A Pregnant Teenager Died After Trying to Get Care in Three Visits to Texas Emergency Rooms
www.propublica.org
It took three ER visits and 20 hours before a hospital admitted Nevaeh Crain, 18, as her condition worsened. Doctors insisted on two ultrasounds to confirm “fetal demise.” She’s one of at least two Texas women who died under the state’s abortion ban.

The first hospital diagnosed her with strep throat without investigating her sharp abdominal cramps. At the second, she screened positive for sepsis, a life-threatening and fast-moving reaction to an infection, medical records show. But doctors said her six-month fetus had a heartbeat and that Crain was fine to leave.

Now on Crain’s third hospital visit, an obstetrician insisted on two ultrasounds to “confirm fetal demise,” a nurse wrote, before moving her to intensive care.

By then, more than two hours after her arrival, Crain’s blood pressure had plummeted and a nurse had noted that her lips were “blue and dusky.” Her organs began failing.

Hours later, she was dead.

[…]

Texas’s abortion ban threatens prison time for interventions that end a fetal heartbeat, whether the pregnancy is wanted or not. It includes exceptions for life-threatening conditions, but still, doctors told ProPublica that confusion and fear about the potential legal repercussions are changing the way their colleagues treat pregnant patients with complications.

  • Saik0AEnglish
    7·
    19 days ago

    Some said the first ER missed warning signs of infection that deserved attention. All said that the doctor at the second hospital should never have sent Crain home when her signs of sepsis hadn’t improved. And when she returned for the third time, all said there was no medical reason to make her wait for two ultrasounds before taking aggressive action to save her.

    Hawkins noted that Crain had strep and a urinary tract infection, wrote up a prescription and discharged her. Hawkins had missed infections before. Eight years earlier[…]

    This has nothing to do with abortion ban. This has everything to do with shitty doctors. None of this required or even remotely called for any abortion. And should that first doctor NOT have been allowed to keep their license from previous cases of being a bad doctor… A women and her child probably would be alive today.

    The other facility that examined the case was also in Texas. Clearly the “ban” doesn’t stop them.

    The well-resourced hospital is perceived to have more institutional support to provide abortions and miscarriage management, the doctor said. Other providers “are transferring those patients to our centers because, frankly, they don’t want to deal with them.”

    Can’t blame a “ban” if there’s places that can and do legally do it.

    This is shitty doctors/hospitals blaming to the law to skirt around hard cases that they simply don’t want to deal with.

    But because the delays and discharges occurred in an area of the hospital classified as an emergency room, lawyers said that Texas law set a much higher burden of proof: “willful and wanton negligence.”

    Now this is a shame… This is what TX should be fixing. Malpractice shouldn’t need a higher standard in an ER

    All in all, I’m not sure how this is related to the abortion “ban” in any way shape or form. So why is it in the article/OP at all? Especially since in this case, it would have been covered regardless…

    Section 170A.002 prohibits a person from performing, inducing, or attempting an abortion. There is an exception for situations in which the life or health of the pregnant patient is at risk. In order for the exception to apply, three factors must be met: A licensed physician must perform the abortion.
    The patient must have a life-threatening condition and be at risk of death or “substantial impairment of a major bodily function” if the abortion is not performed. “Substantial impairment of a major bodily function” is not defined in this chapter.
    The physician must try to save the life of the fetus unless this would increase the risk of the pregnant patient’s death or impairment.

    • Pup Biru@aussie.zoneEnglish
      15·
      19 days ago

      Though he had already performed an ultrasound, he was asking for a second.

      The first hadn’t preserved an image of Crain’s womb in the medical record. …

      The state’s laws banning abortion require that doctors record the absence of a fetal heartbeat before intervening with a procedure that could end a pregnancy. Exceptions for medical emergencies demand physicians document their reasoning. “Pretty consistently, people say, ‘Until we can be absolutely certain this isn’t a normal pregnancy, we can’t do anything, because it could be alleged that we were doing an abortion,’” said Dr. Tony Ogburn, an OB-GYN in San Antonio.

      the delays at the 3rd hospital were almost entirely attributable to Texas abortion law.

      the problem with blaming doctors for fobbing off “hard cases that they simply don’t want to deal with” as you put it, is that they shouldn’t be hard cases - they have to think about more than what’s good for the patient, and that’s kinda ridiculous

      • Saik0AEnglish
        2·
        19 days ago

        the delays at the 3rd hospital

        My statement/arguments were more for the first two visits. I feel (and I’m no doctor) was that it was already too late by visit 3. I don’t think she was going to make it at that point regardless.

        is that they shouldn’t be hard cases

        Sepsis IS ALWAYS a hard case unless you catch it very very early. They delayed her significantly and she was already down the path of symptoms. I’m not sure that shrugging of the hard case of potential sepsis (for the first one that didn’t bother checking her thoroughly) and confirmed sepsis for the second hospital… is anyway at all related to the case being hard because of “abortion”.

        • Pup Biru@aussie.zoneEnglish
          11·
          19 days ago

          I feel (and I’m no doctor) was that it was already too late by visit 3.

          perhaps, but even the other visits it seems the doctors were cagey around pregnancy - that’s what this kind of law does - it dissuades doctors from considering things because they’re worried about repercussions

          if the first 2 doctors had come to the conclusion that it was pregnancy related sepsis and that abortion is the only option, well now they’re in a real hard position - to let the patient get worse and worse in front of them and then likely take all the blame when things go downhill FAST? or “misdiagnose” and send her on her way for someone else to deal with?

          the first is a lot of personal risk; the 2nd is minimal risk… is it selfish? absolutely! but humans act selfishly - thats just how we’re wired, and laws can’t just decide to make people act differently

          • Saik0AEnglish
            1·
            19 days ago

            the first is a lot of personal risk; the 2nd is minimal risk

            This flies in the face of the article though… it expounds quite a lot that it’s hard to sue for this situation at all. With the reviewing hospital doing the procedures in house quite often as they get referrals all the time.

            But because the delays and discharges occurred in an area of the hospital classified as an emergency room, lawyers said that Texas law set a much higher burden of proof: “willful and wanton negligence.”

            It’s clearly NOT a lot of risk since the burden of proof for that lawsuit would be effectively insurmountable. To the point that the no lawyer is willing to take the case according to the article. If it’s that hard to put a lawsuit together on the matter, why would a doctor be scared about conducting an abortion that was already covered as an exception to the law already? I’m not seeing it. I’m not buying the excuse.

            It’s not like sepsis is undocumented and unknown to the medical community. It’s not hard to justify the required treatment through literal decades of medical cases that have been studied and there’s specific exemptions in place for medical necessity in TX (and most[qualifier only because I have checked all] other states with a “ban”). The only way this situation make sense is if these places didn’t actually have the doctor on hand/staffed and it was some other medical provider that didn’t have power to actually make the decision. In which case there’s a whole 'nother bag of worms of a problem that needs to be addressed. If it’s not negligence on the doctor’s behalf (whether that be due to laziness,ignorance,fear, whatever), it’s because there wasn’t a doctor at all like an RN calling the shots. But the article claims to have gone through everything and doesn’t share with us, so I have to assume the former.

            This smells a lot like “cops need immunity otherwise they won’t investigate stuff”. No… they need to do their job better.