Mom suing nurse after suffocation accident

[MunoRN]

This Mother Is Suing a Hospital for Millions After She Accidentally Killed Her Son

A mother in Oregon is suing Portland Adventist Medical Center for $8.6 million after she accidentally smothered her four-day-old baby in a hospital bed.

Monica Thompson says that, a few days after her son Jacob was born in August 2012, the hospital put her newborn in bed with her so she could breastfeed him. But Thompson says in the lawsuit that the baby was put there in the middle of the night, while she was heavily medicated. Thompson drifted off, and when she woke up, Jacob was unresponsive...

Thompson, who is suing both the hospital and the individual nurse involved in the incident, said she was still drowsy and groggy” from her medication when she realized her son was not moving, her lawsuit states. The suit says Thompson called for a nurse, and when none came, she carried her son to the hallway and frantically yelled for help.”

[JKL33]

New study shows that the savings from 'tort reform' are mythical - LA Times

From the link:

"Tort reform" would only eliminate orders made purely because of fear of litigation -- that is, 100% defensively -- and that's a tiny percentage of the total.

This statement involves quite the spurious definition of "defensive medicine." "100% defensively" would mean something like seeking to rule out a condition that is not even in the differential, since if it IS in the differential then whatever is done to rule it out is not strictly "defensive." I've heard these arguments before and they make no sense, but they sound reasonable if not thought all the way through.

[OrganizedChaos, LVN]

The woman is claiming the nurse came in at night to give her, her baby to breastfeed. The woman is saying the nurse is at fault because she was medicated with Ambien & Vicodin & was unsupervised while breastfeeding her son. She then states she dozed off with her son in her bed & then when she woke up her son was in her bed, unresponsive. She called for a nurse but one didn't come. Apparently, the woman had to leave her room to get a nurse to attend to her son.

So, what do all of you think of this? Is this a case of neglect? Does the nurse deserve to be sued?

Access Denied

[Anonymous865]

Losing a child is such an unimaginable tragedy and my heart goes out to any parent who has had to experience such a devastating loss.

I can definitely understand suing if you want to have someone accept responsibility/accountability and to acknowledge wrongdoing (if it took place) and I can also understand wanting to be compensated for the of cost bereavement counselling, loss of wages due to being unable to work during a period of time and for other necessary care/support that follows in the wake of such a tragedy. However seeing that someone is suing for almost double-digit millions (which is an insane amount of money) makes me glad that I live and work in a country where healthcare professionals aren't sued. Here, a patient can definitely report licensed healthcare professionals to the licensing and oversight authority but you can't sue or be sued for zillions.

I can't help it, when I hear of cases similar to this one, the large amount of money makes it seem slightly mercenary to me. You can't assign a dollar value to a human life and attempting to do so in fact has the opposite effect on me. To me, it devalues life when it's viewed in terms of a windfall.

What makes it even more unappealing to me is that if I understand this correctly, a rather large percentage of a potential settlement goes to the lawyers? If I got that part right, it serves as a powerful incentive to file even more big $ law suits (compared to if the legal team were paid a more modest fixed fee).

On a societal scale, the prevalence of law suits in the healthcare industry is bound to ultimately increase the cost of healthcare. I think it's quite unfortunate. Frankly, I think it's a sick system.

Research shows that the top 3 reasons people file a medical malpractice lawsuit is to get the truth, to prevent this from happening to someone else, and to get someone to say I'm sorry and/or acknowledge their injury.

Money does make it on the list of reasons people sue, but only for actual losses and to pay future care costs.

Yes. Lawyers do take 40% of the settlement. This sounds awful until you realize that the lawyer makes nothing unless he wins the case. The lawyer pays all the costs associated with the lawsuit. S/he doesn't recover any costs if s/he loses. An expert witness might charge the lawyer $1,000/hour for reviewing the medical records, meeting with the lawyer, giving depositions, testifying in court. The lawyer is paying clerical staff, overhead, filing fees, etc. It might take 3-5 years before the lawyer gets paid a cent.

Finally 82% of medical malpractice suits get $0. In 82% of the cases the lawyer spends lots of time and money and makes nothing.

In the other 18%, the average settlement is $425,000.

The advantage to this approach is that a lawyer won't take on a case unless they think they have a good chance of winning. If an individual had to pay the lawyer, the expert witnesses, etc. up front, only the wealthy would be able to sue. If someone has been harmed by another's negligence they should be able to get their case heard in court.

[KatieMI, BSN, MSN, RN]

Research shows that the top 3 reasons people file a medical malpractice lawsuit is to get the truth, to prevent this from happening to someone else, and to get someone to say I'm sorry and/or acknowledge their injury.

That's what they say when officially asked. Put on plain clothes and sit for a few hours in a lobby of any pain clinic of your choice - you'll be pretty amazed hearing what they REALLY think.

Yes, 82% of lawsuits do to File 13. But lay public doesn't know it. What they do know is that winning lawsuit against a doctor gives a better chance than playing Mega Million lottery.

It is kind of interesting how different "defence medicine" can look like in this environment. I bet that even if this particular suit ends with nothing, there will be explosion of policies, schmolicies, consents, agreements, waivers, etc. because, not being "official" money-winners in medicine, nurses have only one avenue left to protect themselves- and this is proliferation of medical bureaucracy.

[ComeTogether, LPN]

I had to sue a doctor for a legitimate reason (podiatrist put a screw in my heel and missed my bone...wish I was kidding) and my attorneys took 45%. Its absolutely insane and the whole thing was stretched out over almost 3.5 years because the defendants attorneys got paid hourly. Seriously screwed up system.

[Julius Seizure]

I'm wondering why it took her five years to file the suit.

Don't cases often take years to be built and officially filed as lawsuits?

[Emergent, RN]

I'm surprised at all the negative comments regarding the mother suing. It does sound like negligence. We don't allow people on these drugs to drive home, why would it be considered safe in any place to hand the newborn baby to a mother on drugs in a bed?

If a mother needs to take opiate pain medicine, then there needs to be a policy that she cannot be laying in bed with her baby, unless there is an adult in the room supervising. This is to protect the child, and no exception should be allowed even if a waiver is signed.

[blondy2061h, MSN, RN]

Honestly, I don't think there is more to the story. I think it's exactly how it happened - nurse brought baby in to nurse, mom fell asleep because of narcotics and Ambien, and suffocated her baby.

While we do not routinely give sleep aids to women postpartum, once in a while we have. And all postpartum women are ordered narcotic pain medications - we give that out every 4 hours round the clock.

Is it normal to still need atc opiates 3 days post op from a C section?

[Purple_roses]

That was my first thought as well. Mom kills baby, later blames nurse and sues because she needs cash. People are terrible like that.

Also, why are postpartum moms getting narcotics around the clock??? I get that labor is painful, but can people not tolerate pain anymore or something? Give mom some tylenol and a heating pad.

Eh. I really don't agree with this. I think of all the types of pain out there, post-birth is really deserving of a narc or two. They've been laboring and in pain for hours and hours, then continue to have pain for weeks. They need rest, and they need some pain relief to get that rest.

[traumaRUs, MSN, APRN]

Merged threads

[macawake, MSN]

I am the manager of an OB department in Oregon. I'm wondering what effect this litigation will have on our practices. Are we going to require moms to get up out of bed and sit in a chair every time they need to feed their baby? Will a nurse have to sit in the room with the mom the entire time she's holding her baby unless another adult is there? What effect is this going to have on patient satisfaction? On breastfeeding, and mother-infant bonding?

Your questions illustrates one of the risks I see with multi-million $$ law suits. If you change your guidelines because research show that new guidelines will benefit patients and ultimately improve patient safety, then I'm all for it. However if guidelines are changed primarily out of fear of future expensive law suits, I regard that as just another example of defensive medicine motivated by protection for the provider rather than patient safety.

mom fell asleep because of narcotics and Ambien, and suffocated her baby.

While we do not routinely give sleep aids to women postpartum, once in a while we have. And all postpartum women are ordered narcotic pain medications - we give that out every 4 hours round the clock.

(partial quote)

I don't work on obstetrics so I don't have your expertise in that field, but I do work with treatment of pain. I'm surprised that your facility's policy is to give all postpartum women opioids every four hours. For how many days postpartum do you normally treat that way? I practice in a different part of the world and we don't habitually prescribe opioids after lady partsl deliveries. (It's done if needed but non-narcotic pain medication is generally tried first).

I'm curious, is your treatment regimen evidence-based? (The studies I've found, and I admit that some of them are quite dated, show that ibuprofen is as effective in managing pain following childbirth as is the combination acetaminophen/codeine, but with fewer side effects. I haven't been able to find research that supports opioids as baseline standard treatment).

Codeine-acetaminophen versus nonsteroidal anti-inflammatory drugs in the treatment of post-abdominal surgery pain: a systematic review of randomize... - PubMed - NCBI

We also don't prescribe zolpidem (Ambien) to breastfeeding mothers other than in extremely rare instances. Opioids and "Z-drugs" both cause central nervous system depression. We generally avoid concomitant use of opioid pain medications and benzodiazepine-like sedatives in breastfeeding mothers since it increases the risk of CNS depression.

Very small amounts and yes, it's perfectly safe.

What kind of opioids do you prescribe to breastfeeding mothers? I think it's a stretch to call it perfectly safe, since there have been adverse events associated with mothers breastfeeding infants while taking opioids. I can agree to that it's mostly safe and definitely agree that treating postpartum pain is a priority, but that it's important to be aware of the risk and to be very alert to symptoms of CNS (central nervous system) depression in the breastfeeding infant (and of course also in the mother).

Opioid Metabolism

Opioid pharmacokinetics can be a tricky thing. I've browsed the web to try to figure out what is used to treat postpartum pain in the U.S. One of the treatment options I found was codeine. Is that correct?

Codeine is metabolized into morphine by the enzyme cytochrome P450 2D6/CYP 2D6. Most individuals have two functionals copies of the CYP2D6 gene and they will get pain relief and "normal" blood concentrations of morphine from codeine, but among for example Europeans approximately 1 in 12 don't have any active gene copy (thus unable to convert codeine into morphine) and won't experience any analgesic effect. On "the other end of the spectrum", we have individuals with functional duplications of the genes and these individuals are known as ultrarapid metabolizers. This rapid metabolism will lead to (sometimes much) higher concentrations of morphine in the mother's blood and breastmilk. The percentage of the population who are thought to be CYPD26 ultrarapid metabolizers varies by race/ethnic background. In some populations it's as high as ~30%.

This is a case study about an infant death associated with maternal codeine use:

Safety of codeine during breastfeeding

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Regarding the high cost of healthcare in the U.S. I believe there is definitely more than one factor that affects it and that the factors are entwined and synergistic. I don't necessarily think that law suits is the main one, but I'm a bit surprised that many seem to think that multi-million dollar law suits aren't a factor. Where do people suppose the total amount of billions of dollars actually come from? Out of whose pocket ultimately?

What country are you from macawake? Are you accepting immigrants?

I live and work in Sweden and Norway :) We are.

The lawyers here plead before the jury how morally imperative it is for the wronged individual to be properly compensated for all his or her suffering before the law firm walks off with nearly half the loot. Lawyers routinely seek litigation, advertising that "there is no cost unless we recover for you."

Litigation is the main driver behind costly and often misdirected "defensive medicine."

I agree with you. The entire purpose of "defensive" is to protect against something and I don't see many other plausible and sufficiently powerful threat candidates in the healthcare arena.

Research shows that the top 3 reasons people file a medical malpractice lawsuit is to get the truth, to prevent this from happening to someone else, and to get someone to say I'm sorry and/or acknowledge their injury.

Money does make it on the list of reasons people sue, but only for actual losses and to pay future care costs.

From your response, I get the feeling that I wasn't able to make my point very clearly? I have no doubt that the motivation/priority for most people is to hear someone accept responsibility and to actually get an apology if they've been mistreated. That's pretty much universally applicable, it doesn't really matter if it's a friend or family member who said something hurtful to you or if it's a nurse or physician who has been negligent. People need to be seen/acknowledged and if someone has done wrong by them, it helps if you hear the person accept accountability and offer a sincere apology.

If someone has been harmed by another's negligence they should be able to get their case heard in court.

I guess you are an American? We're likely conditioned to think differently. If I get injured I couldn't care less about my day in court, unless I was the victim of a criminal attack. If I suffer injury from a mistake made by healthcare professionals either due to negligence or unreasonable work conditions (overworked and understaffed), I want an acknowledgment of my suffering and an apology. Money wouldn't make me any happier or heal injuries or any potential psychological scars.

If the physician or nurse's mistake was serious enough that it can't be corrected by additional training and wasn't caused by variables outside of their control, then it's in my opinion appropriate with disciplinary action against their license, up to including revocation when warranted.

I suspect that people in my neck of the woods are generally more trusting and likely happier for it. It might surprise you to hear that we don't have anything like a consent form that the patient needs to sign.

I've had several surgeries myself and I have always been treated with respect and have only one minor complaint which I verbalized when it happened and received a genuine "I'm sorry". That was enough for me.

I work with surgical patients all day long, (well all night long actually). I provide sedation, analgesia, amnesia and muscle paralysis when needed and generally just do my darndest to keep them alive. Before surgery I simply ask them if they want me to provide them with treatment that is medically most sound and do what I have to to keep them safe? Almost everyone simply say yes, and the few who are interested in the details or have special requests will voice them and I will take note. It doesn't have to be any more complicated than that. Not a single piece of paper is signed and I have not had a single complaint filed against me in ten years of nursing. I have however received a ton of boxes of chocolates, thank-you cards/notes, little glass figurines of angels, home-baked cakes, christmas tree ornaments, hand-knit warm socks for winters etc.

I'm surprised at all the negative comments regarding the mother suing. It does sound like negligence. We don't allow people on these drugs to drive home, why would it be considered safe in any place to hand the newborn baby to a mother on drugs in a bed?

I'm not sure if you include me in those you think are negative towards the mother? I deliberately haven't voiced whether I think that her case has merit and whether I think of the specific details surrounding her situation amounts to best practice or is even acceptable.

My gripe is with the phenomenon of multi-million dollar law suits.

[JKL33]

Eh. I really don't agree with this. I think of all the types of pain out there, post-birth is really deserving of a narc or two. They've been laboring and in pain for hours and hours, then continue to have pain for weeks. They need rest, and they need some pain relief to get that rest.

Post-birth? Not in my book. Post-surgery, yes, and she did have a C-section. That's fine. Ambien, in my very humble opinion, is not fine, especially combined with opiates. Ambien is dangerous on its own; amongst other things it shouldn't be taken without a reasonable plan for sleeping a long stretch.

Technically, I don't understand why the physician/provider who ordered these meds isn't named (whether one agrees with their administration or not), and I do think Ambien is possibly the bottom line here. Problems with it are fairly well-known, I thought, and it's not just that it make one very tired/sleepy, it's that the person doesn't know what they're doing if awakened while under its effects. I do think there might be something more to this lawsuit. Elsewhere she is quoted: "What happened to us could have easily been prevented had the nurses been doing their job"...Such as refusing to give her the medication the doctor ordered? Giving her the medication and refusing to bring her the baby? Feeding the baby formula against her wishes? Sitting with mothers while they're breastfeeding is certainly not the expected practice/standard of care.

It's too bad because this medication isn't routinely given to postpartum moms. The patient said something to impress everyone how much she needed to sleep. She has experienced a tragedy that started because she felt the same way that every single mother in the entire world EVER, has felt....TIRED.