man holding wife still during epidural dies!

Specialties Ob/Gyn

Published

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?

As someone pointed out, yes there are other situations where parents may hold their children still for procedures like immunizations or IV placement. It happens.

What I don't get is why it even matters if he was holding his wife or not. If he was standing 5 feet away and saw the needle and passed out, the result would be the same. It wasn't holding her that caused his fall.

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what if a woman somehow becomes unable to "hold still"? That is what the support person is for, right? Sometimes, huge drops in blood pressure occur, or a mom reacts somehow to being stuck, she is in horrible pain, trying to bear through contractions while being stuck? How responsible can she be at all times during such a procedure? I think that is taking her "responsibility" a bit far. It is OUR responsiblity overall as healthcare professionals, to ensure her safety during a risky procedure (and yes it is still considered high risk) like regional anesthesia placement. Now the significant other? I think that person needs to be able to take care of him or herself, or just leave the room while it's going on. That is only my opinion, I know.

Prior to my starting the procedure, I make the people that are staying in the room verbalize (in front of myself and the RN) their understanding that I am about to perform a procedure. I also have them verbalize that they understand that people have "passed out" by watching me do this and if they were to pass out could become a patient themselves. I then give them the option to stay or go and document accordingly. I truly do not mind who watches me perforn the spinal or epidural, I perform the procedure to the highest standard. But I will say that I document the conversation had concerning "passing out".

JMTOT,

Mike

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what a dumb lawsuit

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
Maybe we'll just have dad sign a waiver, too.

That's what it's going to boil down to, as lawsuit-happy as people are nowadays.

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Specializes in L&D/MB/LDRP.

One of our anesthesia docs posted this article in every labor room today. At this hospital they make everyone leave the room for the epid start. At my home hospital we let dads stand in front of mom all the time. However, I always have a chair near by and explain that if they feel the least bit "funny" they should sit down. My favorite policy was at the last hospital I traveled to. They allowed one person in the room but they had to be seated during the procedure. I feel sorry for the family losing their loved one....

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I just think that hugging or comforting a patient is much different that holding a patient steady. One involves a personal interaction and the other is merely mechanical.

I would chart the comforting of a patient as having been provided to address the patient's psychological needs as this is one of the areas our hospital looks at. However, the holding steady that is needed for an epidural....that is not comforting as it sometimes involves stength to keep the patient from accidentally harming themselves.

when i was in labor the nurse anesthetist told me to sit on the edge of the bed and lean forward and when she was happy that i was in position she told me to hold very still and my hubby held my hands in front of me. That was it. I am not a nurse yet, but my personal feelings as I stated in my original post, is that this family is seeking to blame someone for what is in essence a freak accident. Lots of things are done in L/D room such as helping to hold a leg using a birthing ball and bar, dad doing the breathing with mom cutting the umbilical cord, in all of these instances the dad could faint, would the hospital then be liable because the person has a weak stomach? I just think this is suspect at best...

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Both very good points, especially the last one.

So, if the mom who is holding the child for an immunization faints when she sees the needle . . . . is the clinic liable?

steph

another good point to ponder...

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As someone pointed out, yes there are other situations where parents may hold their children still for procedures like immunizations or IV placement. It happens.

What I don't get is why it even matters if he was holding his wife or not. If he was standing 5 feet away and saw the needle and passed out, the result would be the same. It wasn't holding her that caused his fall.

this was my point as well, i could see a case made for an injuy to the mom by improper poisitioning or something, but this is just reaching as far as i'm concerned.

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As someone pointed out, yes there are other situations where parents may hold their children still for procedures like immunizations or IV placement. It happens.

What I don't get is why it even matters if he was holding his wife or not. If he was standing 5 feet away and saw the needle and passed out, the result would be the same. It wasn't holding her that caused his fall.

Again, another great point!

I guess because we all have different experiences, we are reacting from that. We always have a husband or S.O. or mom or somebody in the room when we do an epidural. Always. I cannot remember a time when someone was not in the room. The CRNA does not kick anyone out.

It just seems so very odd to me that the laboring mom would have no support person, no doula, no spouse available when getting an epidural.

steph

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IMO this case will be won or lost on the patient's claim that the husband "assisted in a medical procedure." If helping calm a laboring patient by "hugging" her during epidural placement is considered assisting in a medical procedure, then anyone who helps coach, count, or hold a leg is assisting in a medical procedure. Ultimately, this will lead to one more consent that will need to be signed. The whole story is just so unfortunate.

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I agree this was an unfortunate accident, and am sorry for the family's loss. I just don't understand why this Dad just didn't speak up and say, I feel faint. :o

I had a Dad just the other day that I had to sit down because he felt faint. We have Dads support Mom by standing in front and holding hands all the time. They are not helping with positioning. The CRNA positions the patient. The Dad is just there for emotional support.

I agree that it will come down to the wording of the lawsuit. Did Dad just offer support, or was he actually "assisting" in a medical procedure? :uhoh21:

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I don't think it's a frivolous suit. A professional (RN) should have been holding, not dad. The nurse assigned to the mother should not have permitted dad to "help", and the anesthesia provider shouldn't have asked. Some people faint when seeing medical proceedures.

JMO

I had to have a epidural and am still having problems three years later, it was up to the nurses/consultant to make sure the husband stood back.

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