HGTV Celebrity Couple Lost Cousin in Childbirth

Every time I write one of these posts, it breaks my heart, but these women’s deaths would go unnoticed without raising public awareness.

If you are interested in receiving information about the Black Ob-Gyn Directory that will drop in February 2023, please contact me at DoctorLindaOnline@gmail.com or https://www.thesmartmothersguide.com/contact/

 

“I’m on Maternity Leave Without a Baby”

A young, Black woman, pregnant with her second child, leaves the hospital empty-handed because no one would listen to her. It is a social refrain that bears no repeating. She had a previous delivery at 37 weeks because of preeclampsia. When she became pregnant again, her ob-gyn told her she was not a high-risk patient, but he was wrong. She didn’t receive baby aspirin during the second pregnancy, although she should have. Her provider told her he would prescribe it at 28 weeks, which was wrong because the optimum time to receive it is 16 weeks. She never saw a high-risk pregnancy specialist, although she should have. Instead, she developed the HELLP Syndrome at 25 weeks, and her baby expired.

One might say that the baby died from prematurity. However, evidence-based research reports a 67 to 76% survival rate for preterm babies born at 25 weeks.

She went to a social media group, seeking solace and comfort for her grief, and the disparities were glaring. Painful. Everyone in the group knew what a maternal fetal medicine specialist was except Laney, and no, they did not look like her.

I am weary of those sad stories. I am frustrated that things get worse instead of better regarding our healthcare system. However, I am committed to “Be the change I want to see.” So, I, along with other Black ob-gyn physicians, are rolling out a Black Obstetrician-Gynecologist Directory/Database so people like Laney can receive care from people who respect her culture and, most importantly, LISTEN to her.

Representation matters. Healthy Babies Matter. The dignity of this patient matters.

We, as humans, matter, and that means ALL of us.

My 25th ACOG Rejection While Black Maternal Death Continues to Rise

Dear Dr. Abbasi-Hoskins:

Thanks for your response regarding my 25th rejection to become a member of ACOG’s  Medically Underserved Women’s Committee. Please be advised that I will not be submitting any future applications.

Although I have paid my annual dues for the past 25 years, I cannot guarantee that I will continue to do so in the future.

Have you noticed the dwindling number of obstetricians-gynecologists who pay their dues, especially those who look like me?

Although I originally planned to write a lengthy letter, my former high school photographer teacher (may he rest in peace) once said, “A picture is worth 1,000 words.”

The picture of this Black woman’s unassisted homebirth speaks volumes and represents our dismal failure as effective clinicians in keeping pregnant women safe and unharmed. Some Black women would rather stay home and deliver their babies in a tub without assistance than come into a hospital where they are often disrespected, ignored, and clinically mismanaged. How do we change that narrative?

This week’s JAMA opinion hits home. Medicine is an art as well as a science. Since ACOG will not allow me a membership to the Medically Underserved Committee, let me offer this advice based on my 35 years of clinical and professional experience:

  1. Stop allowing ob-gyn residents to “cut and paste” history and physicals and feign them as their own. This practice represents cheating and does not enhance their clinical acumen. How are residents supposed to learn if they use someone else’s data?
  2. Initiate mandatory competency exams regarding the diagnosis and management of preeclampsia. Some residents do NOT know how to manage preeclampsia effectively, and I have reviewed those dismal malpractice cases to prove it: The case of the late Dr. Chaniece Wallace is a prime example. The state of Indiana could use some much-needed help.
  3. Adopt the California Maternal Quality Care  Collaborative’s clinical guidelines that have proven they can reduce maternal mortality. The present ACOG clinical guidelines for the management of preeclampsia are as clear as mud, especially as it relates to patients who demonstrate preeclampsia symptoms before 39-weeks. My late residency director, Dr. Sterling Williams, former V.P. of Education at ACOG, is greatly missed. We did not have confusing clinical guidelines when he was alive.

I wish you a successful year as the new ACOG president and hope you will consider some of my recommendations.

Respectfully,

Linda Burke (formerly Burke-Galloway), MD, MS, FACOG

You Saved My Baby’s Life

As Preeclampsia Awareness Month comes to a close, I want to share a blog post I wrote on 2/28/2011 that provides a better description of my former patient’s birth that resulted in her amazing son. If nothing else, please pay attention to what her blood pressures were and how the resident physicians had a false sense of security that almost led to her baby’s death. 

I was greeted by those words during a patient’s recent postpartum exam and was both gratified and humbled.  A potential disaster was avoided and her pregnancy had a happy ending.

Katina* (name changed) had registered for prenatal care early so when her blood pressure was a little “different” at 32 weeks, the change was duly noted. She wasn’t complaining of a headache, her feet weren’t swollen but this was her first pregnancy which placed her at an increased risk of developing pre-eclampsia.  A blood pressure of 120/82 would seem normal to most people but in Katina’s case it wasn’t. She was sent to the hospital and then discharged home with instructions to monitor her blood pressure daily and I asked her to return in one week for closer scrutiny.

Upon Katina’s return, her blood pressure was 140/90 so off she went to the hospital’s labor and delivery triage department for further evaluation. Upon her arrival, her blood pressure appeared to have improved. The resident physicians on duty made snide remarks, insinuating that she was referred inappropriately.  As she was about to be discharged, the baby’s heartbeat dropped precipitously. Before Katina could blink, a team of physicians and nurses descended upon her with full force. They shoved papers in her face requesting a signature for an emergency c/section and informed her that it was possible she could die as well as her baby. Her blood pressure had escalated through the roof and her heart raced dramatically. She was quickly put to sleep, a “stat” c. section was done,  and her baby was born alive. For the next four days, the hospital staff had difficulty controlling her blood pressure and her heart continued to pound at rates above 150 beats per minute. It was one of the most harrowing experiences of her life however, in the end, both mother and baby were discharged home and are now fine. Katina experienced what we in medicine call a “diagnostic save.” A life was saved because the proper diagnosis was made in a timely manner. How often does that happen? Not often enough. If you can “see it” then you can treat it. Pregnant moms must be empowered to help their healthcare providers “see” the problem before it spins out of control.

 

The Deadly 17 Minute Cesarean Section: In Memory of Kira Johnson

The public should be wary of certain physicians, and the late Kira Johnson’s physician is one of them.

According to Case No. 800-2016-021723, the California Board of Medicine received six complaints of medical negligence against Dr. Arjang Naim, who is a board-certified obstetrician-gynecologist who practices in Los Angeles and Beverly Hills, California.

On April 12, 2016, Johnson entered Cesar Sinai Hospital for an elective C-Section accompanied by her family but left the hospital without her.

I attended medical school and did my internship with men like Arlang Naim and know them well. Cowboys is what we called them back in the day. They took pride in whizzing through operative surgeries like they were in a race against time. Safety rules did not apply to them. They breached standards of medical care, and no one held them accountable.

In cases of emergency C-sections, the expected length of time is thirty minutes. Kira Johnson had no emergency conditions, and her C-section was an elective procedure. Naim had two medical practices in Hollywood and Beverly Hills and was probably multi-tasking.

Johnson’s procedure began at 2:31 p.m. and ended at 2:48 p.m., 17 minutes, including her delivery. Unfortunately, in Naim’s haste, he failed to close the bladder flap. Shortly after that, he left the hospital, leaving Johnson’s care to the resident physicians who were in training.

At 4:40 p.m., Johnson developed abnormal bleeding in the bag that collects urine (known as the Foley catheter). Then, at 5:45 p.m., a massive blood clot could be felt through her skin incision. Her pulse then increased dramatically, and is a classic sign of impending shock.

Johnson received multiple blood transfusions and exhibited signs of a dangerous condition called DIC (disseminated intravascular clotting) which meant her blood was not clotting properly. Naim did not arrive at Johnson’s bedside until 8:47 p.m. Despite Johnson’s unstable condition, he wrote orders, including a CT scan and then LEFT THE HOSPITAL.

Johnson’s condition deteriorated further, and the resident physicians called Naim again. He arrived at the hospital at 11:45 p.m. but only wanted to continue to merely observe. However, the resident physicians convinced him to return to the operating room to determine the site of her bleeding.

At 12:25 a.m., Johnson was taken back to the operating room, and at 1:15 a.m., the resident physicians scrambled to find a general surgeon to assist Naim with the procedure. Unfortunately, Kira Johnson’s heart stopped beating.

Further evidence from the California Board of Medicine reported that Johnson was not the only patient who experienced medical neglect.

  1. On August 21, 2015, a patient had a ruptured tubal pregnancy. Naim performed her surgery but failed to achieve any follow-up hospital care for three days despite her requiring a blood transfusion
  2. On March 14, 2016, a patient had a ruptured uterus after experiencing a 16-week pregnancy loss. The uterus was repaired, the patient required a blood transfusion, and Naim did not see the patient during her entire hospital stay.
  3. On May 31, 2016 (approximately one month after Kira Johnson expired), Naim performed a C-section on his patient with a placenta previa (placenta covering the baby). Unfortunately, the placenta could not be removed, and the patient required a hysterectomy performed by Naim and a GYN oncologist. Although it was Naim’s patient, he failed to see her daily during her hospital course.

The California Board of Medicine placed Naim on probation in 2018 for two years, but he is practicing medicine again, including delivering

Would you want him to be your physician?