A Turn for the Worse…

Mt. Dora, Florida

“Pulmonary Embolism is the single most preventable cause of in-hospital mortality in the United States today.”

This was the first sentence I read in my search to find understanding as to why Christina died. What followed was a year and a half of research, meetings, e-mails, documentation, photocopies, printouts, phone calls, faxes and interviews.

Isabel Stabile, an renowned and well-written specialist in high risk pregnancies (and someone who fails miserably to return calls, e-mails and following through with professional agreements) wrote in her book, “Ectopic Pregnancy: Diagnosis and Management” (written for health-care professionals, not laymen as myself) that “less than 1 in 4 ectopic pregnancies qualify for Methotrexate management.” This is based on a number of criteria, none of which Christina met.

I poured through thousands of pages of research, filtering down to a collection hundreds of pages long, highlighted, underlined and compared against other articles to determine what happened, what went wrong, who – if anyone – was responsible. I was determined to find the truth and accept it on my own terms, even if that meant that nothing could have been done to save my wife’s life.

What I learned was that there were at least three miserable failures. Christina never should have received the Methotrexate injections from Orange Coast Women’s Medical group to resolve the pregnancy. Instead, she should have undergone laproscopic surgery to have the pregnancy removed. Had this been the case, she would very likely be alive today.

Failure two began at Huntington Beach hospital. There is what is known as “Virchow’s Triad” which determines who is at risk for thromboembolic events. It’s known by nurses and doctors and is particularly important for gynecological surgery patients. Christina met every point of the triad plus a number of other high-risk factors. Being aware of this would have led to commonly used methods of prevention and an awareness for what could likely, and eventually did, occur.

Failure three could have been prevented had failure two not occurred. Instead of recognizing that Christina had developed blood clots through her communications and eventual loss of consciousness (plus a host of other symptoms present), Dugard and Boswell decided to focus on the possible neck injury resulting from her passing out in the hallway (while escorted by a nurse). They also forced Christina to wait on the floor for 45 minutes while someone located a gurney to transport her to radiology.

Further mistakes ensued throughout the entire code-blue process. It is my belief that all of the failures collectively resulted in Christina’s death.

This was what I learned. And this is what I turned to the attorneys with in the form of verbal and written communications. I assembled a huge volume of detailed time lines, medical history, all of the records, backgrounds on each doctor, references, etc. I even handed each a CD with everything on it in an organized, cross-platform, menu-driven suite that could be transported, viewed and printed anywhere. Most of their work was done. All they needed to do was file the suits, contract the experts and show the hell up.

I wasn’t looking for an attorney willing to take my case. I was looking for one that I wanted to represent Christina and me. I even met with attorneys who only defend doctors in malpractice cases, searching for probable methods and arguments that the defense would use.

Few, if any, of the attorneys impressed me with any amount of confidence for any number of reasons. I selected who I believed would be our best bet. I had a warning. I should have listened. My options were limited, though.

So, my asshole, incompetent and inattentive attorney, Jeffrey Raynes – who appears to have done next to nothing with the cases – recently notified me by mail that he is now my ex-attorney. I haven’t mentioned any of this yet because it’s been a lot to deal with in combination with Mother’s day. I’ve worked so hard on this since nearly day 1 and finally thought that after interviewing more than a dozen attorneys that I’d finally found one worth his weight in salt. I was wrong.

Why? His two experts – friends of his – felt that both Margaret Audell of Orange Coast Women’s Medical Group and William Han, Greg Boswell and Matthew Dugard, all of Huntington Beach Memorial Hospital, met the standards of care for ectopic pregnancy management and critical post-operative care.

Any further explanations as to how Christina’s death came to be? Nope.

One of Raynes’ first statements to me during an initial interview was that he was compelled to get those responsible into court and have them explain why a healthy young woman with a manageable ectopic pregnancy is dead. The burden of proof was to be on the medical staff.

What did I get instead? I discovered the hard way that the burden of proof rests solely on myself. First, to educate the attorneys (discussions often involved me correcting their statements then providing research as to where this was learned), then provide arguments and related references to their experts. Next, I would have to clarify to each attorney that this was not necessarily one single case, but two, and that concurrent causation arguments would probably be required (all of this based on documented cases in California and the U.S.). What I heard repeatedly was that they still didn’t understand that I was NOT accusing Orange Coast Women’s Medical Group OR Huntington Beach Hospital of causing the pulmonary embolism. What I have been saying is that each, independently, screwed up in their treatment of Christina and that these concurrent failures failed to meet documented standards of care.

The eventual response was, “concurrent causation is too hard.”

And then, “The standard of care was complied with to the letter.” This without references, documentation or any explanation whatsoever. All we received was a letter consisting of “thanks but no thanks; now find yourself another attorney, represent yourself or drop the case.”

Un-fucking-believable. And completely, totally unacceptable.

So, now I get to start from scratch all over again.

Moreover, today Christina’s mother discovered that there is an evaluation hearing in 2 weeks that requires the presence of either ourselves or an attorney. We weren’t notified of this, it came out as a byproduct of a request for clarification.

Hire an attorney in 2 weeks? That’s nearly impossible. Hiring one involves interviews, review of medical records, contacts to experts (without which there is absolutely no case whatsoever). It can sometimes take up to a week just to get one of the attorneys to call you back.

Self-representation is trial suicide. “He who represents himself in court has a fool for a client.”

So, while I’ve been chewing pretty heavily on where I want to work, where I want to call “home” and what to do next, life has served up its own recommendation in a massive portion.

I need to be in California right now.

I was starting to become quite comfortable here. I guess that was my first mistake.

So, I’ll be heading out soon. There are still a few things to attend to immediately, though. I have to drive through 8 states, one of which is the largest and most desolate in the Union. Memorial day weekend begins tomorrow afternoon (everyone takes the day before off and skips out early the afternoon before that…). I either leave in the a.m. after an oil change and fight the worst traffic of the year through every state (and then have every attorney unavailable until Tuesday) or sit in Mt. Dora and fester until Tuesday a.m. All I know is that I have to be in Riverside and I’m not sure when, or if, I can return to Florida.

I’d very much like to come back, too. I really started to like it here.

Sorry. I hadn’t expected that this post would be so detailed, but the more I wrote, the more I realized that additional background was necessary.

I hope you’re all well. Thanks for your continued support. If you’re the praying type, our families could use a few if you have a moment.

Thanks again-