Baumgartner - Dr. Mark Morehart: State of Washington Appeal Court - aborted use of cell saver machine

by darkspilver 42 Replies latest watchtower medical

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  darkspilver

  For information:
  

  COURT OF APPEALS OF THE STATE OF WASHINGTON
  DIVISION II
  Docket Number: 48070-1
  File Date: 01/24/2017
  
  

  Keisha Baumgartner appeals the summary judgment dismissal of her medical malpractice wrongful death claim against anesthesiologist Dr. Mark Morehart and Columbia Anesthesia Group, P.S. (together Dr. Morehart). Baumgartner filed suit based on the death of her mother, Angela Baumgartner (Ms. Baumgartner), from excessive blood loss during surgery.

  Ms. Baumgartner was a Jehovah’s Witness who refused to accept blood transfusions. But she accepted the use of a 'cell saver' machine, which is designed to collect the patient’s lost blood, recycle that blood, and re-infuse the blood into the patient’s own body. During surgery Ms. Baumgartner began bleeding heavily, but the suction tube used to collect her blood dropped below the sterile field and became contaminated before it could collect any blood. The cell saver machine technician, Michelle Hendrix, announced that Jehovah’s Witness protocol had been broken and the machine had been contaminated, and therefore that the machine could no longer be used. The surgery proceeded without the cell saver machine. Ms. Baumgartner eventually died because of her blood loss.

  Baumgartner argues that Dr. Morehart was negligent in failing to direct the surgical team to set up the cell saver machine on standby and failing to direct Hendrix to continue using the machine during Ms. Baumgartner’s surgery after replacing the contaminated suction tube.

  We hold that Baumgartner’s claims fail because she did not establish (1) that the standard of care required the cell saver machine to be set up on standby, and (2) what standard of care applied when Hendrix announced to the surgical team that the entire cell saver machine had been contaminated, not just the suction tube. Accordingly, we affirm the trial court’s summary judgment dismissal of Baumgartner’s claims against Dr. Morehart.

  https://www.courts.wa.gov/opinions/pdf/D2%2048070-1-II%20Unpublished%20Opinion.pdf
  
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  Crazyguy

  Wonder what was the details to why the machine was deemed contaminated??
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  JeffT

  Wonder what was the details to why the machine was deemed contaminated??

  I just read most of the full document. The suction tube hit the floor, at which point it probably sucked in contaminants or bacteria which would make the whole machine unusable. The doctors believed that they had to keep the blood moving through the machine at all times to meet the JW's requirements. (I don't know if this is still true, these machines were just coming into use about the time I left. It was true then.) So they shut the machine down. Had this occurred during surgery on a non-JW, they would have given a unit or two of blood, and there wouldn't have been a problem.

  So the no blood policy kills another JW.
  
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  darkspilver

  Actually IMHO it's much more involved than that - hence the Appeal
  

  It appears that the cell saver tube fell to the ground, while the cell-saver's named operative had LEFT the operating room - and it was during this time that significant blood-loss started.

  That named operative believed that the cell-saver machine could only be used if "that before the first incision there must be a continuous, closed circuit from the cell saver’s suction input, through the cell saver, and back to the patient."

  There was evidence presented that Jehovah’s Witness beliefs do not require the suction input to be continuously in contact with the patient.

  Also it seems that they say that, for this operation, the cell-saver should have been on stand-by and brought into use only when and if needed. Instead they got it working before it was needed, and this would have helped avoid the above issue.

  Baumgartner argues that the trial court erred in granting summary judgment in favor of Dr. Morehart on her medical malpractice claims. She claims that Dr. Morehart was negligent in (1) failing to direct the surgical team to set up the cell saver machine on standby, and (2) failing to direct Hendrix to continue using the cell saver machine during surgery after replacing the contaminated suction tube. We hold that Baumgartner presented sufficient evidence to create genuine issues of material fact regarding these claims.
  
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  Vidiot

  darkspilver - "...There was evidence presented that Jehovah’s Witness beliefs Watchtower dogma does not require the suction input to be continuously in contact with the patient..."

  Fixed that for you.
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  dubstepped

  You can't have crazy, inconsistent dogma and then cry when outsiders can't keep up. My condolences to the family, but you did it to yourself. Take a poll of JWs and most would think the same, that it must be a continuous, closed loop, that is, if most of them have a clue and didn't fill out a dpa in ignorance.
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  JeffT

  What dubstepped says. Medical personnel need to keep up with advances in medicine, not changes in Watchtower theology.
  
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  under the radar

  As a layman, it seems to me that the cell saver operator breached her duties by leaving the operating room without first being relieved by someone competent to operate the machine in her absence. The court document doesn't make clear whether the suction was actually on or not, or whether it was supposed to be on or not. Regardless, the operator announced that the entire machine was contaminated and could not be used, and the surgeon had no basis on which to question or disbelieve her. So he did the only thing he could do: proceed with the surgery and do the best he could under the circumstances.

  From this document, it seems that the cell saver operator was very (perhaps overly) concerned about the "Jehovah's Witness protocol" being broken and was therefore adamant that the cell saver not be used. Perhaps that would account for her seemingly hasty (and possibly erroneous) announcement that the entire machine was contaminated when it might not have been. In fact, it would not have been if the suction had not on at the time she left the room. That makes you wonder why it was on (if indeed it was) when the machine had not been needed or used up to that point.

  It is obvious that the cell saver operator was more concerned about the protocol being broken than saving the patient's life by whatever means necessary. That makes me wonder if this operator is a JW herself. That would explain her determination that the cell saver not be used after the "circuit" was broken and her perhaps rash declaration that the whole machine was contaminated when it might not have been. That statement would buttress her position that the "JW protocol" had been broken and therefore the cell saver couldn't be used. If it turns out that the operator is in fact a JW, that could bring her true motives for declaring the cell saver machine contaminated into question. At least, it would for me.

  The fact that the operator herself was unclear and perhaps mistaken about the "JW protocol" requiring a continuous circuit being established prior to the first incision and maintained at all times does not rule out the possibility of her being a JW herself. The Watchtower's ever-changing rules and interpretations on the "blood issue," even delving into medical minutiae that few laymen can understand, makes it hard for even HLC members (sometimes referred to as the blood policy Gestapo) to keep up with what is and what is not acceptable for true Christians allowed.

  It is very sad that the patient died as a direct result of coerced adherence to a prohibition dictated by her religious leaders, based on questionable extrapolations of a few passages in an ancient book filled with myths and superstitions and contradictions. But the fact remains that the proximate cause of her death, however regrettable and unnecessary, was her decision to make that prohibition binding upon her doctors regardless of the potential outcome.

  I think the Court was correct in this ruling. But the actions and motivations of that cell saver operator might well be looked into.

  Please submit 2¢ for this insightful commentary.
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  ILoveTTATT2

  "A Jehovah’s Witness who receives a blood transfusion in violation of this belief will be excommunicated from the church and will not go to heaven."
  
  FFS... why doesn't anyone ever report accurately on JW's?
  
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  under the radar

  Thanks for pointing that out, ILoveTTATT2. I noticed it myself, but forgot to mention it in my diatribe about the cell saver machine operator.

  Errors in detail like that are pointed out with glee by JW's trying to prove they're being persecuted and misrepresented by the press. Some even blame "those lying apostates" for giving the press false information just to make the JW's look bad. Yeah, like they need our help...