Gou is practicing medicine in the clinic

Chapter 512 How terrible is postpartum hemorrhage, double compensation

"Although our hospital has an unshirkable responsibility for this maternal death, in terms of medical procedures, I think our doctors and nurses are not responsible."

Chen Hongyue's words revealed a lot of information.

It was vaguely revealed that he was not convinced by the punishment results of the hospital or his superiors.

"With the strength of your Qiao Bang Hospital, even if a mother suffers from postpartum hemorrhage, it is fully capable of curing the patient. How did the person die in the end?"

Li Jingsheng was puzzled by this.

The mother did not listen to the advice, and after sneaking out, she did not return to the hospital ward, but went home to sleep.

Even so, the worst consequence is that the baby will suffer from dystocia, and the baby will be almost dead after being cut out.

Logically speaking, it shouldn't kill two people, which would directly lead to the death of both adults and babies.

Postpartum bleeding that doesn't stop is dangerous, but it's also relatively common.

Not to mention a major tertiary hospital like Qiaobang Hospital, even a second hospital is fully capable of handling it.

Unless you encounter amniotic fluid embolism, which is known as the King of Hell's life-threatening condition, then you can only depend on your fate.

The incidence of amniotic fluid embolism is very low. Only two or three out of 100,000 pregnant women will develop this disease.

Although the probability of its occurrence is extremely low, the mortality rate is frighteningly high.

Even today, when medical technology is relatively advanced, the mortality rate from this disease is far more than 50% worldwide, including all developed countries, the Western world, and island countries.

According to official statistics, the mortality rate is about 86%, but in fact it is even higher.

Because some patients with amniotic fluid embolism are temporarily fine after rescue. However, due to problems such as brain death or multiple organ failure, death will eventually occur.

There was once a 48-year-old mother who suffered from amniotic fluid embolism. After three rescues, she stayed in the ICU for days. Her husband's family sold the entire house to help her treat her illness. But in the end, she still couldn't save her life.

Her life was finally settled at the age of twenty-two.

Only a baby boy who was less than two months old was left behind, as well as a husband who burst into tears, as well as his mother's family and her husband's family who were heartbroken.

Death cases like this are mostly not included in the statistics.

Because of the calculation of the rescue success rate, many hospitals, in order to make the data look better, will be considered saved as long as the rescue is successful on the spot.

According to Li Jingsheng's understanding, at least half of maternal deaths in developed countries are caused by amniotic fluid embolism.

"Alas, no one can tell the cause of death now. The family does not agree with the autopsy, and our hospital advocates autopsy. We follow normal procedures for all rescue operations. The mother's bleeding has not stopped after her first blood transfusion of 400 ml and 1500 ml of fluid rehydration. live.

My doctor still hasn't reported it to me because we see this condition all the time.

That night, I didn't get home until close to eight o'clock. I had four surgeries in the hospital during the day, and I had an important academic conference to attend the next day. They may be worried about disturbing me, but they themselves feel that the mother's condition is not serious and can be dealt with completely.

So the mother was given a second blood transfusion of 400 ml and 2000 ml of fluid rehydration.

In the end, the bleeding did not stop, so surgical repair was chosen.

After surgical repair, the maternal bleeding finally stopped. "

From the words of deputy director Chen Hongyue, it is not difficult to hear the power of Qiaobang Hospital.

Any doctor under her has real talent and knowledge, and has the ability to solve problems on his own.

In this regard, the Second Hospital and the First Hospital are far behind.

Especially in the First Hospital, bureaucracy is extremely prevalent and staff is overstaffed. Many doctors try to shirk responsibility as much as possible. It seems that without the guidance of the superior doctor, everyone will not be able to work.

The Second Hospital has gone through the reforms of President Fu and the previous president, and is much better in this regard.

But his foundation is weak. Take Professor Wu from the Orthopedic Surgery Department as an example. He has quite a few doctors under his command. But when they encounter problems, they all have no choice but to go to Professor Wu.

Then Professor Wu couldn't figure out many things, so he had to ask Li Jingsheng or Director Hua for help.

There are many medical teams like Professor Wu who have a raging group of soldiers.

"Now that the bleeding has stopped, the mother should turn the situation around."

Li Jingsheng said.

As long as postpartum bleeding stops, there will generally be no major problems.

"It was fitting that our department was unlucky. After the mother's bleeding stopped, the doctor called me and reported to me. I was very sleepy at the time, and I felt it was a pity to hear that there was something wrong with the mother's baby. I really wanted to scold me. The pregnant woman was too confused and willful. During the ward rounds, she was told clearly that she must stay in the hospital and not leave.

She didn't listen.

Now the baby is gone. Fortunately, there is no danger for adults.

Considering that the total bleeding volume of the mother was relatively large, which may have reached more than 1,000 milliliters, I asked my doctor to continue transfusing the mother with blood, replenishing fluids, and observing her for an hour. If there were no problems, she would be pushed back to the ward.

An hour later, my doctor told me that the mother’s vital signs were stable.

I asked them to push the mother back to the ward and be sure to observe her carefully. It was very late at that time, close to one o'clock in the morning. I guessed that everyone was very sleepy, so they were not allowed to observe the patient for two hours.

According to the procedure, the patient should have been observed for two hours. This is where my mistake lies. "

For patients with problems like this, it is very necessary to observe them for two hours after blood transfusion.

But doctors are also human beings. They work until one o'clock in the morning. You can imagine how hard it is for everyone.

Deputy Director Chen Hongyue is also a doctor herself. She was considerate of her doctors and only allowed them to observe the patient for one hour, also out of practical considerations.

"Since the mother's physical signs were stable, why did something happen again later?"

After hearing this, Li Jingsheng felt that there was nothing wrong with Qiaobang Hospital's handling procedures.

If a mother has postpartum hemorrhage, she should first transfuse blood and fluids, and use uterotonic drugs to promote hemostasis. It was eventually found that hemostasis was ineffective and surgical repair was chosen.

Every step follows the procedure.

This is why most doctors advise relatives and friends around them to choose regular hospitals when seeking medical treatment.

As long as it is a regular hospital, it has supervision mechanisms at all levels and strictly controls both medical safety and medical quality.

It can be seen from this case in Qiaobang Hospital that even if there are some negligence, overall safety and quality are still guaranteed.

"At around five o'clock the next morning, I received a report from my doctor, saying that the mother's urine output was very small and almost no urine."

Anuria after surgery, which is very serious.

Doctors who have worked in critical care all know that if a patient has not urinated for two days, it is basically difficult to save him.

Clinically, not having urine is much more serious than not having bowel movements.

Almost equivalent to a death signal.

As long as it is not dealt with and corrected in time, big trouble will probably happen.

"When I heard the news, I felt a thump in my heart and realized that the mother's condition was not optimistic. I asked the nurse to give her a diuretic to see how she was doing. I was going to the city to attend an important academic conference in the morning, and I was worried. Something happened to the patient, so I rushed to the hospital to check on the patient's condition while it was still early. I tried to deal with it as soon as possible, and then rushed to attend the academic conference."

She is forty-seven or eighteen years old, which is already on the older side. Many powerful female doctors may have successfully become chief physicians at the age of forty or twelve.

Seeing that Chen Hongyue was only two or three years away from turning fifty, she must have been anxious. I failed to become chief physician at the age of forty, and the age of fifty is basically my last hope.

It doesn't make much sense to really wait until you're about to retire before sprinting.

Moreover, considering her actual value, the hospital is likely to leave the opportunity of being highly rated to younger and more potential doctors.

Therefore, for female doctors to become chief physicians, their last chance is almost before the age of fifty.

The further back you go, the slimmer your chances become.

The deputy chief physician desperately attends some academic conferences just to pave the way for a successful impact on the chief physician.

"I rushed to the inpatient ward of the hospital about half an hour later. The doctor reported to me that the patient had been injected with a diuretic, and the urine output did not increase. I carefully studied the patient's condition and found nothing suspicious. Considering that she had a lot of postpartum bleeding, I asked my doctor to give the mother more fluid. Another 1500 ml of fluid was given.

This time it worked.

The patient's urine output increased by about 400 ml.

I was relieved to see that the treatment was effective. Instruct nurses and doctors to closely observe the mother's condition and provide first-level care.

Then I rushed to attend the academic conference. "

At this point, logically speaking, the matter should have come to an end.

After the patient received a large amount of fluid rehydration, his urine output increased by 400 ml, which can basically be considered as beginning to return to normal.

The bleeding had stopped long ago.

Next, as long as you take good care of it and recover for three or four days, you'll basically be fine.

"After I rushed to the academic conference venue, I was busy preparing my speech. At this time, my doctor called me and reported that the patient was shivering and his vital signs had abnormal changes. When I heard about this situation, I was worried When something went wrong, I quickly asked my doctor to ask the chief physician on duty for help. I gave up attending the academic conference and rushed to the hospital to deal with the mother.

On the way back, my doctor called me again and informed me that the mother was experiencing symptoms such as mental irritability and physical discomfort.

When I heard about this situation, I really regretted it.

If I had known earlier, I would have given up attending the academic conference and stayed in the hospital to deal with the mother.

Fortunately, a chief physician in the department took action in time and immediately took the mother to rescue.

When I rushed back to the hospital, the rescue was still going on, but the results were far from ideal.

In the end, the rescue efforts ended at 11:27 a.m., but the mother died after ineffective rescue efforts. The whole process from her onset of mental irritability to her death was very fast, and her condition progressed extremely rapidly.

This was the entire treatment process for the mother. "

When Deputy Director Chen Hongyue mentioned what happened, the expression on her face was very complicated, with a hint of sadness and deep regret.

Indeed, in this death case, although the mother herself was at fault, the doctor's negligence, negligence, and carelessness were equally serious.

If Chen Hongyue had not been in a hurry to go home after a caesarean section and waited until the mother's condition was stable before going home, such serious consequences might not have occurred.

During the period from postpartum hemorrhage to death, which lasts for nearly twenty hours, there are many opportunities to investigate the cause and provide timely rescue.

But it was all wasted by Chen Hongyue.

Of course, there is nothing wrong with Qiaobang Hospital’s rescue measures.

Just from another perspective, if Chen Hongyue could proactively follow up on the mother's condition instead of just leaving it to her doctors, she might be able to find out the cause.

The deputy chief physician is generally more powerful than the attending physician.

Especially the deputy chief physician who can lead the team independently is basically no worse than that.

Taking a step back, even if Chen Hongyue failed to find out the cause of the mother's illness through her own efforts, she could still ask other doctors from the Department of Medicine for consultation.

If necessary, chief physicians from other relevant departments can even be invited for consultation.

By the next morning, when the mother developed symptoms such as chills and irritability, it was already too late.

At this time, no matter which doctor performs the rescue, it is estimated that the final result will be similar.

"It's such a pity to learn a painful lesson with one dead body and two lives. Director Chen is looking for me. What do you want me to do?"

Li Jingsheng sighed. He had been a doctor for a long time. Although he was used to seeing life and death, he still felt sad every time he heard about the death of a patient.

It's really not pretentious.

Most people are saddened to hear about maternal and infant deaths.

No one wants this kind of human tragedy to happen.

"The mother's family is now claiming double compensation, but the hospital only agrees to compensate according to the normal standard. I would like to ask Dr. Li to help testify and let the family know that you once persuaded the mother to return to the hospital ward. In this way, they will understand that the mother There is also responsibility.”

Chen Hongyue's request is not too much.

Although Li Jingsheng was unwilling to get involved in this kind of dispute, looking at the other party's pleading eyes, he did not refuse.

"Ask me to accompany you to meet your family members. I can't agree. But I can provide you with a written explanation or a video recording."

You can help her, but you can't possibly make yourself angry, right?

"Thank you Dr. Li! Please help me write a description of the situation!"

When she heard that Li Jingsheng agreed to help, a hint of joy suddenly appeared on her brows.

There must be something wrong on the part of the hospital in this matter.

This is why the hospital agreed to compensate.

Death compensation, one corpse and two lives, is estimated to be at least over one million. Doubling it would require more than two million, or even three million.

This is an astronomical number.

The hospital is only willing to bear a standard compensation. If the family insists on double compensation, Chen Hongyue will definitely have to bear the remaining portion personally.

This is a huge amount of compensation that she cannot afford.

For an ordinary deputy chief physician, this kind of money is not enough even if he does not eat or drink for several years.

I wrote a statement to her, signed it, and fingerprinted it.

"Okay, Director Chen, you can take a look at this note. If there are no problems, I wish you to resolve the dispute as soon as possible."

Li Jingsheng basically means seeing off guests.

"No problem, it's absolutely fine to be strict in wording. Thank you again Dr. Li for this great help."

After she finished speaking, she took out a red envelope from her pocket and placed it on the table.

"Just be careful. I'm leaving now. Goodbye."

(End of this chapter)