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.”

[RobbiRN, RN]

Interesting discussion. I want to clarify my position on a few things:

My comments about lawsuits here were generalized in response to macawake's question. I stand by them.

I'm not in a position to judge if this patient has a legitimate reason to sue. She may have one.

I agree with Klone that this case will shape policy but not necessarily result in an overall improvement.

I've only worked in the ER for the last 24 years. About once a week a patient announces that he/she will be contacting his/her lawyer, either because he/she did not get what he/she wanted from us or because of the minor injury that brought him/her in. The one on my shift two days ago slipped on "sand" in a parking lot at Dollar General. At least it wasn't Walmart -- again. I'm a little jaded in this arena. They all have lawyers. I don't.

We should learn from countries that spend half of what we do on health care and have a lot more health to show for their money.

[Purple_roses]

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.

I was speaking generally--not voicing an opinion on the specific meds this woman was prescribed. Generally speaking, I think some women may genuinely need stronger meds for pain control.

[Kooky Korky, BSN, RN]

I don't know what "ATC" is, but yes, it's normal to still need narcotic pain relievers 3 days post-op from a C/S. Women are typically sent home with an Rx for an additional week's worth of narcotics. She just had open abdominal surgery, and not only that, she is doing something every 1-3 hours that is causing her uterus, which was just sliced open, to painfully contract. And women, in spite of just having had major surgery, are still expected to tend their child(ren), get up several times a day to pick up their baby, change diapers, make a bottle if not breastfeeding, etc.

I can't think of any other type of major surgery where the patient is expected to pretty much just go back to their normal active lives 3 days later.

It's called misogyny I think.

I couldn't agree more that CS pts should NOT be expected to care for their baby right away. Even NSVD moms are in pain. In the US, we need for women who have recently delivered to get more rest. Some people in the Hispanic cultures observe "cuarenta dias" - a period of 40 days during which Mom rests. She does absolutely minimal care of anything or anyone besides herself and the baby. Her mother or other female relatives tend to her, to the newborn, and to the household and the rest of her family and other obligations, giving her time to recover from L & D and from being sliced open surgically in the case of a CS.

Unfortunately, some people don't have many relatives to help, I guess, but that would be a tremendous custom to adopt.

[Kooky Korky, BSN, RN]

Thankfully mistakes as serious as amputating the wrong limb are extremely rare. I found one case in the past ten years (countrywide) and I looked in the database with all reported healthcare related incidents and the conclusions of the investigations. It wasn't really a case of amputating the wrong limb, but rather that of a misdiagnosis/delayed diagnosis that allowed the underlying disease process progress until amputation was the only available option. (The hospital would of course file a complaint against itself when something like this happens and the patient can also report). I'm not claiming that mistakes don't happen, because they definitely do but most don't have catastrophic consequences.

I don't know how much you know about the Scandinavian countries? We have an extensive social safety net in place. First of all, we have universal healthcare so your hypothetical double amputee would get the medical care he needs (medications, prosthetics, physiotherapy, psychological counselling, the necessary remodelling and equipment to make his home suitable for his condition and whatever else he might need). Transportation if he needs it (special taxi service for people who need it due to disease or physical disabilities). If he could no longer work at his previous job he would get retraining/a degree free of charge and of course also receive pay during the time he went to school. If he could only work for example 4 hours per day, he'd get paid for that from his employer and the remaining 4 hours would be sick pay (until reitirement age). If he for some reason was no longer able to work at all, he'd get sick pay until retirement age (65) or something called early retirement pay and then at 65 regular retirement pay.

All people who are employed also have insurance through their employer or union which will also pay you a lump sum if you are injured and/or lose parts of your bodily "functions".

Of course we acknowledge suffering and realize the importance of quality of life, but from my own experience (I've spent a couple of years in the U.S. and lived in about a dozen countries in my life) our societies are different in many aspects. We have a different attitude in some ways. We're not as "punitive-minded" and are basically focused on making the best of a crappy situation (which becoming a double amputee due to a medical error would certainly qualify as) for the individual who was the victim of the mistake. The focus of the hospital/facility where the mistake happened is to learn from the incident and actively work to prevent the same thing from happening again.

Hope that answers your questions :)

Yes, it does and I feel reassured. The US is definitely NOT like this. That is, the retraining for work you mention is hard to come by unless the pt or his advocate goes to bat for him. I guess he could get retrained and special ride service, etc. But you have to ask for it, beg for it, hunt it down. Unless one is extremely fortunate and has the best Case Manager/Social Worker on the planet, one is really out of luck. Could become homeless. That's why a pt who's been the subject of a grievious error will sue. He's going to need money to live. Even just getting an orthotic/prosthetic/therapy, etc. is a battle all the way. Even for veterans who've been wounded in war it is a terrible battle to get the care they need.

Thanks for sharing. How in the world do countries like those in Scandinavia afford to be so humane and be proactive about it?

[NutmeggeRN, BSN]

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'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).

Usually 30-40%

[That Guy, BSN, RN, EMT-B]

-EDIT-

never mind not worth it.

[fmf13]

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.

I am an OB Mother/Baby RN. We do give our C/S moms narcotics 3 day PO, but not all choose to take it. It is very common for moms to still be taking narcotics even after they are discharged. They were afterall, cut open and a baby was removed from the uterus and the uterus is involuting on top of that.

I don't agree with this being neglect, because, at our facility, when we bring baby in to breastfeed, mom accepts responsibility of infant. I know at my facility, we are required to do 2 hour rounds on nights for PO 3 C/S moms. I would not be surprised if this mother was warned several times throughout her stay about sleeping with the infant. I sometimes have to remind moms several times throughout the night to not sleep with their infants and I usually get a "I am the parent and I will do what I want" or they ignore the warning. All we can do is chart that we warned the mother about sleeping with the infant and that we explained the consequences of continuing to do so.

Don't get me wrong, I think this is a terrible tragedy and cannot begin to understand what this mom has gone through. At some point though, the mom has to take some responsibility. If the mother felt sleepy, she could have told the nurse that she wanted to sleep and to do a bottle. I know this isn't ideal for some, but it is better than falling asleep and something like this occurring. We aren't going to be with these moms when they go home and routinely they are provided narcotics for home. If this was something she felt uncomfortable with, then she has the responsibility to tell the RN that she would prefer not to have any narcotics, because it makes her too drowsy. At some point, the patient has to speak up about her care. We cannot read the patient's mind.

[Skippingtowork]

I don't think the point is whether the woman should or shouldn't have had an Ambien. I personally never took anything for childbirth or afterwards and put up with the pain. But let's face it it's a stressful transition And a lot of women do want pain medicine.

In that case, the policy should be that will be a support person to mind the baby, and that the woman not take the baby in bed with her while she's alone in the room. That sounds like common sense and not overreaching regulation. After childbirth is a vulnerable time for both baby and mom and mothers need help and support.

Rooming in is a great thing but that doesn't mean that it should let healthcare workers off the hook. The rules should be spelled out to the patient and her family, just like the hospital won't release the pair unless there is a properly installed car seat.

Rooming in is a great thing, but in reality you have tired mothers who think they know everything and refuse to put the baby back in the bassinet no matter how much you beg to do it for them. An worse, they put a fluffy pillow by the bed rails so the baby does not fall out. When you point out the danger, they dismiss you. And some of the men in the room are absoutely useless, not even wanting to hold the baby or change a diaper, claiming they are too small. I have cared for smothered babies as both a bedside nurse and an NP. The blame cannot be on the nurse or the facility. Sometimes people must suffer the consequences of their poor judgement and refusal to listen to the nurse's advise.

Lawsuits are often the result of anger. The mother waiting 5 years to sue may be related less to placing blame and more to the fact that the child (if alive) is now quite big and the road ahead is now obviously going to be difficult. It is a matter of survival.

I vote for bringing back the nursery.

[DebRN43]

Years ago I worked for an attorney. It can take 2-3 years to just gather information from all defendants in order to see if you even have a lawsuit. This is not an unusual amount of time to pass to file a lawsuit.

If the mother was sedated and not fully awake, the nurse should not have left the baby alone or should have made sure the mother was awake.

For the plaintiff to win the lawsuit, they have to prove the nurse was negligent. This can be hard to prove, but with a baby dying they will probably settle out of court.

[Cococure]

This is a very sad situation overall and I cannot begin to imagine what the mom when through and the guilt the nurse is feeling. I am going to chime in I work on post partum and yes moms do get narcotics for c-sections and vag deliveries...keep in mind the more babies you have the more painful breastfeeding will be for the mom. Also it depends on her lacerations 3rd or 4th degree tear is no joke. With that being said narcotics are given very cautiously and my hospital is designated a baby friendly so we do encourage bonding and breastfeeding. However we do tell the patient that they need a support person to be with them during their stay to help with baby. Does everyone have a support person no? No..but we are careful about giving narcotics. Most hopitals also have a safety policy/pledge that we have to go over and explain to the mom and support person and they have to sign it. We also round on the mothers constantly to make sure everyone is ok ...do patients always like it? No but it's does for safety. As a side story a mom once suffocated her baby while breastfeeding not because she fell asleep but because the room was completely dark and she was on her phone. This mom had large breasts and was advised several times to keep the light on and pay close attention. This was not the patients first child so she felt comfortable and was quite annoyed when staff checked on her. Sadly infant was suffocated and later passed away in the NICU. Everyone was devastated no one wants to lose a child the mom or the nurse. As for sleeps aids yes mom have gotten them in the past on ante partum and rarely on post partum and if they request it...we explain why we don't give sleep aids and most patients are ok only a few are upset. I have worked on a few post partum units and safety aslways comes first. Babies are watched at the nurses station at night if the mom wants to sleep for 1-2hrs and no support person and it's a available and it's a slow night or they go to the nursery if there is one...Sometimes at this point where baby is hungry and is exclusively breastfeeding the parents can make the choice to give 1 bottle so that mom can take her med and rest. If she gets narcotics and breastfeeding the nurses monitors the mothers as much as possible. This is where I am not a fan of the breastfeeding friendly policy and there is no nursery for the babies to go and nurses cannot watch all five couplets constantly...

[Cococure]

I personally never took anything for childbirth or afterwards and put up with the pain. But let's face it it's a stressful transition And a lot of women do want pain medicine.

In that case, the policy should be that will be a support person to mind the baby, and that the woman not take the baby in bed with her while she's alone in the room. That sounds like common sense and not overreaching regulation. After childbirth is a vulnerable time for both baby and mom and mothers need help and support.

Rooming in is a great thing but that doesn't mean that it should let healthcare workers off the hook. The rules should be spelled out to the patient and her family, just like the hospital won't release the pair unless there is a properly installed car seat.

You are correct on many points but you cannot use yourself as a benchmark. I have had patients who "put up with the pain" only to be in so much pain they couldn't take care of themselves or the baby. I am not advocating for narcotics but if ibuprofen is not working something else will take the edge off. And yes there should be a support person ...they are told about it on the tours, at registration...in L&D and in post partum. Even with the support person they don't realize that they are there to help and just go to sleep. Also the rules are spelled out, they even have to sign an agreement form stating that they understand what we just read aloud and explained to them.i agree we can't be let off the hook but we can't be expected to be with them all night. On my until we have 4-5...sometimes 6 couplets on a crazy day to care for. Also assisting with breastfeeding takes a lot of time and if I am helping one mom I can't leave and rush to another unless it's an emergency. We do have techs and lactation that help but it's not enough of them. I have been doing post partum for years and I get so many parents that refuse to put their babies to sleep in the bassinet. I get the "it's my baby I will do what I want". Some will even drop the baby during the night and not report it until they see the doctor in the morning. I would love to hear the nurses side of the story...maybe there was a super person there ...who knows.

Just my 2 cents

[Emergent, RN]

That reminds me of when one of my sons was a newborn in the first week of life. I had a old fashion pram with the spring wheels that was really good for a brand new baby because you could rock it.

At that time of life I was having waking dreams kind of like sleepwalking where I would briefly hallucinate as I was waking up that there was something happening in the room that wasn't. Very large spiders were theme for a while. I went through a phase where I imagined complicated surveillance equipment coming out of the walls and then going back in. I would come to my senses once I was fully awake.

My new baby boy was swaddled nicely in the pram because if I heard him stir I could rock him back to sleep if I knew he had already fed.

It must have been the hormone changes, but I had one of these dreams where there was something very bad in the pram and I ended up knocking it over in one of these states. Of course the baby started screaming and that woke me up totally and I realize what I had done. It was scary. It never happened again and the baby was fine.