One afternoon, a woman in her late 20s was shopping with her husband in Sugar Land, Texas. She was 32 weeks into her pregnancy with their first child. When she went to the restroom, she noticed some blood in her urine, so they went straight to a local hospital for her to get checked out.
She told the hospital’s Labor and Delivery Department nursing staff how her stomach had been tightening for a few weeks. A nurse hooked her up to an electronic fetal monitoring machine and noted contractions and variable decelerations of the baby’s heart rate. Her OB/GYN physician did not come to see her in the hospital, but instead sent her home based on what the nurse told her.
Without having the prenatal doctor seeing the mom and her unborn baby, it was impossible to rule out dangerous conditions including placental abruption, placental insufficiency, preterm labor, chorioamnionitis, and fetal maternal hemorrhage.
The next morning, the mom was alarmed when she woke up and noticed that the baby was not moving as much as normal. From my experience as a Texas medical malpractice lawyer, decreased fetal movement should be an alarming sign to any obstetrician or nurse, requiring a thorough work-up.
She called her OB doctor’s office and spoke with a nurse, who told her not to worry, but just drink some orange juice to wake up the baby. The nurse did not tell the physician about the call.
When orange juice did not work, the mom called back and the nurse told her to come in to be checked out. At the physician office, a nurse hooked her up to monitoring equipment, concluded that everything was all right, and sent her home without seeing the doctor.
A few hours later, she called the OB doctor’s office again to report that the decreased fetal movement had gotten worse. The nurse told her to return to the office. This time the OB physician saw her. A non-stress test was non-reactive, which is a negative finding, as were the doctor’s findings of decreased fetal heart rate variability in a biophysical profile of 2/10.
The doctor told the mom to go straight to the hospital Labor and Delivery unit for observation. Eventually, the doctor delivered a baby girl by C-section. The baby was extremely depressed at birth, required cardiopulmonary resuscitation (CPR), and intubation, just to survive. Because of the delays experienced in her care, the baby had a permanent brain injury.
Our medical expert, an obstetrician, testified that the OB physician and nursing staff at both the doctor’s office and hospital were negligent and led to the baby’s permanent brain injury.
Telephone calls and treatment delays
In my experience as a Houston, Texas medical malpractice attorney, many physician offices do a poor job of handling patient telephone calls about medical problems. The standard of care treats this type of telephone call as a nursing triage or assessment. Such calls must be handled appropriately by the office staff, including obtaining appropriate information and making an accurate assessment without a face-to-face visit.
In addition, office staff handling such calls must document the discussion in the medical records and convey the information to the physician. At a minimum, the standard of care requires documentation of the patient name, name of caller and relationship to patient, date, time, complaint/concern/question, and any instructions or advice provided by the office.
Too often, I have found that office staff discount patient concerns and complaints that are made over the phone. Patient and family members frequently tell me that they felt like the nurses felt like they were overreacting and wanted to get them off the phone as quickly as possible.
Unfortunately, in some situations, poor handling of phone calls by a doctor’s office leads to a significant delay in diagnosis and treatment, leading to lifelong injuries.
We are here to help
For a free consultation about your potential case, call the experienced medical malpractice attorneys at Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.
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Robert Painter is a medical malpractice and wrongful death lawyer at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in lawsuits against hospitals, surgeons, physicians, anesthesiologists, and other healthcare providers. He is a past editor-in-chief of The Houston Lawyer magazine and currently serves on the editorial board of the Texas Bar Journal.
