man holding wife still during epidural dies!

[smk1]

Just read the ap report about a woman in labor at a kaiser hospital. Apparently the anethesia professional (don't know which kind crna, mda or aa) asked the husband to help hold the wife still while the needle was inserted into the epidural space of her back and, he saw the needle going in and fainted, fell over and hit his head, suffered a fatal brain bleed and died 2 days later. Of course the wife is sueing, stating that he was asked to assist the procedure and so "reasonable" care should have been taken to prevent reasonable forseable complications/accidents. My thoughts as a simply a student, is that this is a firviolous lawsuit, and the lawyer that is encouraging her to go forth with this case should be ashamed. Also I am so saddened for this family to have such a joyous event marred and a life gone without warning. I guess to all of you L/D nurses and CRNA's etc... don't ask a family member to help hold the mom still. :uhoh21: What are your takes on this?

[SmilingBluEyes]

I think part of this has to do with the different philosophy in OB. It is expected that family be supportive during labor where as in other specialties, family is not so much in the picture. The professionals here are confusing support with assiting in this case. Smaller hospitals may be more apt to allow family to provide more support, be more involved in the labor, as well, which is why families choose to have their babies in this environment.

Sad thing is, if this type of suit makes money, we can expect to take several giant steps backwards as far as involving family as support in labor and other areas, too.

it will certainly set some sort of precedent. That much, we can agree on.

[CrunchRN, ADN, RN]

New hospital policy:

all visitors (non-employees) must wear a helmet, complete padded biohazard suit, and bring their own oxygen supply. Puleeeeeeeeeeze - sometimes crappy things just happen.

[L/DRNinMO]

So in the above quote, if Dad isn't holding Mom (in a hugging position) what exctly is he doing?

I am sorry to hear that you don't involve the dads. It sure makes you have two free hands to hold the monitor on while she is sitting up etc., write on the strip, whatever...... Dad is a awonderful help if you just involve him.

I completely agree! Dads (who like to be in control) are put in a situation where they have NO control... over the pregnancy, over their wife's pain, the outcome of the day, ect...Involving Dad at least gives him some feeling of control and importance. I have the Dad sit on a stool at Mom's feet, he feels involved and cannot see what's going on. Birth should be about both parents.

[Sheri257]

I don't mean to stray off topic here but ... speaking of lawsuits and personal responsibility ....

Sometimes I help relieve sitters on patients who have attempted suicide because, apparently, the hospital is liable if they commit suicide in the hospital.

I've often wondered why the hospital would be liable. A patient can refuse medical treatment and commit suicide that way. So ... why is the hospital liable if they commit suicide by their own hand?

[LydiaNN]

I don't mean to stray off topic here but ... speaking of lawsuits and personal responsibility ....

Sometimes I help relieve sitters on patients who have attempted suicide because, apparently, the hospital is liable if they commit suicide in the hospital.

I've often wondered why the hospital would be liable. A patient can refuse medical treatment and commit suicide that way. So ... why is the hospital liable if they commit suicide by their own hand?

I never thought of it that way. You have a point, though.

[UM Review RN, ASN, RN]

I don't mean to stray off topic here but ... speaking of lawsuits and personal responsibility ....

Sometimes I help relieve sitters on patients who have attempted suicide because, apparently, the hospital is liable if they commit suicide in the hospital.

I've often wondered why the hospital would be liable. A patient can refuse medical treatment and commit suicide that way. So ... why is the hospital liable if they commit suicide by their own hand?

Because a suicidal person is an irrational, mentally ill person who has come to the hospital either by way of self or others, and has the right to be treated for a possibly fatal condition. That person has the right to expect that just as we protect the anesthetized or confused person from harm, so we will protect the suicidal or mentally ill person.

PS Did you know that suicide is illegal in many states? (How they prosecute a successful suicide I have no idea, but there you are.)

Back to topic: While I feel sorry for the people involved in this death, I don't believe there's liability here, either.

[shylite]

I agree with the last person. When a suicidal patient is in the hospital they become our responsibility. They obviously most times are not coherent, irritational and are not in a competent state to make their own decisions. When they become competent by way of the Psychiatrist or the court system all we can do is cover ourselves with documentation. At my hospital if there is a suicide within the hospital it is of course investigated to be sure that everything was on the up and up.

I don't mean to stray off topic here but ... speaking of lawsuits and personal responsibility ....

Sometimes I help relieve sitters on patients who have attempted suicide because, apparently, the hospital is liable if they commit suicide in the hospital.

I've often wondered why the hospital would be liable. A patient can refuse medical treatment and commit suicide that way. So ... why is the hospital liable if they commit suicide by their own hand?

[sbic56, BSN, RN]

Because a suicidal person is an irrational, mentally ill person who has come to the hospital either by way of self or others, and has the right to be treated for a possibly fatal condition. That person has the right to expect that just as we protect the anesthetized or confused person from harm, so we will protect the suicidal or mentally ill person.

PS Did you know that suicide is illegal in many states? (How they prosecute a successful suicide I have no idea, but there you are.)

Back to topic: While I feel sorry for the people involved in this death, I don't believe there's liability here, either.

Perfect answer to lizz question. When someone exercises their right to decline prescribed treatment, it is not the same as suicide. There may be other motives for doing so other than suicide, such as preserving quality of remaining life by avoiding unpleasant side effects of the treatment. Suicide is unquestionably a violent and deliberate act against oneself and a crime. If someone has been found to be mentally incompetent, we have the responsibility to protect them from themselves. Suicide is often a permanent solution to a temporary problem.

[Spidey's mom, ADN, BSN, RN]

It may interest you all to know that, whatever the outcome of the suit, the fact that this tragedy occurred, and the subsequent lawsuit, has caused me to rethink my practice.

In the past, if dad wanted to stand in front and help mom hold her position while I placed the epidural, I allowed it. In every case where someone wanted to stay in the room while I placed the epidural, I gave them the same speech. "If you feel faint while I am working, sit down. If you faint, you are on your own because I only care for one patient at a time." (Always said with humor, but while it got laughs, it also got the point across.)

No more. I will continue to allow family members to stay in the room while I put the epidural in, but will insist that they are seated throughout the procedure. Yes, the lawsuit concerns me, but it concerns me more that dad/grandpa/grandma/whoever is still around after the birth of the child.

Kevin McHugh

But will you let the family member (father) hold his wife during placement while he is sitting on that chair?

Seriously, I have women who DO NOT want to have the nurse hold them. They are scared and want their husband.

I don't think making a rule for a rare (freak) occurance is not the answer. Definitely teach the family member about the possibility of fainting and sit them down but let them help.

steph

[Marie_LPN, RN, LPN, RN]

I don't think making a rule for a rare (freak) occurance is not the answer.

But how else to avoid people who bring on emotionally-based lawsuits?

You could probably explain every little detail, and draw pictures, but if there's not rule against it, i guarentee we'll hear of another lawsuit.

[candyndel]

Because if the patient is impaired (cognitive &/or behavior) we have a duty to keep them safe.

They can not refuse medical treatment if they have any impairments in judgement. That's why when our psych pts (schizos usually) refuse a needle, we have to give them the med. If their thoughts were lucid, that would be considered battery.

And ther recent adoption of the Patient Safety Act is going to change a lot of current practices in acute care settings!!

I don't mean to stray off topic here but ... speaking of lawsuits and personal responsibility ....

Sometimes I help relieve sitters on patients who have attempted suicide because, apparently, the hospital is liable if they commit suicide in the hospital.

I've often wondered why the hospital would be liable. A patient can refuse medical treatment and commit suicide that way. So ... why is the hospital liable if they commit suicide by their own hand?

[Spidey's mom, ADN, BSN, RN]

But how else to avoid people who bring on emotionally-based lawsuits?

You could probably explain every little detail, and draw pictures, but if there's not rule against it, i guarentee we'll hear of another lawsuit.

You will never avoid those kinds of folks - I can't live my life in fear of them. Then they win.

steph