Sunday, September 12, 2010

2002: RU-486 death in Tennessee

Brenda Vise, a 38-year-old pharmaceutical representative, died on September 12, 2002, of a ruptured ectopic pregnancy after a chemical abortion at Volunteer Women‘s Clinic (the Lime 5 clinic) in Tennessee. Her survivors filed suit against the facility, as well as Dr. Edgar Perry and Dr. Richard Manning.

The lawsuit filed by Brenda‘s survivors notes that "Volunteer Medical Clinic, Inc. (‘VMC‘) was administratively dissolved by the Tennessee Secretary of State because of its failure to comply with applicable law. VMC has been administratively dissolved by the Tennessee Secretary of State since September 17, 1999." Dispite having been shut down by the state, VMC continued to do business and to advertise in the yellow pages for abortions, including chemical abortions.

Brenda took a home pregnancy test on September 5, and it was positive. The suit implies that she found VMC in the yellow pages, and made an appointment for Friday, September 7. VMC staff did a pregnancy test and did an ultrasound. "Ms. Vise was advised that the ultrasound showed no fetus in the uterus. Clinic personnel explained that this was because the fetus was ‘too small to be seen.‘ It was estimated that Ms. Vise was approximately six weeks pregnant. By such point in her pregnancy, a fetus in the uterus would have been easily seen with a proper ultrasound examination."

The lack of a visible fetus in the uterus should have clued the facility in to the fact that Brenda had an ectopic pregnancy. Ectopic pregnancy is a medical emergency and is a contraindication to the administration of Mifeprex.

VMC gave Brenda a dose of Mifeprex. "Ms. Vise was advised by the Clinic that side effects of Mifeprex were mild and short-lived."

Brenda was then sent home from the facility with a dose Cytotec that she was to self-administer to complete her abortion. She did not have a follow-up appointment scheduled for the recommended 2-3 days after the administration of Mifeprex.

The suit also mentions that "The Federal Government has never approved Cytotec for use in pregnant women and specifically has not approved it in pregnant women for the purpose of inducing an abortion, and in fact has warned against such use." It also noted, "In August, 2000, the manufacturer of Cytotec specifically issued a letter to healthcare providers that Cytotec was contraindicated in women who are pregnant and that Cytotec was not approved for the induction of labor or abortion, and in fact should not be used in an abortion. Ms. Vise was never advised of these facts."

"Ms. Vise was never advised of who [her qualified physicians] were and, in fact, Ms. Vise was specifically advised that she would have to return to Knoxville rather than consulting a local physician or hospital in the event of any complication."

Brenda called VMC to report problems upon returning home. In that first call, and in Brenda's repeated calls to VMC, she was assured that her symptoms were "normal and routine."

Brenda took the Cytotec as instructed roughly 48 hours after her initial dose of Mifeprex. She continued to experience pain and nausea, and called VMC. She was told to take some medications for her symptoms. VMC was told that Brenda had a sub-normal body temperature, that she was pale, and that she had significant pelvic pain. "Instead of advising Ms. Vise to immediately proceed to a doctor, the Clinic continually assured her that all of these were normal symptoms and that she was not to be concerned."

Brenda called VMC again on Monday, September 10, indicating her deteriorating condition. She was told that her symptoms were "to be expected,"; and was told to travel to VMC, in Knoxville, for a check-up at 3:30 p.m. "She was specifically directed not to go to a hospital in Chattanooga because, according to the Clinic, no hospital in Chattanooga would have knowledge about the drugs that had been administered."

Brenda‘s boyfriend tried to take her to Knoxville, but for a reason not cited was unable to do so. Instead, he called an ambulance, which rushed Brenda to a Chattanooga hospital.

"Ms. Vise was immediately admitted to the hospital in very critical condition. Exploratory surgery revealed that Ms. Vise had had an ectopic (tubal) pregnancy which had ruptured. Such rupture led to massive infection and a collapse of her vital systems."

"On September 12, 2001, the attending physician certified that Ms. Vise was terminal with no reasonable medical prospect of recovery and was in a coma and totally unresponsive. Ms. Vise died later that day."

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.


OperationCounterstrike said...

So far RU486 has caused fewer than thirty patient deaths, out of more than thirty MILLION successful, uneventful uses.

Getting an RU486 abortion is safer than driving to work.

Christina Dunigan said...

So I guess that just TOTALLY excuses the behavior of the people who killed Brenda. Why don't you go tell her family that?

OperationCounterstrike said...

If the clinic had used methotrexate, instead of ru486, this would not have happened. Methotrexate kills ectopic pregnancies.

I don't understand why people use ru486 instead of methotrexate. I am not aware of any advantage ru486 has over methotrexate.

Christina Dunigan said...

How about if they'd fixed the problems that had made the state shut them down, rather than operating illegally?

How about if they had done proper differential diagnoses when the ultrasound didn't reveal a uterine pregnancy?

How about properly scheduling her for a follow-up appointment?

How about giving her a list of symptoms of ectopic pregnancy (which they should have suspected), and letting her know this is a potentially fatal condition she should be aware of?

How about instructing her to go to an emergency room if she had symptoms of an ectopic pregnancy, rather than instructing her to see only them?

How about sending her to a local physician when she contacted them to report symptoms of an ectopic pregnancy?

How about at least telling her to come back for a follow up when she contacted them to report symptoms of an ectopic pregnancy?

Any of the three times she called with increasingly alarming symptoms?

How about they treat Brenda like a HUMAN BEING and not just a source of cash flow?

Any of that would have been refreshing, would it not?

Lilliput said...

Thi is why I don't uderstand why obs/gynaecologist don't give abortions. If you went to a gynae he would do a scan and then ask you whether you would like hime to deliver the baby or terminate.

Then there wouldn't need to be these disgusting clinics

Kathy said...

"So, do you want me to kill this baby or deliver it?" That's what you want him to say? Really? Don't you think that sounds a little... cold and heartless, especially considering that most women who get prenatal care are there because they intended to get pregnant and/or intend to carry to term; and even those who are ambivalent about their pregnancies at that time, most will come to embrace the idea and actuality of a baby (and those that don't can give their babies up for adoption).

Lilliput said...

Now I want him to say, " the pregnancy test result is positive and confirms the test you took so you are pregnant. How are you feeling? What would you like to do about it? " And she would either answer "wooppeeee when is it due? Or oh my god I don't know how I feel or shit I can't belive it happened and I'm on the pill! I don't want it!

And then he can either say - ill book you in for your scan next month or say - why don't you think about it and come back to me in two weeks and let's talk then or should we schedule a termination?

There is nothing cruel or heartless about that!

Christina Dunigan said...

Lil, asking "Do you want a live baby or a dead baby" is creepy at best. And I'd not want my child cared for by a doctor who would just as cheerfully snuff his life out.

Lilliput said...

No one is asking do you want a live or dead baby? Someone is asking how do you feel about your pregnancy and how would you like me to help you?

What's so creepy about that?

Are you telling me its more creepy the women creeping into ill run clinics staffed by bottom of the barrel physicians? I can promise you I'd feel more comfortable explaining my situation to the gynae I've known for years then to some strange clinician.

Christina Dunigan said...

If you're discussion "options for this pregnancy" -- to include abortion -- you're discussing if you prefer a live baby or a dead one.

Once she's pregnant, that baby's gonna come out one way or the other. Abortion is just making sure the baby comes out dead. Typically in a puree but sometimes in chunks or even more rarely, whole, with or without the brain sucked out.

Lilliput said...

Christina, I am being practical about wanting to save women from dying from botched abortions. To me incorporating abortions into general obs gynae practice will help. You getting gory and squeamish about is doesn't!

And just so you see how ridiculous you are being - please note that this discussion is taking place under a post of an abortion of an ectopic pregnancy. The baby would have died anyway,puree,chunks and all - it may have taken the mother with it!


Christina Dunigan said...

Lil, "You have an ectopic; how can we approach this?" is different from "Okay, you're pregnant. How do you want to, shall we say, manage this pregnancy?" which is code for "Dead baby or live one?"

Lilliput said...

Do ectopic pregnancies ever survive?

Christina Dunigan said...

Actually, yes.

Personally, I'd go for it, and I've heard from other women who would as well. Though the chances are slim, the baby CAN survive and the mother can be monitored closely so that doctors can intervene at the first sign of trouble.

Lilliput said...

I don't know what I would do but if I had other children, I wouldn't take the chance.

Christina Dunigan said...

Thanks for the link, Lil.

Considering the risk/benefit assessment (virtually 100% mortality of the unborn baby, high risk of maternal death), it's not surprising that intervention of some sort is the most typical response. But some of us would opt otherwise, not just in the hopes of saving our own babies, but in the hopes of developing treatments that might enable successful management. I'm wondering if carefully opening the tube so it doesn't rupture, then grafting it to the top of the uterus to provide a comparatively safe blood supply, couldn't work.

Lilliput said...

I understand where you are coming from but considering how many other medical advances that have to be made to improve people's quality of life and health - I can't see how we could justify putting resources there.

If I was a donor, I wouldn't support that research.

Christina Dunigan said...

Well, Lil, that's the wonderful thing about free enterprise. You can choose to support or not support research.