Thursday, September 27, 2007

NY: Get a lawyer to deliver your baby

It was one of the saddest decisions of his life. Tamer Seckin, who had spent 20 years working as an obstetrician-gynecologist in Brooklyn, was faced with the prospect of a 14 percent hike in his malpractice-insurance rate, so he decided four months ago to stop delivering high-risk babies. "Just today, I had to tell a woman I'd been treating for years that when she goes into the delivery room, I won't be there," said Seckin, who is the chief of gynecology at Kingsbrook Jewish Medical Center. "This is what I'm trained for, but I can't afford to do it anymore."

And he's not alone. The American College of Obstetricians and Gynecologists and the Medical Society of the State of New York both say that, with malpractice-insurance premiums rising, the dwindling number of OB/GYNs who can afford to practice has become a crisis, particularly for risky patients such as older women or those with medical conditions. "The impact of these rate hikes is tremendous," said Donna Williams of ACOG. "We're seeing many OBs who aren't willing to stay in practice because they just can't afford it."

Nationwide, malpractice-insurance premiums for OB/GYNs constitute about 5 percent of expenses, Williams said. In New York state, they are 36 percent. According to an ACOG survey, in the past four years, rising malpractice premiums have led 8.7 percent of New York state OB/GYNs to stop practicing obstetrics; 12.6 percent have decreased the number of deliveries they perform. And although the total number of births in New York City was down by 6,697 between 1995 and 2003, those requiring a Caesarean section - and a trained obstetric surgeon - rose by more than 3,000. At the same time, the city's supply of practicing OB/GYNs fell by 6 percent.

Edward Amsler, of the Medical Liability Mutual Insurance Co., says most of the blame lies with the tens of millions of dollars New York juries award families of disabled children.

Gov. Spitzer has convened a task force to find a compromise involving the interests of insurers, trial lawyers, doctors and patient-advocacy groups. "The line between a disaster and a happy ending is very thin in the delivery room," Seckin noted. "Events turn rapidly in a way you can't always control, and having an experienced doctor there is the best way to avoid disaster."


Another public hospital disgrace in Australia

Pregnant woman ignored: Miscarries in hospital toilet

A PREGNANT woman miscarried in a emergency department toilet while waiting for medical help at Sydney's Royal North Shore Hospital, her family says. Despite complaining of acute pain, the 32-year-old woman was not seen by a doctor or given painkillers at the hospital overnight, Macquarie Radio reported today.

The woman's husband, identified as Mark, said his wife, Jana, had already had one miscarriage this year. He said Jana went to the hospital about 6.30pm (AEST) yesterday because she was experiencing similar symptoms to when she had the earlier miscarriage. Mark said that after Jana had been waiting more than an hour at the hospital, he was told by a triage nurse there was nothing they could do, and they should just wait in the queue.

"In the course of our waiting, she's ended up on the floor in a squatting position .. with her hands wrapped around her legs ... directly in view of the administration section of the emergency ward. "She's grimacing in pain and nothing's being done."

Jana then went to the toilet and stayed there for a while, he said. "Next minute, I just hear a scream and a smash, and I jumped up, and I raced into the toilet, and ... I just couldn't believe the scene in front of me. "It is my wife ... sitting on the toilet, screaming ... an image in my mind I'll never be able to get out, the look on her face, screaming, tears, hysterical, pants around the ankles ... holding a live, live mind you, live fetus in her hands ... with blood everywhere."

The woman's husband complained to emergency staff about the pain his wife was experiencing, but was repeatedly told to sit back down and wait, the report said. The man's cousin, identified only as Peter, said on Macquarie Radio that the treatment they received was disgraceful.

"When we weren't looking she walked off into the toilet and had a miscarriage," he said. "People have come running (from) everywhere. "I can't go into the finer details, it's just so gruesome, mate. It's just something I wouldn't say on air. "She's holding the little fetus in her hand, basically, and was wheeled out of the toilet in front of this packed waiting room. "Not only that, but once they found her a bed they left her lying with the fetus between her legs for one hour."


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