December 9, 2009
An All Too Familiar Horror Story
The tragedy of Roshunda Abney, (Las Vegas Review, Woman Says She Was Ignored in ER, Paul Harasim ) occurs much too often. She went home after a six-hour hospital wait, and returned with a dead baby.
Abney was a part-time customer service rep in Las Vegas who lived with her high school sweetheart. They had relocated from Mississippi for a better life.
Abney had irregular menstrual periods, so she didn’t know that she was pregnant. For the past two days she had experienced menstrual-type cramping that wouldn’t go away despite taking over-the-counter painkillers. When the pain became unbearable, Abney went to a hospital-affiliated urgent care center. A nurse requested a urine sample but Abney was not able to supply one. Thirty minutes later a decision was made to transfer Abney to the hospital ER because she needed “higher care.” She was also uninsured.
Abney’s vital signs were taken upon her arrival to the hospital ER and then she proceeded to wait. And wait. And wait. Her pain became worse and she unsuccessfully attempted to receive medical attention. When she told a certified nursing assistant that her pain was getting worse, he told her that if she endured it for two days, “another 45-minutes wouldn’t make a difference.”
Sympathetic patients who were present in the waiting room offered to allow Abney to go ahead of them. They were subsequently informed to “mind their business or they would never see a doctor.” After a six-hour wait without being seen, she went to another hospital where she was also not seen and went home thinking she had gallstones. Twenty minutes after she reached home, her membranes ruptured and the feet of a baby was emerging. Paramedics were called and subsequently delivered a 24-week breech baby girl who was lifeless.
Abney’s case illustrates why hospitals and physicians get sued. She had to contend with layers of arrogance and calloused gatekeepers.
I strongly encourage all pregnant women to read The Smart Mother’s Guide to a Better Pregnancy. If you think the story of Roshunda Abney is an isolated incidence. Please, think again.
September 2, 2009
Invoking the Miraculous: A Case for the Public Health Option
If JT had private insurance and not Florida Medicaid, her baby would probably be dead.
JT’s pregnancy was miraculous, considering she had conceived with only one fallopian tube and ovary and she had no prior children. Things went well until her 27th week when she developed vaginal spotting. She went to a local hospital and was discharged home with a clean bill of health although they never ordered an ultrasound.
Bleeding during pregnancy is not a normal phenomenon. When I saw JT three days later during a routine prenatal visit, I ordered an ultrasound although the bleeding had stopped. A few hours later, the radiologist emergently reported that the placenta completely covered the opening to her womb and the baby’s umbilical cord was wrapped tightly around its neck three times. JT had a complete placenta previa and someone at the local hospital had regretfully missed the diagnosis.
I discussed JT’s case with a high-risk obstetrician and we both agreed that she should be admitted to the specialty hospital if only for observation. Thankfully, JT had state-sponsored Medicaid insurance because a commercial insurer would have made us jump through hoops. They would have required pre-authorization, endless forms and an inappropriate premature discharge home where she would have subsequently returned to the hospital with a dead baby.
What was supposed to be a 24-hour admission turned into a sixty-four day hospital stay because JT bled on a weekly basis. The cord remained around the baby’s neck and the prognosis was guarded regarding successfully carrying the baby until it was full term.
At 35 weeks, JT had an amniocentesis to make certain that her baby’s lungs were mature. She was subsequently delivered by cesarean section with the umbilical cord STILL wrapped around her baby’s neck. Because of skill, compassion and medical expertise, both mother and baby are just fine.
Marie Curie once said, “Nothing in life is to be feared. It is only to be understood.”
Please do not let fear cloud your judgment. Support the public health option, America. We need these miracles to continue.
