About 700 women die from pregnancy-related deaths each year, and the majority of those deaths are preventable. This is according to the United States Department of Health and Human Services. Virtually every organization concerned with patient safety has recognized that this number of preventable deaths is far too high.
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The Joint Commission—the leading national organization that accredits hospitals—has identified four common, preventable patient-safety errors that cause these needless pregnancy related deaths:
- Bleeding to death;
- Failing to monitor and control blood pressure properly;
- Failing to diagnose and treat pulmonary edema (fluid in the lungs) properly; and
- Failing to monitor vital signs after a c-section.
All of these Pregnancy Related Conditions are Preventable
Bleeding to Death
There have been incredible advances in medicine in recent decades, and massive bleeding of any type is often something that doctors can safely treat. No one should ever bleed to death in a hospital setting. Patients must get the right care, at the right time.
Before a baby is born, the mother exchanges oxygenated blood with the fetus through blood vessels in the placenta. After the baby is born, the mother’s side of the blood-exchange system remains there, but the baby’s side is gone. Think of a whole lot of water pipes suddenly open and sticking out of the ground. When we get a cut, our blood forms clots and the bleeding stops. But when a baby is born, there are just too many pipes for the usual clotting system to work fast enough, so the body has an alternative system: muscles in the mother’s uterus contract, physically squeezing and clamping off the pipes. This does not always work perfectly, but thankfully doctors have medications available that they can use to firm up the muscles in the uterus and stop this kind of bleeding. But these medications don’t work if doctors and nurses don’t notice the problem promptly, have the right medications available, and administer the medications to the patient at the right time (most often, this means immediately).
Excessive bleeding can also occur during a caesarian section delivery. A c-section is a common surgical procedure, but it is still major surgery, and as with any surgical procedure, unexpected and excessive bleeding is always a possibility. The body provides many warning signs that blood loss is occurring. The most common symptom is an elevated heart rate, known as tachycardia. It is all too easy for nurses and doctors to dismiss an elevated heart rate and chalk it up to the stress of childbirth. But that is not a safe approach. Careful doctors and nurses will recognize that an elevated heart rate can also be a life-saving warning sign indicating that the patient is bleeding inside. Sometimes emergency surgery is the only way to stop the bleeding.
Excessive bleeding is something that medical professionals know how to treat. In many cases, what patients need is a massive blood transfusion–many units of blood replacement, delivered as quickly as possible. Every hospital should have a set of written rules in place for this situation and should ensure that every member of the care team is trained about these policies and procedures. Hospitals also need to have an adequate supply of blood products available. By the time an obstetrical emergency occurs, it’s too late to train, and it’s too late to request blood supplies from a blood bank in some remote location. Some hospitals do a very good job implementing these procedures. Other hospitals, unfortunately, do a poor job of training, and do not always have enough blood products or the right kinds of blood products available when an emergency situation presents itself. Such hospital shortcuts can result in needless deaths.
Blood pressure is easy to measure. We all know this. Elevated blood pressure, even during pregnancy, is something doctors and nurses know how to treat. But sometimes patient complaints are ignored, and a patient is sent home from the doctor’s office, clinic, or hospital too soon. Sometimes phone calls are ignored or not returned. Failing to heed these early warning signs (just like failing to measure blood pressure in the first place) can be extremely dangerous.
The same thing is true of pulmonary edema, which is, in layperson terms, excess fluid in the lungs. This condition is easy to detect, but only if doctors and nurses pay attention to what the patient is saying. We know when we can’t breathe. The most famous example of this scenario involved tennis star, Serena Williams, who complained of trouble breathing after her daughter was born. Even though she was in one of the world’s best hospitals and was a famous athlete, doctors and nurses initially dismissed her complaints until her breathing problems, which were caused by a blood clot in her lungs, had become a life-threatening medical emergency. The Serena Williams story tells us something important: it doesn’t matter how prestigious the institution is or how famous the patient is. At the end of the day, it’s all about doctors and nurses and midwives and the entire medical team paying attention to what patients (and the patient’s vital signs) are telling them. No patient should ever die as the result of a medical provider’s inattention.
Failure to Monitor Vital Signs After a C-Section
For busy hospitals, caesarian sections can come to seem routine. Parts of the procedure are often handed off to doctors who are still in training. And because mothers tend to be younger and healthier than other patients in the hospital, it is easy for providers to become complacent. The majority of patients do well without any extraordinary medical attention or interventions. But some patients do require extra help. That is why mothers remain in the hospital right after caesarian sections. When problems do arise, they can almost always be addressed, but only if doctors, nurses, and physician assistants pay attention and the problems are recognized and addressed early enough.
The Elephants in the Room – Pregnancy Related Deaths & Injuries
There is an elephant in the room for all of these issues — two elephants, really: money and race. Or as the doctors and public health professionals who study these issues would put it, “socioeconomic disparity, rooted in long-standing systemic racism.” An article in the May 9, 2021 Philadelphia Inquirer reminds us yet again that these factors play a noticeable role in maternal death rates and other complications relating to childbirth. None of this comes as a surprise to lawyers who handle maternal death cases and birth injury cases. While medical negligence can happen even at the most prestigious hospitals, it is the hospitals which serve those less favored by fortune that seem to have more than their share of overworked staff who are ill-prepared to handle obstetrical emergencies when they arise. At least that’s our experience, over decades of handling these cases.
The guiding principle here is that every patient, no matter what her background is, deserves the careful attention of doctors and nurses who have been properly trained, who are able to pay individual attention to every patient, and who have all the tools, medicine, and equipment they need to take care of new and expectant mothers. If a hospital or clinic cannot meet or exceed these expectations, that institution has no business being entrusted with the lives of mothers and the lives of children, born and unborn.
All too often, medical providers take a “circle the wagons” approach in these situations, and important information is not disclosed to families. To lawyers who are familiar with these cases, however, it is not all that difficult to dig into the records and figure out what really happened. Especially lawyers who have handled these cases for decades, have a medical doctor on staff, and work with some of the nation’s leading medical experts. Lawyers like the team at McLaughlin & Lauricella.
Contact Our Experienced Birth Injury Lawyers
The birth injury attorneys at McLaughlin & Lauricella, P.C., have more than 100 years of experience representing individuals and families involving pregnancy related deaths and injuries across Philadelphia, Berks, Bucks, Dauphin, Delaware, Lackawanna, Lehigh, Luzerne, Montgomery, and Northampton Counties, as well as the State of New Jersey. Contact us today toll-free at 215-568-1510 or fill out our confidential contact form to learn more about your legal options.