Friday, February 19, 2010

Anniversary: Diagnostic failure costs woman her life

Magnolia Reed Thomas was a 35-year-old mother of two when she went to Hedd Surgi-Center in Chicago for a safe, legal abortion. The abortion was performed by Rudolph Moragne on February 19, 1986. Moragne failed to note that the fetus was growing in Magnolia's fallopian tube, rather than in her uterus. After Magnolia was discharged from the clinic, the undiagnosed ectopic pregnancy ruptured, and Magnolia was rushed to the hospital. There, doctors did everything they could to save her, but she died from blood loss and shock on February 19, 1986.

This was Magnolia's third abortion. Multiple abortions are a known risk factor for ectopic pregnancy.

Even though, in theory, women who choose abortion should be less likely to die of ectopic pregnancy complications, experiences shows that they're actually more likely to die, due to sloppy practices by abortion practitioners.

Another patient, Diane Watson, died of anesthesia compliations after she'd undergone a safe, legal abortion by Moragne at Hedd.

For more abortion deaths, visit the Cemetery of Choice:

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OperationCounterstrike said...

Repeat after me, boys and girls:


Methotrexate kills ectopic pregnancies dead, and it doesn't do anything if there is no pregnancy.


Christina Dunigan said...

Surely you're being facetious, to pretend that there's a one-size-fits all to every situation in which one possible diagnosis is an ectopic.

A conscientious doctor does a differential diagnosis and plans an appropriate treatment regimen depending on the patient's wishes and needs.

But then, if he's a conscientious doctor, he's not likely to become an abortionist, is he?

OperationCounterstrike said...

I'm not being facetious, and unless your patient has an allergy to methotrexate or ulcers or other contraindications, there's no reason not to give it. Some times one size DOES fit all. For instance, if someone has a broken leg, you put them in a cast no matter who they are!

Your crack about conscientious docs not doing abortions is just stupid. Even if it were true, how would YOU know?

(Personal anecdote: where I went to med school there was one attending doc in OB/GYN who was a legendary terror--he was so consciencious he was almost impossible to work with; he could smell disasters long before they would emerge, he'd yell at you for stuff you MIGHT do. Not just errors, mere sub-optimalities were physically painful to Dr. C******. Conscientiousness incarnate! He was a double-prof with a formidable publication record, also one of the youngest full-profs in the history of the university. And, abortion was his specialty. He was the leader of the abortion community in the region. One of the first to use methotrexate for abortions of normal pregnancies. And the go-to-guy, the guy to consult, on all kinds of surgical GYN emergencies. All the gyn-ER docs had his phone number written on their sleeves to call if they needed help. So when I read your suggestion that abortion docs are unconscientious, it's especially funny for me and would prompt some bitter laughter among my classmates. But this is just a personal anecdote.)

Christina Dunigan said...

OC, ANY woman of childbearing age with abdominal pain MIGHT have an ectopic pregnancy! So are all doctors to treat all women of childbearing age with methotrexate if they report abdominal pain?

OperationCounterstrike said...

I see, I have not made myself clear. I mean ANY PATIENT WHO HAS A POSITIVE PREGNANCY TEST (urine) and wants an abortion, if you can't find the pregnancy on ultrasound, you give her methotrexate rather than sending her away possibly with an ectopic. THAT'S what should be automatic.

OperationCounterstrike said...

The "Boys and girls" addressed were the abortion docs.

Christina Dunigan said...

OC, I'd want to see a protocol followed, where they are doing serial hCGs and the woman has very clear instructions of what to do if she experiences symptoms of a rupture. The patient probably ought to be discharged with not only clear instructions for herself, but a brief write up of findings to bring with her in case she has to seek care at another facility, such as an emergency room.

But thank you for clarifying.

OperationCounterstrike said...

The trouble with your suggestion is: patients are often non-compliant, and, a series of tests costs a series of dollars.

Christina Dunigan said...

I don't see how the noncompliance of Patient A should lead a doctor to give less diligent care to Patient B.

A Reasonable Physician standard of care will probably be the serial hCGs. A Community standard of care will be lower if you're defining the community as abortion practitioners -- and that is, no doubt, partly due to the lack of relationship with the patients. That's a two way street, in that a doctor is likely to be less diligent with a patient he perceives as yet another in a series of identical procedures he's doing in rapid succession, sometimes as rapidly as every five minutes, than he would be with a patient he sees regularly and tends to spend more time with.

And a patient is more likely to be compliant with a doctor she sees regularly and knows and trusts, than with a doctor she was going to to deal with a one-time, stressful situation that she's likely in a hurry to try to put behind her and to think about as little as possible.(I wonder if that's part of the reason for the paradoxically higher rate of ectopic-related deaths among abortion patients than among obstetric patients.)

Christina Dunigan said...

Oh -- and the protocol with the serial hCGs is hardly *my* suggestion. That protocol was developed by ob/gyns over decades of practice. Interesting that, just as with the informed consent issue, you are so far out of step with what the medical community holds as standards of patient care.

You wouldn't be Ronachai Banchongmanie, by any chance?

OperationCounterstrike said...

You missed the point. If you order a series of hCG tests, some patients will fail to show up, and have the ectopic-pregnancy emergency which you could avoid by giving a slug of methotrexate and sending the patient on her merry way.

I dunno whether you'd be liable for that legally, but you would be MORALLY.

RE: "Lack of relationship with the patients". Sure, same as surgeons, dermatologists, radiologists.

OperationCounterstrike said...

You need a new server. Your current server non-posts and then multiple-posts.

Christina Dunigan said...

Evidently, OC, you didn't follow the link and read it, because it indicated what the serial hCG results should be AFTER administration of a dose of methotrexate.

I guess the "give 'em a slug and send 'em packing" protocol is entirely your own.

Again, I ask: Are you Ronachai Banchongmanie?

OperationCounterstrike said...

OK, christina, we'll give everyone a series of hCG tests--and YOU can pay for them.

OperationCounterstrike said...

Besides, your link is to a protocol for treating KNOWN, DIAGNOSED ectopic pregnancy. I've been talking about using the methotrexate PROFILACTICALLY, to treat a POSSIBLE BUT UNCONFIRMED ectopic pregnancy.

You give the mtx, and the ectopic pregnancy, IF IT'S THERE, goes away and never even presents. No need to follow up a case which does not occur!

Tonal Bliss said...

"For instance, if someone has a broken leg, you put them in a cast no matter who they are!"

LMFAO!!! You are hilarious, OC.