and families.
  • Feb 20, 2009, 04:18 PM
    artlady
    Quote:

    Originally Posted by rikkifarkas View Post
    I dont want to sue for money. I want to know who i can report this to so that this does not happen to other woman

    I recently saw a documentary titled*pregnant in America*.
    It was very interesting and discussed your concern at some length.
    It is a very eye opening expose.
  • Feb 20, 2009, 04:20 PM
    JudyKayTee
    Quote:

    Originally Posted by artlady View Post
    I recently saw a documentary titled*pregnant in America*.
    It was very interesting and discussed your concern at some length.
    It is a very eye opening expose.


    Patiently waiting for J_9.

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