Deadly Epidural

burn out · Jun 6, 2006

My daughter just had a baby 5 months ago but she was going so fast that they didn't have time to put the epidural in. When the baby was born they took her to NICu and started anitbiotics and gave my daughter antibiotics. They said she had a strep b infection (i guess lady partslly) that was passed on to the baby and both needed treatment. When she went into the hospital her vital signs were fine no temp and no complaints of any infection. Even though this women in the article had no outward signs she could of had an infection going into the hospital.

RunnerRN, BSN, RN · Jun 6, 2006

:wakeneo:

Meningitis comes on fast; its hallmark is that it strikes a previously healthy person: e.g., one minute the person is shopping, 8 hours later the person is dead. We read about these cases in the paper every year; a kid at ballet lessons on Friday, dead on Saturday; a college student studying for exams, dead by morning. It happens.

While I agree that we are getting only one side of the story, it seems quite coincidental that there were so many problems with the epidural, including having it become completely contaminated and then replaced without a second thought. If it walks like a duck and talks like a duck......

I have always been an advocate of natural labor. I had a teacher in nursing school who had a theory that "associating the end of pain with this little red faced infant is good for bonding." I don't know about that, but I like to keep the number of foreign substances in my body to a minimum :) Who knows if I will change my mind once I am in the throes of labor pains, but this is my opinion for the current time.

I definitely think there are too many people who just go with whatever their doc/RN says....."Oh, you want me to cut off my head and donate it for science? Whatever you say oh mighty doctor." The average lay person has NO IDEA how to protect him/herself while in the hospital. It drives me insane when a patient wants to walk to the BR in her bare feet. Then get back in bed. And then there are the people who can't keep their hands off the IV or some wound. "Is this infected? Is it alright?" Trust me honey, if you keep touching it, it will hurt and it just might become infected.

Lurksalot, BSN, RN · Jun 6, 2006

At 10pm that night julie woke up and c/o a headache and said her eyes felt as if they were swelling!!!!!!!!!
The nurse gave Percocet. Why did they not call the MD? Does anyone have a problem with this. What about an allergic reaction? Would that have made a difference if it was treated then?

yeah, first thing that came to mind for me was "eye swelling"=ICP.

Maybe that's just because I've been studying neuro, but nevertheless...

bahamabread · Jun 6, 2006

Let me inform everybody. I consider myself a somewhat of a baby birthing expert. I only have three but with those three I have had everything!!!!!!!!! The first one was overdue and my cervix was hard as steel. So they induced me. After 9 hours of HELL I had only dilated to 2 cm. I was going crazy!! Literally.........I told my mummy I didnt mind if I died so the pain would stop. It was 15 yrs ago..........in a third world country so epidurals were not routine. I had a c-section.

8 yrs later.......overdue ( again) cervix hard as steel (again) big baby (again) The doctor gave me something to ripen my cervix overnight in hosp. Didnt do much........so he began me in the ptocin ( again) Now I knew what this pain was like so I was more able to cope because when it got bad it wasnt sooo surprising to me. Well after 12 hours of HELL and only 4 cm dilated............I was at the end. I was at the let me die stage again .......NO its no joke...........thats how bad the pain is with no breaks between. They offered me an epidural and it was that or another c-section. So I tried it ( but it was a last resort) The thing numbed my breasts. But I was sooo happy............pain was gone. 6 hours later...........sensation came back and I felt I had to sh** But it was the baby! ( what did I know? I never pushed out any baby!)I was at 10cm! I pushed for an hour.....................but doc had to end up using forceps after episiotomy ( and I still tore some more).

Ok .........7 yrs later...........I went through this mess again. Cervix like a rock.........at the due date check up. BUT two days overdue..........I felt back pain . This lasted all day! Then at 11 pm.......definately had contractions..........good solid ones..........but I breathed through them and didnt tell my husband until 5 am when they got strong. I laboured all day at home........taking hot showers..........sitting down..........laying down..........walking..........moaning............breathing..........holding my breath................whatever it took. They said dont come to hospital until pains are 3-5 minute apart. So I waited because they were 10 minute..........5 minute.........7 minute.........3 minute............11 minute...........but constant back pain all the while. ( I should have known to go to the hospital) But I was being a good patient! WELL.........my mother thought I should be going to the hosp so we listened to her and when I stood up and walked in the car ( at 10:30 in the night) I felt severe pain and my body began to push!!!!!!!! I dont know how made it. I wanted to take off my pants and push in the car.............the pushing feeling and the pain was bad! I somehow made it and she was born 5 minutes after I got to the hosp.......had some meconium.........I think she was stressed out while we were driving to the hosp. They asked me why I didnt come in sooner and I told them the truth. The pains I had with my two other children ( the induced babies) was soooo horrible.............and because I was coping with the pain at home...........I had no idea I was that far into my labour. I was waiting for the Hell to start..........then I would have known.

ALL OF THAT TO SAY THIS.............Not every labour is the same. I coped well with the natural labour..........but I would never had made it the second birth without the epidural. I would have ended up with another c-section which has more complications and risks. So it is good when it is necessary. BUT........most people nowaday have only one birthing plan................an epidural. That is not how it should be. They may be able to cope if they give it a real try and save themselves and the baby from risks. If they try and CAN NOT COPE..........by all means..........dont suffer the woman. Labour pains can be HORRIBLE. But women should have an open mind.............expect PAIN.............cope as best as they can............and they may be pleasantly surprised to have a natural birth with no drugs at all. It is worth a try. And the best for them and the baby. But to all those who feel that wome NEVER really need pain relief..................well.............I can tell them...............they never went to that hell I went to with that drip in my arm!! ( Another reason to wait past your due date until your body is ready..............it is soo easy and wayyyy less painful. Maybe the other times if I had waited another week ( I was only a week overdue..........and it can go to two weeks overdue. I always wondered if I waited.........I may have had all of my children naturally. Who knows?

subee, MSN, CRNA · Jun 7, 2006

Probably cuz the hospital isn't a fun place to try and do it naturally. You've got people running around threatening induction/c-sections if the baby isn't born at a certain time, giving episiotomies without even telling you, not letting you change positions. Who wants to lay on their BACK during the whole labor? How uncomfortable. Then some places do the whole count to 10 when pushing, I have to change the channel when watching the baby shows when I hear that! LOL

Keshia, I don't know how long you've been around but 30 years ago we all did it "naturally" except for an injection or two of demerol when you really got tired. When I was a student, we did an OB rotation at a very, very tough hospital in Brooklyn. However, the section rate was 10% because these women didn't come there to be pampered as a "client" - they simply walked until they crowned. These were high risk patients but they did great. Labor is supposed to hurt! I'm not advocating that no one get the garden hose in the back but that it be treated like a medical procedure with complications and reserved for those in whom its medically indicated. And you don't think that we put them in for FREE? Its a very expensive embellishment that we're ALL paying for. Its like the 50's or early 60's again where too many women want to lay on their backs and let someone else do all the work - they know nothing about giving birth and their expectations are so very unrealistic. How did this get so screwed up? I've already expounded on my theory. Let's hear somebody else's.

bahamabread · Jun 7, 2006

I dont know if I would like to be as rigid as it was in the "old days" ( as my mummy would say) I KNOW from experience that sometimes the pain can be UNBEARABLE. Awfully unbearable. In those instances.........an epidural is a lifesaver. It probably helps many women not have c-sections from long unbearable labours. But I agree.........its too commonplace...........much too overused.........as is inductions and c-sections!!

texas-rn-fnp · Jun 7, 2006

but with my first, they gave me an epi even though I hadn't wanted it and told them up front.

How did they make you get an epidural. The way you phrased makes it sound like they tied you down and forced it into you?

I assume you meant that they highly motivated you to get it and you consented although that wasn't your original plan.

Otherwise, isn't that assault and battery?

texas-rn-fnp · Jun 7, 2006

I don't think the GYN's want to be bothered by women in pain so they'll put up with anything to get them quiet. Caveat emptor.

I have not seen this to be a common situation of the Obstetricians forcing epidurals on patients. It has been my experience that patients either plan for it in advance or request it quickly when the pain gets worse.

The fact that the woman is having labor pain is not very significant to the obstetricians. The patients are counseled on their options and what is available and appropriate to their situation at that time and the patient makes the choice of what they want.

There are obviously disadvantages to certain analgesics at certain points, typically when delivery is getting close.

texas-rn-fnp · Jun 7, 2006

Probably cuz the hospital isn't a fun place to try and do it naturally. You've got people running around threatening induction/c-sections if the baby isn't born at a certain time, giving episiotomies without even telling you, not letting you change positions. Who wants to lay on their BACK during the whole labor? How uncomfortable. Then some places do the whole count to 10 when pushing, I have to change the channel when watching the baby shows when I hear that! LOL

If every patient wasn't demanding an epidural maybe it would be just a little easier for some of these interventions to be implemented.

How do you think you are going to walk around after an epidural if you can't feel your legs?

How do you think you are going to deliver in a variety of positions if you are so numb you can move your on legs or support yourself? BTW...historically (back in the caveman days) squatting is the position nature intended and opens the pelvis right up for baby to come out. All fours is also good for rotating baby, but can't do it or at least not without great difficulty if you have an epidural.

The tone of these postings is like all these poor innocent women are having the epidurals forced on them by the evil doctors....

I have worked at a dozen or so L/Ds and this is typically not the case. Either the patients have the plan for the epidural or they change their mind real quick once the pain comes. I don't blame them. I am a big weanie when it comes to pain. I would want one too.

RE: Informed consents...how much of an informed consent is possible when the patient is screaming out in 10/10 pain? That person is not going to listen to a thing you say. All they want is the pain gone. The solution is to educate before they are in active labor and get consent then. That is fine if they plan for an epidural. But what do you do when the patient is suffering in agony because she wanted to go natural and now changes her mind and wants an epidural. The anesthesia provider tries to sit down and explain everything to her. The only thing she wants to hear is that the pain is going away. The patient is not in the receptive learning mode at this point making an informed decision. That patient will sign anything to get the pain gone. Probably the best option is IV narcotics to get her under control and then do proper consent and then epidural with a pt under control. Let me know if you have a better way.

texas-rn-fnp · Jun 7, 2006

Oh and then when the baby is born they let you see them for 2 seconds and then take them off to the nursery for HOURS. That really made me PO'd. I was in the birth euphoria and didn't know what was going on. Then waking me up in the middle of the night pretty much every hour to take my vitals and sign stuff was a PITA. I have to admit though the nurses were great except 1 that smelled BADLY of cigarettes.

The current trend is for babies to stay with the moms until they go home to promote better family bonding and increase security (which is great). But then you have the families that want the baby sitting service because they are tired (legitimately so). Most pp nurses have so many patients that they cannot sit around baby sitting. They probably wish they could but staffing doesn't permit it.

If the nurse is checking on you every hour, be happy they are concerned about your well-being. That probably would have prevented the poor outcome that this whole thread is about. I know moms just wish they could sleep for a few days after delivery. It's a lot of work. But better safe than sorry. Mostly everything is ok, but if you don't check then you will miss the problems that come up.

texas-rn-fnp · Jun 7, 2006

You know, any information we have on this case is hearsay. We do not know for a fact that the hospital caused this woman's meningitis. Looking over the case there are things that could have/should have been done differently, but that is not inherently evidence of cause; and a one-sided news interview is not a court of law.
Meningitis comes on fast; its hallmark is that it strikes a previously healthy person: e.g., one minute the person is shopping, 8 hours later the person is dead. We read about these cases in the paper every year; a kid at ballet lessons on Friday, dead on Saturday; a college student studying for exams, dead by morning. It happens.
As for the response, we don't really know what happened there either. Postpartum headaches and fever can have more than one cause. If I had a patient who had a postpartum headache I'd be thinking pre-eclampsia and possibly post-epidural headache, not meningitis. Even with the fever, which could be a result of dehydration or a virus. Maybe the antibiotic wasn't given because it had to come up from pharmacy and wasn't available yet.
I have no connection to the hospital, and I'm not trying to diminish the family's pain; I just think we ought to be careful rather than assume we know the truth.
No one expects a previously healthy person to drop dead.
Altalorraine

I totally agree. We all have no clue what actually happened, except a horribly sad event that this mom is not here with us today. What really happened will be decided in a court of law.

The media is great at manipulating the truth.

luilui_604, BSN, RN · Jun 8, 2006

i just wanted to mention that my hospital has an epidural rate of 80% for laboring patients! although this is an unusual and heartbreaking case, none of my patients have ever complained or regret the fact of having an epidural! there are definately risks of infection, but many times the benefits outweigh the risks........i feel so bad the family had to go through such an ordeal :crying2: