Mother of Nine Sues Massachusetts Hospital After Unauthorized Sterilization

[pgwenthold]

I wouldn't suspend colleagues at the same level who weren't involved, but I have no problem shutting down the hospital and leaving them to fend for themselves. However, everyone with an administrative position above the offending doctor would be included in the punishment.

ETA: I should give an example: I don't believe, for example, that a hospital radiologist who had nothing to do with the woman's case should be personally punished, although they would have to find a new place to work.

 

[Rasmus]

In this case, I suspect it would be less than the eventual settlement, she and her lawyer will split ..

Yes, and I would consider that a good thing, as this example also has its difficulties. The compensation is also for the fact it was not a voluntary decision, after all. And it should be fair in regard to other, similar cases.

But I'm not sure what type of settlement or compensation would be likely here, or how much or little money people would actually accept to be sterilized. If we look at people who are

- reasonably well off (a fair restriction; you can get kidneys or have people killed for preciously little money if you find someone poor enough)
- planning on having (more) children
- capable of having children in the first place

I guess the number would not be very small. I could be wrong, though.

 

[drkitten]

Hmmm. So, other than accidental sterilization, what other medical blunders should shut down an entire hospital? Or do you claim that accidental sterilization is the worst?

Unauthorized withholding of medical care, or unauthorized practice of unapproved experimental treatment would also qualify. (See the Tuskegee syphillis treatment for examples, which is why I mention them.)

Of course, if I were actually dictator of the world, I wouldn't need to prepare a list of what would qualify for shutdown in advance.

 

[drkitten]

I wouldn't suspend colleagues at the same level who weren't involved,

I would. Based on what I admit is the thoroughly Stalinist principle of providing an example to everyone. [Although the appropriate phrase, pour encourager les autres is actually French (Voltaire), and the incident that precipitated it is English.]

This gives the radiologist an incentive to actually seek out and prevent similar gross breaches of ethics. Because he knows that if Dr. Erlenmeyer's mistake can cost him not only his job, but his ability even to practice radiology, he will be inclined not to accept Dr. Erlenmeyer's mistakes.

Of course, since I'm being so thoroughly Stalinist, if the radiologist actively covers up Dr. Erlenmeyer's ethical lapses, practicing medicine will be the least of his worries. After he serves his sentence for conspiracy to obstruct justice, he can worry about what other punishments I've dreamed up to make his life utterly miserable.

 

[bookitty]

Eh? When you have children on welfare, you are expecting others to pay for them.


Why would you have a baby when on welfare?

I can imagine a scenario where you are able to afford a child and continue the pregnancy, then somehow lose your income when it's too late for an abortion. But that scenario, while possible, seems mostly unlikely.

I agree that it is irresponsible to have children that you can not pay for. I do not condone it. Sometimes it even makes me angry. (Octomom, grrrrr!) At the same time, that opinion has nothing to do with the mother's choice to have more children. That decision rests with her. Being pro-choice means supporting choices that I might not agree with.

It will be interesting to see what other information is offered after the OMG! Forced Sterilization on Welfare Mom! headlines have run their course.

 

[INRM]

If true, that's totally unethical, and they should be sued for it. Technically criminal prosecution for assault might be warranted...

 

[drkitten]

How would shutting down the entire hospital (thus removing ease of access to health care for hundreds of people) and holding responsible the colleagues of physician who made the error be in any way productive?

Pour encourager les autres. I wish to send a message to the entire health care profession that some levels of mistakes are not acceptable.

That's the entire purpose of punitive damages in the first place.

In particular, the mistake I wish to punish is the mistake of not double-checking your colleagues' work.

 

[politas]

Keep in mind we are talking about two different possibilities here. A mistake on one hand and intentional violation on the other. Intentional, this is completely unethical and a major violation. Mistakes during an operation can happen and that is excusable within reasonable limits. I have no idea on any numbers but would not be surprised if there is a high risk of sterilisation with C-sections after multiple pregnancies. We wait to see if there is even any evidence of her infertility yet. I assume there is a logical reason why she claims so, but we wait to see evidence.

There is a third possibility. The woman may be mistaken or intentionally lying, and she has not been made permanently infertile at all. If I were a doctor performing a c-section, and the patient proudly presented an IUD for implantation, I would tell her that the only form of contraception that would be possible during the procedure would be a tubal ligation, and then get on with the C-section.

The woman may have mistaken such a statement as a statement of intent. After all, she's undergoing major surgery, and quite likely not thinking perfectly clearly. Until I hear that there is some evidence that a ligation actually happened, my belief is that it probably didn't.

 

[bookitty]

Pour encourager les autres. I wish to send a message to the entire health care profession that some levels of mistakes are not acceptable.

That's the entire purpose of punitive damages in the first place.

In particular, the mistake I wish to punish is the mistake of not double-checking your colleagues' work.

So you would make all the doctors responsible for each other with dire consequences for mistakes? In hospitals they have heavy case loads. You would add non-medical responsibilities at no additional recompense, distracting them from their proper job of treating the ill.

How is this beneficial? Yes, this situation could have been avoided with a redundant peer-review. But this situation is far outside the norm. Mistakes of this scale have happened in the past, but they are very uncommon. It simply doesn't make sense for doctors to set aside their duties in order to look out for a once-in-a-lifetime error. They didn't go to medical school to be police officers.

 

[drkitten]

So you would make all the doctors responsible for each other with dire consequences for mistakes?

For sufficiently dire mistakes, yes.

How is this beneficial? Yes, this situation could have been avoided with a redundant peer-review.

You've just answered your own question.

But this situation is far outside the norm.

Demonstrably not far enough.

 

[NYCEMT86]

I love how most people on this forum have already found the doctors and hospital liable without even seeing any decisive evidence. Is this the new era of skepticism?

As I have stated before, at this point, I am completely neutral on this until more information is released.

So let me throw this hypothetical question out there;

What if this woman's lawsuit is nothing more than a fringe attempt to cash in. What should her consequences be?

Maybe we should hold her to the same harsh ideals of punishment that people like Dr. Kitten have towards the Hospital and Doctors.

Why not blacklist her from being able to receive any form medical care?
Why not force her to pay for all legal fees?
Why not have her publicly apologize to the staff directly involved and then to every single employee to the hospital?

 

[pgwenthold]

So you would make all the doctors responsible for each other with dire consequences for mistakes?

I can see drkitten's position on this, but I would add that IF we are going to add that "meddling responsibility" then there has to also be some additional rights built in as a consequence. Maybe something like more shared responsibility in other respects, too (although I can't think of one off the top of my head)

The net effect here is to move some of the administrative responsibility out onto the colleagues

 

[bookitty]

For sufficiently dire mistakes, yes.

No. How would the doctors know ahead of time that a situation would be sufficiently dire? They would need to check every aspect of case. This would include reading the entire medical history, keeping track of all medications, observing surgery and a host of other tasks.

In other words they would double their workload at no additional pay. This would also be so time consuming that it would interfere with their ability to provide care for their own patients.

I fail to see how this system would have protected the woman in question. The mistake was made in the operating room. Unless a non-involved doctor was standing by (just in case!), the mistake would still be made.

 

[AvalonXQ]

That's the entire purpose of punitive damages in the first place.

Punitive damages would only ever be leveled at the doctors themselves and/or the hospital -- in other words, those who should have been responsible to see that no such error occurred. Unrelated colleagues? That's just silly.

 

[drkitten]

I can see drkitten's position on this, but I would add that IF we are going to add that "meddling responsibility" then there has to also be some additional rights built in as a consequence.

I don't see it, frankly.

One of the few problems that everyone involved in medical malpractice reforms accepts as an issue is the lack of a culture of mutual responsibility among doctors. Too many doctors are failing to take responsibility for preventable errors, and the medical disciplinary boards are too lax on them. Even after the fact.

As I said, almost everyone (doctors included) accepts this as a problem in the abstract, but few doctors are willing to act on this in the concrete and take the necessary steps to stop the few bad apples practicing in their hospital.

I'd like to contrast that with the system of allocating responsibility (and punishment) in most of the world's militaries, in which if something goes wrong "on your watch," you are responsible for it and will be punished accordingly, even if you didn't know about it and couldn't have known about it.

This has the effect not only of reducing the incidence of things going wrong, but of encouraging cooperation and espirit de corps. People look out for each other because mistakes both can't really be covered up, and because a mistake made by one member of the team will result in punishment for everyone involved.

If the radiologist knows that his job is on the line if the surgeon screws up, he'll double-check the surgeon's work. It's not unreasonable to take a few minutes at the beginning of the procedure to make sure that everyone, including the patient, knows exactly what will be done. I can't, in fact, imagine any reason why you would want to withhold that information from ANYONE.

This simply makes it very clear that you trust someone else's ability to do their job at their own risk. That there are no circumstances under which "that's not my department" or "that's not my responsibility" will be accepted. Because the ethical and safe practice of medicine is everyone's responsibility, not just the responsibiliy of the person who is performing a given procedure.

 

[bookitty]

I don't see it, frankly.

One of the few problems that everyone involved in medical malpractice reforms accepts as an issue is the lack of a culture of mutual responsibility among doctors. Too many doctors are failing to take responsibility for preventable errors, and the medical disciplinary boards are too lax on them. Even after the fact.

How does failure to take responsibility for their own errors translate to guilt for their non-involved colleagues?

As I said, almost everyone (doctors included) accepts this as a problem in the abstract, but few doctors are willing to act on this in the concrete and take the necessary steps to stop the few bad apples practicing in their hospital.

There is a huge difference between reporting potential issues with a doctor and being responsible for their every action.

I'd like to contrast that with the system of allocating responsibility (and punishment) in most of the world's militaries, in which if something goes wrong "on your watch," you are responsible for it and will be punished accordingly, even if you didn't know about it and couldn't have known about it.

This has the effect not only of reducing the incidence of things going wrong, but of encouraging cooperation and espirit de corps. People look out for each other because mistakes both can't really be covered up, and because a mistake made by one member of the team will result in punishment for everyone involved.

How can you possibly compare the level of responsibility between surgeons and the lower-echelons of the military. This allocating responsibility is not done at higher levels. If a general makes an error, no other general need worry about repercussions.

If the radiologist knows that his job is on the line if the surgeon screws up, he'll double-check the surgeon's work. It's not unreasonable to take a few minutes at the beginning of the procedure to make sure that everyone, including the patient, knows exactly what will be done. I can't, in fact, imagine any reason why you would want to withhold that information from ANYONE.

Probably because it doesn't happen. The picture you paint, of a surgeon hiding the charts from his radiologist, is ridiculous.

This simply makes it very clear that you trust someone else's ability to do their job at their own risk. That there are no circumstances under which "that's not my department" or "that's not my responsibility" will be accepted. Because the ethical and safe practice of medicine is everyone's responsibility, not just the responsibiliy of the person who is performing a given procedure.

Can you please explain exactly how this would be implemented. There would need to be some system. Although you keep dodging the issue of an additional workload, there is no way that your scenario could avoid it. Would everyone be checking everyone work? They would have to. Otherwise someone might think that a procedure or prescription had already been double-checked and could overlook a potential problem.

It is insulting to the medical profession to treat them as if mistakes are the norm, that they are all so incompetent that every aspect of their practice needs to be double-checked by a non-involved hospital employee who may not even be a peer.

 

[Morrigan]

Natural consequence of sexual activity? Being on welfare does not appear to be much of a dissincentive to have sex.

Um, I didn't ask why/how she got pregnant, I asked why she would have a baby. Pregnancies can be prevented, and if that fails, they can also be aborted, in case you were unaware.

(Hey, if you're going to use lame and condescending sarcasm, expect the same thing in return.)

Food?

Pour encourager les autres. I wish to send a message to the entire health care profession that some levels of mistakes are not acceptable.

That's the entire purpose of punitive damages in the first place.

In particular, the mistake I wish to punish is the mistake of not double-checking your colleagues' work.

I think others have done a good job of explaining why your "solution" is wrong and thoroughly impractical, but I'll add that by shutting down the hospital for one physician's mistake, you're also punishing every other hospital employee, from the nurses to clerks to secretaries to janitors (are they all accountable to the physician's mistakes too?), and you are also punishing the patients (who'd have to go elsewhere, perhaps with great difficulty if it's not a big town, to get care). If that's not counter-productive, I don't know what is.

 

[The Fallen Serpent]

Um, I didn't ask why/how she got pregnant, I asked why she would have a baby. Pregnancies can be prevented, and if that fails, they can also be aborted, in case you were unaware.

Okay good point. A number of people don't care for abortions though. That is why someone would have the baby while on welfare. I suspect the US population would be significantly smaller if being in economic trouble was much of a determining factor for most people in keeping a baby. Money may be important for when people plan to have a baby, but for unplanned pregnancies (which is really common) few people decide to get an abortion because they are in a financially strained situation.

(Hey, if you're going to use lame and condescending sarcasm, expect the same thing in return.)

Perfectly fair and I do not mind.

 

[Skeptic Ginger]

Really? So the guy who shot up the ABB factory yesterday didn't kill 3 people, as reported, but actually only killed 1? The nursing home that was fined $1.6 million by the state was actually fined $4 million? The news reported that Alabama won the national title last night, when in fact it was USC who won? Etc...

I sounds like your ridiculous claims are the only thing that are rarely accurate.

So you believe everything you read in the news? Dang, that explains a lot.

 

[Skeptic Ginger]

35 and a grandma? I'm 36 and don't have ANY grandkids...I must be doing something wrong.

When I was 36, my first child was born.