Hi :)
I received quite a few private and list mails about the HMO suit....so I
thought perhaps you all would like to know the details of the case.
Ill try to be brief without leaving out any major details.....bear with
me!
About 4 months ago the mom who is perusing the suit (I'll call her Mary
for the sake of the post) attended my prenatal breastfeeding class, hence
this is how I met her. She lives in my town but works in the city about
an hour and half away.
Baby boy (ill call him John) was delivered vis section for failure to progress and CPD. on the
morning that John was 5 days old mom called me since she had taken my class, she was in tears,
baby not latching well, not nursing well, she had given a few bottles. Hosp also gave a few
bottles to the baby so she could rest.....any way she obviously needed lacation help so we made
arrangement for a consult , in the meantime, she went to city to the HMO OB doc to have her
incision checked and just dropped in at the ped office because she was so worried about John, he
was wieghed and examined and doc told her everything was ok and sent her out, the original first
appt for John was for when he was 2 weeks old.
She came directly from the HMO to me ........ I assessed baby, breastfeeding, mom etc...... baby
had a major weight loss, 15% loss at 5 days of age. He was slightly lethargic but able to get
him to latch, mom reported minimal fullness in breasts, not sure if her milk was in, pumped with
classic and got 3 oz total, used SNS to get baby to breast and he did fairly well, taught mom
how to finger and cup feed and to use SNS. I was worried about Johns significant weight loss,
and called the ped that is my back up ped for problems, and she was also concerned. (This is
where it gets tricky) My ped recommended lab work on baby but HMO wouldn't pay for it at our
hosp. Mom had just gotten back from the HMO hour and half away. She called HMO and spoke with a
triage nurse and that nurse talked another HMO doc who said that 15% loss was ok and if MARY was
still concerned to bring baby back to HMO the next day but they would not authorize anything to
be done at our hosp (They wouldn't pay) Ok, so mom confused, didn't know what to do.... she
asked me can this wait till morning? I told her that my ped said no and if it was my baby I
would not wait, I would have him seen and worry about the $$$$ later. I left mom and dad alone
(BTW this is an non married inter racial couple) to discuss what they wanted to do. After a bit,
they decided to have baby checked at my hosp. Arrangements were made between our Emergency Room
MD and My ped to have baby checked in the ER (ie blood work done) and the ER doc would call the
ped and if baby needed to be admitted she would do the admission. This was tricky because docs
don't routinely take new patients like this in a crisis situation. and it was about 11pm at
night by now. I escorted John and John's dad to ER and Mary went to register him, lab work was
ordered and it was abnormal. We did a chem 7 and everything was abnormal . I don't remember the
specific values but it was not good and John was definitely dehydrated. Ped came in , talked to
parents, admitted baby for dehydration started IV and Mary had several LC consults from me. Got
John to latch well, with SNS on a consistent basis, Johns dad was supportive, but Mary VERY
uptight, smoking and not eating/sleeping well. HMO doc called me while John was in the hosp for
medical update and when I wouldn't give it to him he became angry with me.I had explained to him
that Johns mom would have to give me permission to give out that info or she could give it
herself. Baby stayed in hosp for 3 or 4 days then dc with close follow up from me and doc. Mary
was instructed to pump to inc milk supply because I felt it to be low, she did this sporadically
in the hosp, baby not supplemented in hosp, just nursed and IV and gained.... but prob mostly
from IV, he lost a little after discharge and mom supplemented with ABM via syringe or SNS,
depending on what she wanted to work with at the time.
So, now Mary is suing HMO for
#1. Not seeing that a 15% weight loss at 5 days of age was abnormal
#2 Not authorizing tx and admission at our hosp.
Mary wants a letter from me about what happened the night John was admitted.
Since then , HMO has called our hosp and states they will pay the *full* bill! and that they are
looking into why the HMO ped that saw the baby before me did not see this wt loss as abnormal.
Apparently this doc was new to the field.
Also of interest, is the fact that there was no continuity of care from the HMO peds. She saw
several diff peds in the hosp and a different one the day she took John in and talked to yet a
different one that night when she called.......
And lastly, Mary has quit breastfeeding :( She nursed him for about a
week after he went home and decided the stress of not knowing how much he
was getting was too much for her, so she stopped. (He was getting daily wt
checks and need ABM supplement to maintain his weight)
So she stopped bf cold turkey and reports that she never got full after
she stopped, that her breasts remained mostly soft......All along I has
questioned her supply, esp since in the hosp she never felt full to me. So
i guess due to ?the stress?smoking?poor diet? she had a very low supply,
even when she did pump she got very little, except for that first time.
I hope this better explains the circumstances around this case, feel free
to post questions if something is not clear. Its hard to post every detail
in writing ;) but I tried.
Cindy~~~~~
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e mail: [log in to unmask] home page: http://www.summit.net/home/Cindy
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