I apologize sincerely if this is a repost...... but I dont think it made
it through the first time.
--- On Sat, 11 Jan 97 10:58:45 [log in to unmask], [log in to unmask] wrote:
>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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-----------------End of Original Message-----------------
Cindy~~~~~
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e mail: [log in to unmask] home page: http://www.summit.net/home/Cindy
1/14/97 3:11:02 PM
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