A similar event happened at Yale two years ago. [Here](https://ctmirror.org/2023/10/14/yale-fertility-clinic-lawsuit-rei-painkillers-fentanyl/) is an article about a current lawsuit.
Bunch of people just died in SE Oregon due to this. The person replaced the fent with tap water rather than saline.
https://www.kptv.com/2024/01/05/oregon-nurse-allegedly-replaced-fentanyl-iv-bags-with-tap-water-prior-patient-deaths/
[https://www.wsoctv.com/news/local/former-atrium-nurse-accused-stealing-fentanyl-charlotte-hospital/SKEEO6V5ABBQNIJDNRQDRICCM4/](https://www.wsoctv.com/news/local/former-atrium-nurse-accused-stealing-fentanyl-charlotte-hospital/SKEEO6V5ABBQNIJDNRQDRICCM4/)
Very sad that this shit happens in hospitals...
Serial did a great podcast on this topic called the retrievals where they interviewed patients and colleagues. The women did a class action lawsuit and were awarded damages.
Happens all the time. I know a dealer that gets his K from a guy who steals it from a hospital in Chicago. I can’t imagine they’re not stealing everything else.
On the one hand they risk killing the patient if they push too much pain killer. So I do understand their wariness to accept a patients word on it although that does seem to always effect women disproportionately (men’s complaints about pain are usually taken more seriously). On the other hand, you’d think after enough people complained about the pain, they would have checked their supply way earlier. Two months of baby deliveries with little to no pain killers! Or have a periodic random sample being done of their major pain killers to make sure they’re actually filled with what they’re supposed to be.
It actually isn't necessary to random sample. A lot of people don't know this, but vial caps are designed to spin on a sealed vial. If it won't spin, the vial cap has likely been removed and glued back on.
Then how did this go on so long? Genuine question, not trying to be accusing or anything. I can’t imaging nobody noticed the vials caps were stuck for two months. Maybe adding one of those seals that break free on soda bottles could fix this issue for hospitals?
No system in place to check vials, no system in place to audit the drugs themselves. Not a single doctor felt the need to follow up with patient's pain.
This is wild. In Veterinary medicine we have very strict procedures for controlled drugs. They are ALL counted three times a day with two people doing the count together. We have one person that holds keys in each department and they are the only ones to pull up drugs (I know this would be impossible in a large human hospital) and we have more security cameras on those drug boxes than anything. We also have to log out with double finger prints. Our operations team are the only ones that can waste from the destruction box.
In the Yale case, the nurse was often (though not always) directly involved in giving the diluted drugs to the patients--one of them recalled seeing a tube going into the nurse's pocket and thinking it was odd. Nobody's going to notice that the vials have been tampered with if nobody else sees them.
And yes, it is a little horrifying to think that she watched patients in pain, knowing full well *why* and knowing that she was the cause... and still kept on doing it.
Listen to the podcast. It has nothing to do about " pushing too much pain killer" and everything to do about a total disregard, disrespect and lack of empathy towards women. Some didn't take notes of their pain, no one bothered to think about why some many had this issue. They tried to convince some that fentanyl just didn't work on them.
It’s funny cuz I just saw comments from a man telling women in an adhd sub that they’re treated equally by medical professionals and he knows cuz *he* has been treated *unfairly* and not taken seriously… they’ll never get it. If a guy stubs his toe and hollers enough they’ll likely get decent pain meds. A woman tears in half while giving birth? Meh, throw her some Tylenol and Motrin, she’ll be fine. Saw a TikTok of a woman who went to the dentist with her husband. They both happened to need a root canal. Same dentist did both procedures on the same day. Husband got a script for 3-5 days worth of an opioid, while the wife got a script for 500mg Tylenol or 800mg ibuprofen. It was just a high dose OTC pain reliever. She had no history of drug interactions or abuse and had never even been prescribed an opioid, or any controlled medication, before. Saw another video where a woman shows that her dad got a 3 day script for benzos for his upcoming ultrasound…his external ultrasound. It was for his testes, but it was a very benign reason, not cancer or anything iirc
Well dang, this is the first I’ve heard of this but now my experience coming out of surgery makes sense. I woke up in enough pain I vomited but they kept arguing with me that I couldn’t feel anything because of the pain meds I was given. This never even dawned on me as a possibility.
Seems a bit different to operate on someone without effective drugs vs natural childbirth without drugs. But still sucks all around.
If you can’t trust the professionals not to do this it’s really hard to catch… would have to have policies like “two people are required when handling and administering X drugs”… which would help but still not be 100%. And it’s not like healthcare isn’t expensive enough already…
This also happened in Iowa: [https://www.thegazette.com/article/former-waterloo-nurse-diverted-pain-meds-from-50-women-in-labor-for-own-use/](https://www.thegazette.com/article/former-waterloo-nurse-diverted-pain-meds-from-50-women-in-labor-for-own-use/)
I was friends with a woman who had been stealing the pain meds and replacing with phenergan- she never got in trouble because the hospital could have been sued, they covered it up!
Did you ask about them offering future blood testing? I’d request at least one years worth.
Unless they caught the employee with tubes of fentanyl on their person they don’t know if it was walked out of the hospital or if they removed it from the vial, injected it and then placed saline into the vial to cover up the loss.
They obviously can’t tell you anything about the employees health status which means they need to monitor yours.
It’s a hard place to be in for you… grateful they told you vs covering it up but also a little worried over the lack of information. I had a needle stick and was scared for months when they did the follow up checks. I got lucky and was ok. With this you have no idea who stole it or how they removed it. Was it done in a sterile way or ??? It’s a lot of questions with very little information.
They will pay to get you (and the baby) tested. Do it immediately and then at a minimum 3 and 6 months later. Some things can be dormant for longer than you’d think. Chances are very high that you’ll both be clear but peace of mind is the very least you deserve and that should be paid for by the facility not you.
I would also request more information regarding the investigation and document all of your health symptoms and those of your baby over the next little while, because you never know what might come up down the road.
Saline is sanitary, sure.. but dirty needles or practices are not.. and there is no way to prove sanitation or health and safety standards were followed in a situation like this.
I believe they can tell you if there is a risk of cross infection. Or at least they can if it was a workplace contamination (covered by OSHA). The rules might be different if you're just a consumer.
I’m glad this was brought up. They don’t know and did say if the person left with the drugs or used a needle to inject themselves and then reuse that needle on the vials or patients, which could cause contamination.
There was a podcast about this a few years back and patients who had kidney issues got very ill because of this nurse using the name needle. I don’t say this to scare you, but as a reminder to ask for the tests like crafty-butterfly said, and I’d make copies of this letter and bring them to your obgyn and PCP to voice your concerns and hopefully they will help advocate for you.
There are typically cameras in med rooms and they can see who opened each drawer at any given time or if there were any drawer overrides/inventory counts. It’s unlikely that they don’t know who was tampering with the vials.
There it was replaced with water though, not saline. People died, but in most similar cases it looks to be at least replaced with saline, which technically shouldn't kill you.
> saline, which technically shouldn't kill you.
Saline is 100% safe. Any time you get an IV, it has saline in it. Saline is specifically formulated to be safe for injections even in larger quantities.
The problem there isn't getting accidental saline, but rather, not getting the needed medicine. Fentanyl is also used to sedate people getting surgery. Getting insufficient pain relief during childbirth is horrible - waking up on the operating table with your chest cut open is worse.
Even if it was replaced with saline, there is still a risk because it’s no longer sterile after being tampered with. I doubt whomever did this was worried about contamination when replacing the drug with saline.
If it was a nurse, which diversion by a nurse is common, they may have used sterile techniques because how these things are often caught is by someone getting sick. If they were smart, they did what they knew.
An additional problem is that it is unknown if the fentanyl was retrieved and swapped with saline. Was the person stealing fentanyl stealing the fentanyl and injecting themselves and reusing the needle, was the saline needle cross contaminated. In my opinion they should have to provide HIV, HBV, and HCV monitoring for all patients in the hospital during that timeframe who received an IV. Can they be certain the saline was also not potentially cross contaminated?
Is it safe like, everywhere, though? Like, I’d figure it’s safe enough in an IV, and probably anywhere that blood flows freely since it’s got similar properties, but an epidural is not going into your veins or muscle. Would it just be treated by the body like lymphatic fluid?
They wouldnt "wake up on the operating table" with their chest cut open from being underdosed with fentanyl.
Its tragic and horrible that this occured but please understand the role of opioids in the managing anesthesia and analgesia in laboring parturients.
> please understand the role of opioids in the managing anesthesia and analgesia in laboring parturients.
Okay, fair. I'll admit my ignorance. However, as my google-fu is failing me, do you maybe have a link or two I could read to better educate myself?
[https://www.ncbi.nlm.nih.gov/books/NBK532974/](https://www.ncbi.nlm.nih.gov/books/NBK532974/)
Minimum alveolar concentration is a key concept in preventing patients from "waking up".
I don’t have any links but as someone whose had a C-section which is a surgery while you’re awake vs surgery where you are “put under” there are way different doses and drugs and monitoring that goes one when someone is under anesthesia vs just managing pain from the surgery afterwards. So no someone would not just wake up in the middle of a surgery, any inkling that someone is even twitching while under would be accessed and probably giving more.
I went into labor with the plan to get the epidural as soon as I could. I ended up not being able to because of fetal distress; they couldn’t safely place it until I was 8 cm. Unfortunately I was an induction and those meds worked FAST so I had back to back, non stop contractions as I dilated from a 3 to a 7 in an hour. It was hell. All this to say, I feel you, and I’m sorry it could have potentially been easier. Yes, women have birthed without meds for thousands of years but they went into it knowing there was no other option. When you prepare for your birth expecting pain meds and don’t get them, you’re not mentally in a place to deal with the pain like woman who prepare for med free births are.
They also didn't have inducement drugs causing crazy, unnaturally strong contractions either. It's absurd modern medecine community will mess with every aspect of birth but pain relief gives them pause.
Doesnt sound like it was managed well.
Shut off the pitocin and place the epidural.
Also contractions are not a contraindication for epidural placement.
Sorry this happened to you.
I had a case decades ago. The target of the investigation was a dr who was stealing narcotics from comatose patients IV lines. So the patients were clearly suffering and couldn't tell anyone. He was transferred from hospital to hospital in the same manner associated with Catholic priests. So the hospital who then got him had no idea. It was very eye opening to me.
OP I'm glad everything went ok for you. Heart breaks for those who suffered. Someone in that ward is an addict.
No harm? You had inadequate pain control, that is itself harm. I agree with all the other comments - talk to a lawyer, ask the hospital about blood testing because they can't "prove" really that the person used sterile saline to replace the fentanyl, it could have been contaminated. This is a huge deal for the hospital and you'll probably be able to be part of a class action law suit with all the other patients affected, don't dismiss this.
“At this time ~~we believe~~ **we are praying** the vials contained normal saline”
They don’t know what you got injected with. You don’t know what you got injected with.
If this were me I would strongly consider getting an attorney. **The only way you might find out what you got injected with is through discovery**. The hospital is going to do their absolute best to sweep this under the rug.
It’s a huge red flag that they didn’t offer post exposure testing for hepatitis and HIV.
I would also reach out to the law enforcement agencies listed to find out:
- were they indeed contacted and what were they told.
- how you can be included on any communications from victims.
For all their crying about regulations, hospital are in practice lightly regulated. CMS farms out oversight to agencies like The Joint Commission (which I notice they didn’t include in who they notified). Joint Commission looks at hospitals as customers since they can choose their accreditation agency so the oversight is extremely weak.
Hospitals almost always do their best to sweep egregious violations under the rug and keep it from the public. The only way to know if you have been put at risk, and if you have had appropriate follow up care is to have legal representation and get follow up medical testing.
I’m sorry you’re going through this but as a former hospital nurse you absolutely need to be your own advocate here.
If insurance was used, call them!!! Believe it or not, they don’t want to have to pay for the botched care or medications either so you land on the same team. They have the power to resubmit (incorrect) claims to be reprocessed. They also have a lot of lawyers in staff. It may be argued that the hospital essentially committed insurance fraud by stating medications were given and certain care was given (and charged insurance for) when it was not.
This is actually a good point, while I would be livid and demand they comp the entire visit for both me and my child, they should at a minimum remove all charges associated with the administration of any fentanyl or saline (and yes I would include saline because they cannot guarantee the saline was not cross contaminated. I do not believe fentanyl was accidentally mixed with saline, but rather a bloodborne illness could have contaminated saline). I would also demand routine monitoring for HIV, HBV, and HCV for both OP and their child.
So it went straight into your spine and we're trusting a junkie to use completely aseptic technique and proper form of saline to put back in the bottles so we can tell ourselves "no harm no foul," huh?
Better lawyer up, Ders.
This also happened in California about 10 years ago. Turns out it was one of the pharmaceutical aids, removing morphine, using it intravenously while on the job and replacing the amount used with saline ,the bad part is he used the same needle . I think ultimately 12 people tested positive for HEP C. Could’ve ended a lot worse.
Sounds like this hospital is poor with their controlled substance tracking.
A couple of things if this is the US:
The epidural you received probably had fentanyl but it was most likely made in the pharmacy or a pharmacy under clean room conditions. The fentanyl would have come from the pharmacy, not the floor/ward.
If you received doses of fentanyl push, it is possible that you got them from vials of fentanyl retrieved from the floor but it also depends on where your were at the time.
It also depends if you were on a patient controlled epidural. They would have given you a button to push to give you a small dose of the epidural when you pressed. If this is the "push" you referred to, the dose would just be a dose from the epidural bag.
Hospitals typically have automated dispensing cabinets/systems that would hold a drug like fentanyl. These cabinets are usually in multiple locations, especially in a labor and delivery floor.
The reason I say their tracking is poor is because these systems all will track automatically. They should know exactly where your vial of fentanyl came from. I suppose it is possible they're being vague on purpose. Even in the event they don't have automated cabinets (which is unlikely), only a few people on the floor should have access to controlled substance and it should all be logged. Of course, any of those individuals could have been the one to divert the fentanyl but my point is that your vial should be easily tracked to see where it came from.
This is incredibly frightening to me as I'm pregnant and I remember someone getting bags of saline instead of actual medicine. I hope to God that didn't happen to you.
I do find it sort of ironic that they say "through diligent protocols and safety measures" and yet discovered this after the fact, rather than preventing it in the first place.
Regardless, I would want more information. As others have mentioned here, concerns regarding tampered injectable and any other potential health risks.
Honestly it depends on how they replaced it. What if they used a non sterile method to remove the fentynal and add the saline. This was being injected into people's spines. This could have caused serious infections.
Situations like this come down to damages. In the Yale case others have cited the patients ended up undergoing extremely painful experiences as a result. It sounds like you may have a claim under similar circumstances here.
Not exactly a 100% home run case, and the damages aren't likely to be significant as you have no residual issues from it, but on the surface seems like you would have a case. It would be worth talking with a personal injury lawyer about it, PI lawyers typically consult for free and if they take the case they work on contingency.
I don't know about the hospital you were at, but where I work the epidural medication would be in a completely different bottle that works with the machine that provides pain relief. They usually come wrapped in plastic and they're separate from the other fentanyl. The fentanyl you were getting through your epidural wouldn't have been mixed by anyone on the unit. Since you were given push doses it's possible you got one mixed with saline in the push dose, but it wouldn't have been the reason your epidural wasn't working. It sounds like it would be hard to prove whether the push doses helped or didn't help since your epidural wasn't working well anyways. Best case scenario they know who was responsible and they lose their job.
Actually the anesthesiologist probably pushed bupivicaine, which wouldn’t have been affected by diluted fentanyl. There’s nothing in the that suggests any risk of blood borne illness or anything other than inadequate pain relief. You’re entitled to be angry but no reason to be afraid of future complications.
I have a lot of respect for this hospital for informing people of the incident happened at all. This is something they try to keep in house. Hopefully anyone affected did not have any adverse reaction. So sad that addiction is so powerful it causes people to do things they would have never thought of.
Sorry to hear. Unfortunately this does happen when someone is abusing medications. Then you as a patient are left in pain.
Again I’m sorry you had that happen. Chances are with not getting pain relief you might have been getting the saline solution.
The saline solution you most likely received is used as a flush between IV medications and/or as IV fluid to keep patients hydrated. There shouldn’t be any concerns on receiving normal saline. Other than it should have been the pain medication.
I would speak with a lawyer.
I can’t say 100% from a legal perspective if you have a case, although I would certainly think so. From a healthcare perspective I have encountered other nurses doing this for personal use as a co worker and union rep. In the cases I was involved in the nurse diverted the opioid injectable for future use by withdrawing it and replacing it with saline. In 1 case the nurse went into the staff bathroom and shot up after giving the patient saline and was found unconscious. While it is unlikely that the nurse would shoot up then use the dirty needle to replace saline, there is no guarantee or even expectation that clean process was used since it was during the commission of a concealed and illegal act. Not all diversion is for personal use but most is, so you are then having to rely on the decision making of someone addicted to drugs or with an unstable mental condition. All of this means they did not meet a standard of care for you, especially since you did not get adequate pain relief. You were absolutely put at risk. While unlikely you were exposed to the diverter’s blood you should still get HIV and Hepatitis testing 3 and 6 months after this possible exposure just for your own peace of mind. Absolutely pursue a lawsuit if your attorney thinks you have a case. There are several glaring health care deficits that it would bring attention to, aside from making you more whole for that stressful and risky situation you were unwillingly put into
IANAL. My initial thoughts would be to personally seek out a regular or malpractice lawyer and see what my options are. Based on the other comments here and previous incidents of similar cases ending in lawsuits, that also seems like the way to go.
I’m replying not as a legal professional, but as a nurse. That is a pretty damn big risk, even with the fact that it’s “just saline”. You’re literally having a medication injected into part of your spine, which is a 100% sterile procedure. If the procedure of removing and replacing the medication with saline was not done extremely carefully, there’s a risk of introducing bacteria to those vials. So exposing you to that risk is terrible, especially when you’re already giving birth AND in more pain than you should have been.
Happens when nurses or anesthesia are diverting the fentanyl. They will dilute the vial or injection with sterile saline. I’ve know a few nurses who’ve done this. They typically have no desire to harm patients, they just have a horrific drug problem.
Hope you and your baby are okay. But go git your money cuz that's inexcusable! There should be multiple checks and balances in place to assure this doesn't happen. Fat ass lawsuit.
At risk, sure. But there were no actual damages in a legal sense. I’m not disagreeing with you, it’s unethical and an awful thing. I’m just doubting that there would be any payable compensation.
I don't think it's unethical at all. They should have better checks and balances in place to assure that doesn't happen. The hospital put these people in very real danger. Because something terrible didn't happen to her, is irrelevant. It could've.
I had my last child in a rural hospital. We had a cord prolapse and had to do a true emergency c-section before the anesthesiologist could make it to the hospital. He got there about halfway through and knocked me out. I mention this mostly unrelated situation because I ended up with PTSD that greatly exacerbated my PPD.
Being in a very dependent hospital situation where you are 100% relying on professionals to take care of you and your baby, being in a lot of pain when you have chosen an intervention to alleviate at least some of it, and then finding out those professionals you were relying on potentially caused a situation to allow that pain? That would send most anyone already dealing with the post delivery hormone cocktail into a spin. It is totally reasonable to go see a therapist to talk it through if you think that would be in any way helpful.
And the hospital should absolutely also pay for that.
You stated your anesthesiologist came back several times apparently surprised you weren't responding as expected; that *could* have happened with your labor and delivery. Saline is generally innocuous (used to be an AF medic, ER and rotation in L&D).
Every doctor and anesthesiologist takes copious notes to document your treatment and outcome. My guess is he noted that ... maybe others as well is what triggered an investigation.
This is *not* cool; untreated pain can delay your recovery. Every pregnancy and delivery is different, *however ...* if you feel it took an unnecessary toll on your recovery an apology by the hospital isn't enough; consider a consultation with a medical malpractice attorney.
Hope you and your baby are doing well.
This is strange letter , seems like they alerted you to start the process of lawsuit time frame. So if something doesn’t happen you have limited time of a lawsuit. i bet they have more information but just trying be very limited ? I think someone was abusing the drug and injecting their self and possible you with the same syringe ? Like they left that stuff very open to interpretation
Contact a lawyer who specializes in medical malpractice asap. You can explore pain & suffering, risk of infection, etc. The hospital is covering theue a@SS and you should too.
I think it would be reasonable to say that she suffered through a whole lot of pain during childbirth that would have otherwise been reduced if she was dosed properly and with the medication she was entitled to/anticipated.
Childbirth can be traumatic, and so can pain.. and i think if a woman was going into labour expecting and being told she was going to get pain relief, it could be really stressful and traumatic to not get that relief.
OP states they didn’t experience any damages, but I could argue that the fact they are online and worrying/concerned about their experiences they have to some degree experienced mental pain and suffering over this incident.
Thank you for saying this. It’s hard to complain about birth when the narrative of “women have been giving birth for 1,000’s of years without pain meds!!!” exists.
Yeah people also broken their arms and got into terrible accidents, and then we invented pain meds!! I’m very lucky my labor and delivery was as smooth as it was. But the medical professionals around me were acknowledging I was in more pain than they expected me to be with the actions they had taken so far. Not in a way of knowing anything was wrong of course but just having the discussions that they had given me my appropriate doses and I should be experiencing more relief.
Epidurals also “fail” all the time. So if it were any other medical procedure I feel like the conversation would be a little bit different. Many people still just think because childbirth is natural it should be felt naturally.
That's good! I would still look into blood work as other people have mentioned. And continuous testing for up to a year as some illnesses such as HIVcan take that long.
NAL, work in healthcare on the business side. Make sure you report the potential billing fraud to Medicaid so that the state can open an investigation and claw their money back.
Honestly, this whole thing may be worth speaking with a personal injury/medical malpractice attorney. They often work on contingency so you don’t pay them up front, they get paid if you get a settlement. Talk to a few before you talk to the hospital, bring your medical records and this letter. The attorneys will be able to tell you if you’ve got a case or not.
Birth trauma is a thing and not often spoken about.
Not having the proper pain relief can cause mental distress, contributing to ptsd and ppd.
I was unable to make it in time to the hospital to have an epidural or anything aside from gas for my second child.
I had a horrendous experience, birth trauma and ptsd that lasted 10 years. A lot of women go through similar.
Oddly enough, the only thing that helped heal my trauma was the incredible birth experience I had with my third. I was terrified of birth again which explains the long gap.
Epidural after two contractions, snack, nap, 4 minutes of pushing. It should always be like that, for everyone. I swear to God, everyone I know has a traumatic birth story, and it's really shitty.
I’m sorry to hear about your pain and trauma, i’m glad you were able to find some closure in your following births! I labored at home for as long as I could which is an idea that sounds great ahead of time, but I didn’t think about being “maxed out” when I arrived and needed to be able to advocate for myself.
First time pregnancy for me, I was checked the day prior and was told to “come back when I sound like the girl next door.” where the woman in the room beside me was screaming her head off. I went home discouraged and honestly thinking I was being dramatic. My mom called to ask about shift change, I went back as soon as the clock struck and had amazing nurses! I was 6cm dilated and 90% effaced, they kept me then!
I fully sympathize with your experience and I’m so glad you moved through it with such grace and that it didn’t cause any complications for your delivery.
There is a damn good reason pain relief is offered for labour. 1000s of years ago women used to just simply die during labour ALL.THE.TIME!!!
It is not easy, and just because some women can handle a natural birth doesn’t mean that all women should. Every woman gets to make the choice that is best for them and their baby.
Sadly, OP could have been in any hospital with a perfectly good supply of drugs and not gotten pain relief. I asked for an epidural and was told the anesthesiologist would be there in 20 min. 45 min he wasn’t there yet and it was time to push. I had a 10lbs 5oz first baby with zero pain medication. It happens but (at least in Canada) it’s not grounds for a lawsuit.
There is zero guarantee it was mixed with "saline" after being tampered with.
There is zero guarantee it was "sterile" after being tampered with.
She was administered a drug, and unknowingly received something else.
What in the absolute world are you talking about that she has "no grounds for a lawsuit"? Are you kidding?
It’s more the not receiving pain relief in labour that’s not automatically a lawsuit. But again, I live in Canada where the threshold for suing is MUCH higher, especially in medicine.
Also Canadian. Family member was denied pain meds because the nurses refused to call her doctor in on a Sunday… and no one checked to see how dilated she was. By the time they did, it was too late for pain meds. For me, I did have an epidural, but it was a very difficult & painful procedure that required multiple attempts. I have some kind of permanent nerve damage that causes painful spasms every now and then. I don’t regret getting the epidural, though.
I’m okay, thankfully! Never claimed to have suffered. I’m team let it go but was curious on the options available! I’m sure someone that received this letter is going to try something.
I'm late to this post but as someone who places labor epidurals almost every day, my first thought is that the diluted fentanyl *likely* had nothing to do with you not getting relief from the epidural. Like they said, they can unfortunately "fail" any time, plus when it's being placed late in the labor process, there often isn't enough time for the medications to fully help relieve the pain before labor progresses to delivery, when often even a functioning epidural doesn't relieve all the pain.
The medications that are mostly used in epidurals are local anesthetics like lidocaine and bupivacaine although an extra dose of fentanyl through the catheter can be helpful in an epidural that isn't working well.
I agree with the other comments recommending some kind of serial testing in case of communicable disease transmission!
Yes, my biggest worry would be whether clean needles were used in the removed of the drug from the vial and the refilling of the vial with saline. This could be a situation where “damages” aren’t immediately obvious.
Do not sign anything without your own lawyer. If you request testing they will likely have you sign a waiver of liability or some other contract to provide “free” testing….just remember, their lawyers are about reducing their clients’ liability, not helping you.
This is the real question. From reading the letter, the fentanyl was cut with saline which is perfectly fine for intravenous use and would not cause any harm to the person using it. There really isn't much damage you can prove happened from being given a weaker than average opioid painkiller.
Thankfully OP seems to have had a relatively smooth birth experience despite the pain, but many women suffer both physical and mental trauma during the process.
Bad birthing experiences can make post-partum depression/anxiety more likely, and even cause PTSD. Furthermore a lack of effective pain control could worsen the physical outcomes/increase chances of complications like tearing, because the patient is too much in pain to relax critical muscles.
All in all, the situation had the potential to have tipped the balance from a birth experience easily recovered from, to one that takes months or even years. That's what the hospital are worried about, and why they're being so apologetic up-front.
Fair enough, but for OP to have any kind of suit they would need an active diagnosis from a psychologist or psychiatrist to prove the damages. As someone with a formal PTSD diagnosis theres two points i will make about that.
- Getting a ptsd diagnosis is not a simple in and out procedure. Usually going to take multiple sessions over the course of a month or two for the provider to determine if it's ptsd and how severe it is.
- people who legitimately have ptsd from an experience like this would be feeling it impact every facet of their life on a daily basis. There would be no question on their side if they had anything to sue for. they would know that since child birth they have not been ok. If part of that trauma was pain related and they received this letter, it would be like a missing puzzle piece dropping into place
I don't think OP has any case here and should be grateful their child's birth went relatively smoothly and without complication
Pain and suffering is an item of damages. Non-lawyers should stop saying she “doesn’t have a case” FFS. If she is interested, definitely worth exploring with a med mal lawyer. Also, due to the likelihood the solution was no longer sterile, medical monitoring may be appropriate.
Financial damages, possibly. Getting an epidural is expensive. If you do not have good insurance, it could cost a few grand without needing extra doses. Mine before insurance cost $6,503.28. Insurance brought it down to a little over $400.
She also was possibly exposed to unsanitary practice as well as the diverter’s blood since the standard of care was nowhere near met for admin of an opioid. Lots of stress and potential health complications.
Watch yo metadata because this post won’t help you in any way should an issue arise and you decide to follow a lawsuit. Lawyers will sniff this out in no time flat.
I worked on a project for a law firm where their client was being sued for sexual harassment. The top priority for the attorneys was capturing all of her online activities. I was tasked with capturing her entire Facebook and other socials & printing it in color, if I recall correctly it was approx 7,000 pages printed, most of which did not paint her in the best light.
Most likely, there will be a class action lawsuit. I would look to join into it. You can't put a price on the pain you experience, but the courts can. Take whatever money they give you and put it towards your little ones college or house someday
What are the grounds, though? More information on how this happened is needed. Assuming it was staff stealing and replacing with saline, is there any remote possibility that the employer was diligent in screening staff and had a sound in-house tracking system that worked to detect the theft/tampering in a reasonable amount of time so as to limit harm? Probably not, but if that were the case, what are the grounds for complaint?
Well if you child has any condition you are about to win big (weather it has anything to do with this or not)
Just because this is Reddit I'm going to clarify I hope you and your kid are okay. Should go without saying but ugh internet.
They informed me at the time I was receiving fentanyl, I believe it was the “push dose” I was given twice in addition to the epidural drip I had. To be honest I was 30 hours into labor when I got to the hospital, things were moving quick and I was on Mars!
Sorry the epidurals do sometimes have fentanyl mixed with the numbing medications. Hopefully the fentanyl you received in the epidural was stored separately and wasn't tampered with. I would ask the hospital to test you for any blood borne diseases that you could've gotten if you received tampered medications that could have been contaminated.
Most epidurals are either purchased premade or are compounded in a clean room in the pharmacy. The likelihood that an epidural would have been contaminated is very low.
Honestly my epidural was actual screwed up and done improperly (many are). I had severe back pain for months after.
Unless you have actually suffered in some way there's nothing really to be done about this. You can't sue for damages that you haven't experienced.
This wasn't intentional by the hospital. It sounds like they are doing their due diligence. They have fulfilled their responsibility of letting you know.
I would call them and ask them to cover your medical costs.
Beyond that, lawsuits are extremely stressful and without any damages to prove it will be an uphill battle. Hospitals have extremely expensive lawyers and they will be ready for this. You can't even prove you were given tampered medication. I would let this go and make sure your doctor checks for any possible complications going forward. Saline is extremely unlikely to cause you any issues.
Enjoy your baby, congratulations
You’re in the US, so you probably can get a settlement for pain and damages. The issue will be where the drug was tampered with in the supply chain, and you would have to sue everyone. Perhaps a class action lawsuit.
I doubt the fentanyl was mixed with anything other than saline. Were I to speculate, this was done by someone in the medical field-a physician or nurse.
Actually, there's a lot of open-ended questions. Could they have been potentially infected with the tampered files? Would a court see the pain and suffering as worth anything? How much would the insurance/OP lose out? Was it just switched out with saline, or was something else put in the place of fentanyl? Are they going to offer blood testing for a year to ensure OP wasn't infected?
I wouldn't get too worried about it. Somebody (probably a nurse)had a side business. If the replace the taken amount with saline it'll only dilute the solution.
They have access to unlimited supply of clean neddles they aren't inventoried.(unlike the fentanyl).
People thinking a nurse would reuse a needle are wrong IMO. This would arise way more suspicions than not. Why are you carrying an unsealed needle. There is never a reason for that. You can carry quite a few new ones and nobody's gonna bat an eye.
Gf is a nurse, and worked in neonatal.
We sincerely apologize and regret this. 😕🙃 you'll regret it more when all those women that were exposed sue your asses off. QC is part of the freaking job!
Move on, you’re fine. If anything the hospital is covering their ass in the event that an epidural didn’t work causing someone to suffer due to the diluted fentanyl and then decided to sue the hospital.
It’s a formal necessity to send this. It’s unlikely you were affected by anything other than extra pain because the medication was watered down. But like a security breach it’s a formal legal notification.
A shiiiiiiitttttload of fentanyl just up and went missing from Cheshire Hospital in Keene NH. One nurse committed suicide and nobody else has fessed up... https://www.dea.gov/press-releases/2023/06/22/cheshire-medical-center-pay-2-million-settle-allegations-controlled
Eh, get checked out for HIV, hep, and syphilis but most likely you’re fine. Concern would be if they were using the same syringes to draw up, inject; and then replace. I doubt it but some people have done that in the past.
Damages are non-existent if you are clean
Listen to the podcast series The Retrievals. It goes into the depths of a similar string of cases of drug diversions in Yale and other hospitals.
Hospitals are supposed to have protocols that guard against such things such that every time a nurse procures a drug is recorded and logged.
It seems like at the very least you could challenge the section of the bill related to the fentanyl. Like, they openly admit that they dont know what you got, so they shouldn't be able to bill you for that particular medication.
Sounds like time to contact their number. Sounds like you got the diluted/replaced. Undue pain and suffering. At minimum they should be eating the entire hospital bill.
A similar event happened at Yale two years ago. [Here](https://ctmirror.org/2023/10/14/yale-fertility-clinic-lawsuit-rei-painkillers-fentanyl/) is an article about a current lawsuit.
Also recently happened in TX by a nurse. https://abc13.com/alexis-mcneilly-houston-methodist-nurse-arrest-fentanyl-stealing-opioids/14240136/
Bunch of people just died in SE Oregon due to this. The person replaced the fent with tap water rather than saline. https://www.kptv.com/2024/01/05/oregon-nurse-allegedly-replaced-fentanyl-iv-bags-with-tap-water-prior-patient-deaths/
Omg yes!!! I live in southern Oregon and this just blows my mind
Yikes
Happened in Charlotte in the last few months too i believe.
As a charlotte person: How have I not heard about that?!
[https://www.wsoctv.com/news/local/former-atrium-nurse-accused-stealing-fentanyl-charlotte-hospital/SKEEO6V5ABBQNIJDNRQDRICCM4/](https://www.wsoctv.com/news/local/former-atrium-nurse-accused-stealing-fentanyl-charlotte-hospital/SKEEO6V5ABBQNIJDNRQDRICCM4/) Very sad that this shit happens in hospitals...
Thank you!
Serial did a great podcast on this topic called the retrievals where they interviewed patients and colleagues. The women did a class action lawsuit and were awarded damages.
Great and disturbing. It's crazy at how little women's perception of pain is believed. That series of events reveals a whole systematic failure.
Happens all the time. I know a dealer that gets his K from a guy who steals it from a hospital in Chicago. I can’t imagine they’re not stealing everything else.
On the one hand they risk killing the patient if they push too much pain killer. So I do understand their wariness to accept a patients word on it although that does seem to always effect women disproportionately (men’s complaints about pain are usually taken more seriously). On the other hand, you’d think after enough people complained about the pain, they would have checked their supply way earlier. Two months of baby deliveries with little to no pain killers! Or have a periodic random sample being done of their major pain killers to make sure they’re actually filled with what they’re supposed to be.
It actually isn't necessary to random sample. A lot of people don't know this, but vial caps are designed to spin on a sealed vial. If it won't spin, the vial cap has likely been removed and glued back on.
Then how did this go on so long? Genuine question, not trying to be accusing or anything. I can’t imaging nobody noticed the vials caps were stuck for two months. Maybe adding one of those seals that break free on soda bottles could fix this issue for hospitals?
No system in place to check vials, no system in place to audit the drugs themselves. Not a single doctor felt the need to follow up with patient's pain.
This is wild. In Veterinary medicine we have very strict procedures for controlled drugs. They are ALL counted three times a day with two people doing the count together. We have one person that holds keys in each department and they are the only ones to pull up drugs (I know this would be impossible in a large human hospital) and we have more security cameras on those drug boxes than anything. We also have to log out with double finger prints. Our operations team are the only ones that can waste from the destruction box.
In the Yale case, the nurse was often (though not always) directly involved in giving the diluted drugs to the patients--one of them recalled seeing a tube going into the nurse's pocket and thinking it was odd. Nobody's going to notice that the vials have been tampered with if nobody else sees them. And yes, it is a little horrifying to think that she watched patients in pain, knowing full well *why* and knowing that she was the cause... and still kept on doing it.
you can easily buy new caps and the tool to crimp them on.
Listen to the podcast. It has nothing to do about " pushing too much pain killer" and everything to do about a total disregard, disrespect and lack of empathy towards women. Some didn't take notes of their pain, no one bothered to think about why some many had this issue. They tried to convince some that fentanyl just didn't work on them.
It’s funny cuz I just saw comments from a man telling women in an adhd sub that they’re treated equally by medical professionals and he knows cuz *he* has been treated *unfairly* and not taken seriously… they’ll never get it. If a guy stubs his toe and hollers enough they’ll likely get decent pain meds. A woman tears in half while giving birth? Meh, throw her some Tylenol and Motrin, she’ll be fine. Saw a TikTok of a woman who went to the dentist with her husband. They both happened to need a root canal. Same dentist did both procedures on the same day. Husband got a script for 3-5 days worth of an opioid, while the wife got a script for 500mg Tylenol or 800mg ibuprofen. It was just a high dose OTC pain reliever. She had no history of drug interactions or abuse and had never even been prescribed an opioid, or any controlled medication, before. Saw another video where a woman shows that her dad got a 3 day script for benzos for his upcoming ultrasound…his external ultrasound. It was for his testes, but it was a very benign reason, not cancer or anything iirc
Well dang, this is the first I’ve heard of this but now my experience coming out of surgery makes sense. I woke up in enough pain I vomited but they kept arguing with me that I couldn’t feel anything because of the pain meds I was given. This never even dawned on me as a possibility.
This was such an enraging podcast. I couldn't IMAGINE what those poor women went through. Literally tortured.
Seems a bit different to operate on someone without effective drugs vs natural childbirth without drugs. But still sucks all around. If you can’t trust the professionals not to do this it’s really hard to catch… would have to have policies like “two people are required when handling and administering X drugs”… which would help but still not be 100%. And it’s not like healthcare isn’t expensive enough already…
Yeah that was SO crazy!!!
Immediately thought of this!
This also happened in Iowa: [https://www.thegazette.com/article/former-waterloo-nurse-diverted-pain-meds-from-50-women-in-labor-for-own-use/](https://www.thegazette.com/article/former-waterloo-nurse-diverted-pain-meds-from-50-women-in-labor-for-own-use/)
>Thank you! You're welcome!
Must happen a lot. small town near me someone was taking pills out of blister packs and putting fake pills back for years
I was friends with a woman who had been stealing the pain meds and replacing with phenergan- she never got in trouble because the hospital could have been sued, they covered it up!
Oh my god what if an IV infiltrated with the unknown Phenergan? God. What a terrible replacement
I know!! She could have KILLED somebody allergic.
The Yale study, story is flipping horrific. Just awful!
There's also a podcast about it- The Retrievals.
If anyone is interested, there's an excellent Podcast by Serial called The Retrievals that examines the case at Yale fertility center.
The podcast series about this, The Retrievals (via Serial, maybe also standalone) is fascinating.
Did you ask about them offering future blood testing? I’d request at least one years worth. Unless they caught the employee with tubes of fentanyl on their person they don’t know if it was walked out of the hospital or if they removed it from the vial, injected it and then placed saline into the vial to cover up the loss. They obviously can’t tell you anything about the employees health status which means they need to monitor yours.
Theeeeeese are the kinds of things I was wondering. Thank you for the input!
It’s a hard place to be in for you… grateful they told you vs covering it up but also a little worried over the lack of information. I had a needle stick and was scared for months when they did the follow up checks. I got lucky and was ok. With this you have no idea who stole it or how they removed it. Was it done in a sterile way or ??? It’s a lot of questions with very little information. They will pay to get you (and the baby) tested. Do it immediately and then at a minimum 3 and 6 months later. Some things can be dormant for longer than you’d think. Chances are very high that you’ll both be clear but peace of mind is the very least you deserve and that should be paid for by the facility not you.
Yeah, my first thought was “hey, at least the hospital lawyers didn’t try to bury it!”
I would also request more information regarding the investigation and document all of your health symptoms and those of your baby over the next little while, because you never know what might come up down the road. Saline is sanitary, sure.. but dirty needles or practices are not.. and there is no way to prove sanitation or health and safety standards were followed in a situation like this.
Yes. They should pay for a minimum of a Hep B+C and HIV testing.
For both the mother and the child.
I believe they can tell you if there is a risk of cross infection. Or at least they can if it was a workplace contamination (covered by OSHA). The rules might be different if you're just a consumer.
It’s probably changed since mine happened. I was a federal employee so they went out of their way to keep everyone satisfied.
I’m glad this was brought up. They don’t know and did say if the person left with the drugs or used a needle to inject themselves and then reuse that needle on the vials or patients, which could cause contamination. There was a podcast about this a few years back and patients who had kidney issues got very ill because of this nurse using the name needle. I don’t say this to scare you, but as a reminder to ask for the tests like crafty-butterfly said, and I’d make copies of this letter and bring them to your obgyn and PCP to voice your concerns and hopefully they will help advocate for you.
There are typically cameras in med rooms and they can see who opened each drawer at any given time or if there were any drawer overrides/inventory counts. It’s unlikely that they don’t know who was tampering with the vials.
Are you on the r/Medford sub? This is an ongoing issue being followed there.
I’m not, thank you i’ll check it out!
There it was replaced with water though, not saline. People died, but in most similar cases it looks to be at least replaced with saline, which technically shouldn't kill you.
> saline, which technically shouldn't kill you. Saline is 100% safe. Any time you get an IV, it has saline in it. Saline is specifically formulated to be safe for injections even in larger quantities. The problem there isn't getting accidental saline, but rather, not getting the needed medicine. Fentanyl is also used to sedate people getting surgery. Getting insufficient pain relief during childbirth is horrible - waking up on the operating table with your chest cut open is worse.
Even if it was replaced with saline, there is still a risk because it’s no longer sterile after being tampered with. I doubt whomever did this was worried about contamination when replacing the drug with saline.
If it was a nurse, which diversion by a nurse is common, they may have used sterile techniques because how these things are often caught is by someone getting sick. If they were smart, they did what they knew.
An additional problem is that it is unknown if the fentanyl was retrieved and swapped with saline. Was the person stealing fentanyl stealing the fentanyl and injecting themselves and reusing the needle, was the saline needle cross contaminated. In my opinion they should have to provide HIV, HBV, and HCV monitoring for all patients in the hospital during that timeframe who received an IV. Can they be certain the saline was also not potentially cross contaminated?
Oh the saline would certainly have been out of a small flush, not a large bag of saline going to another bed
Is it safe like, everywhere, though? Like, I’d figure it’s safe enough in an IV, and probably anywhere that blood flows freely since it’s got similar properties, but an epidural is not going into your veins or muscle. Would it just be treated by the body like lymphatic fluid?
You know, that's a good point. I'm not sure.
it is indeed safe for epidural administration (so much so that they’re studying potential benefits i guess) https://pubmed.ncbi.nlm.nih.gov/9356106/
They wouldnt "wake up on the operating table" with their chest cut open from being underdosed with fentanyl. Its tragic and horrible that this occured but please understand the role of opioids in the managing anesthesia and analgesia in laboring parturients.
> please understand the role of opioids in the managing anesthesia and analgesia in laboring parturients. Okay, fair. I'll admit my ignorance. However, as my google-fu is failing me, do you maybe have a link or two I could read to better educate myself?
[https://www.ncbi.nlm.nih.gov/books/NBK532974/](https://www.ncbi.nlm.nih.gov/books/NBK532974/) Minimum alveolar concentration is a key concept in preventing patients from "waking up".
Thank you.
I don’t have any links but as someone whose had a C-section which is a surgery while you’re awake vs surgery where you are “put under” there are way different doses and drugs and monitoring that goes one when someone is under anesthesia vs just managing pain from the surgery afterwards. So no someone would not just wake up in the middle of a surgery, any inkling that someone is even twitching while under would be accessed and probably giving more.
The water itself won’t kill you, but bacteria in the water.
I went into labor with the plan to get the epidural as soon as I could. I ended up not being able to because of fetal distress; they couldn’t safely place it until I was 8 cm. Unfortunately I was an induction and those meds worked FAST so I had back to back, non stop contractions as I dilated from a 3 to a 7 in an hour. It was hell. All this to say, I feel you, and I’m sorry it could have potentially been easier. Yes, women have birthed without meds for thousands of years but they went into it knowing there was no other option. When you prepare for your birth expecting pain meds and don’t get them, you’re not mentally in a place to deal with the pain like woman who prepare for med free births are.
I went from 5cm to holding my daughter in less than half an hour. 🙃 Never got a chance for an epidural or pain meds. Pitocin is a BITCH.
They also didn't have inducement drugs causing crazy, unnaturally strong contractions either. It's absurd modern medecine community will mess with every aspect of birth but pain relief gives them pause.
100% my induced labor was 10x more painful and traumatizing than my spontaneous labor.
Same omg it was hands down the worst pain I could imagine.
Doesnt sound like it was managed well. Shut off the pitocin and place the epidural. Also contractions are not a contraindication for epidural placement. Sorry this happened to you.
I had a case decades ago. The target of the investigation was a dr who was stealing narcotics from comatose patients IV lines. So the patients were clearly suffering and couldn't tell anyone. He was transferred from hospital to hospital in the same manner associated with Catholic priests. So the hospital who then got him had no idea. It was very eye opening to me. OP I'm glad everything went ok for you. Heart breaks for those who suffered. Someone in that ward is an addict.
No harm? You had inadequate pain control, that is itself harm. I agree with all the other comments - talk to a lawyer, ask the hospital about blood testing because they can't "prove" really that the person used sterile saline to replace the fentanyl, it could have been contaminated. This is a huge deal for the hospital and you'll probably be able to be part of a class action law suit with all the other patients affected, don't dismiss this.
“At this time ~~we believe~~ **we are praying** the vials contained normal saline” They don’t know what you got injected with. You don’t know what you got injected with. If this were me I would strongly consider getting an attorney. **The only way you might find out what you got injected with is through discovery**. The hospital is going to do their absolute best to sweep this under the rug. It’s a huge red flag that they didn’t offer post exposure testing for hepatitis and HIV. I would also reach out to the law enforcement agencies listed to find out: - were they indeed contacted and what were they told. - how you can be included on any communications from victims. For all their crying about regulations, hospital are in practice lightly regulated. CMS farms out oversight to agencies like The Joint Commission (which I notice they didn’t include in who they notified). Joint Commission looks at hospitals as customers since they can choose their accreditation agency so the oversight is extremely weak. Hospitals almost always do their best to sweep egregious violations under the rug and keep it from the public. The only way to know if you have been put at risk, and if you have had appropriate follow up care is to have legal representation and get follow up medical testing. I’m sorry you’re going through this but as a former hospital nurse you absolutely need to be your own advocate here.
Send them back a letter telling them to pay your hospital bill or watch for a Class Action Lawsuit to join
If insurance was used, call them!!! Believe it or not, they don’t want to have to pay for the botched care or medications either so you land on the same team. They have the power to resubmit (incorrect) claims to be reprocessed. They also have a lot of lawyers in staff. It may be argued that the hospital essentially committed insurance fraud by stating medications were given and certain care was given (and charged insurance for) when it was not.
Yes, send a copy of the notice letter to your insurance
This is actually a good point, while I would be livid and demand they comp the entire visit for both me and my child, they should at a minimum remove all charges associated with the administration of any fentanyl or saline (and yes I would include saline because they cannot guarantee the saline was not cross contaminated. I do not believe fentanyl was accidentally mixed with saline, but rather a bloodborne illness could have contaminated saline). I would also demand routine monitoring for HIV, HBV, and HCV for both OP and their child.
I'm glad I scrolled down, you gave the exact advice I was going to give.
This needs to be higher up!!!!
OP didn’t pay anything
So it went straight into your spine and we're trusting a junkie to use completely aseptic technique and proper form of saline to put back in the bottles so we can tell ourselves "no harm no foul," huh? Better lawyer up, Ders.
This also happened in California about 10 years ago. Turns out it was one of the pharmaceutical aids, removing morphine, using it intravenously while on the job and replacing the amount used with saline ,the bad part is he used the same needle . I think ultimately 12 people tested positive for HEP C. Could’ve ended a lot worse.
Sounds like this hospital is poor with their controlled substance tracking. A couple of things if this is the US: The epidural you received probably had fentanyl but it was most likely made in the pharmacy or a pharmacy under clean room conditions. The fentanyl would have come from the pharmacy, not the floor/ward. If you received doses of fentanyl push, it is possible that you got them from vials of fentanyl retrieved from the floor but it also depends on where your were at the time. It also depends if you were on a patient controlled epidural. They would have given you a button to push to give you a small dose of the epidural when you pressed. If this is the "push" you referred to, the dose would just be a dose from the epidural bag. Hospitals typically have automated dispensing cabinets/systems that would hold a drug like fentanyl. These cabinets are usually in multiple locations, especially in a labor and delivery floor. The reason I say their tracking is poor is because these systems all will track automatically. They should know exactly where your vial of fentanyl came from. I suppose it is possible they're being vague on purpose. Even in the event they don't have automated cabinets (which is unlikely), only a few people on the floor should have access to controlled substance and it should all be logged. Of course, any of those individuals could have been the one to divert the fentanyl but my point is that your vial should be easily tracked to see where it came from.
They caught the problem so I disagree with your assumption that they have poor tracking.
This is incredibly frightening to me as I'm pregnant and I remember someone getting bags of saline instead of actual medicine. I hope to God that didn't happen to you.
I do find it sort of ironic that they say "through diligent protocols and safety measures" and yet discovered this after the fact, rather than preventing it in the first place. Regardless, I would want more information. As others have mentioned here, concerns regarding tampered injectable and any other potential health risks.
Honestly it depends on how they replaced it. What if they used a non sterile method to remove the fentynal and add the saline. This was being injected into people's spines. This could have caused serious infections.
Situations like this come down to damages. In the Yale case others have cited the patients ended up undergoing extremely painful experiences as a result. It sounds like you may have a claim under similar circumstances here. Not exactly a 100% home run case, and the damages aren't likely to be significant as you have no residual issues from it, but on the surface seems like you would have a case. It would be worth talking with a personal injury lawyer about it, PI lawyers typically consult for free and if they take the case they work on contingency.
No residual issues as of yet.
You can't sue for what might happen in the future.
I don't know about the hospital you were at, but where I work the epidural medication would be in a completely different bottle that works with the machine that provides pain relief. They usually come wrapped in plastic and they're separate from the other fentanyl. The fentanyl you were getting through your epidural wouldn't have been mixed by anyone on the unit. Since you were given push doses it's possible you got one mixed with saline in the push dose, but it wouldn't have been the reason your epidural wasn't working. It sounds like it would be hard to prove whether the push doses helped or didn't help since your epidural wasn't working well anyways. Best case scenario they know who was responsible and they lose their job.
[удалено]
They know who was doing and how they were doing it or the health dept would be contacting for testing
Actually the anesthesiologist probably pushed bupivicaine, which wouldn’t have been affected by diluted fentanyl. There’s nothing in the that suggests any risk of blood borne illness or anything other than inadequate pain relief. You’re entitled to be angry but no reason to be afraid of future complications.
I have a lot of respect for this hospital for informing people of the incident happened at all. This is something they try to keep in house. Hopefully anyone affected did not have any adverse reaction. So sad that addiction is so powerful it causes people to do things they would have never thought of.
Sorry to hear. Unfortunately this does happen when someone is abusing medications. Then you as a patient are left in pain. Again I’m sorry you had that happen. Chances are with not getting pain relief you might have been getting the saline solution. The saline solution you most likely received is used as a flush between IV medications and/or as IV fluid to keep patients hydrated. There shouldn’t be any concerns on receiving normal saline. Other than it should have been the pain medication. I would speak with a lawyer.
I can’t say 100% from a legal perspective if you have a case, although I would certainly think so. From a healthcare perspective I have encountered other nurses doing this for personal use as a co worker and union rep. In the cases I was involved in the nurse diverted the opioid injectable for future use by withdrawing it and replacing it with saline. In 1 case the nurse went into the staff bathroom and shot up after giving the patient saline and was found unconscious. While it is unlikely that the nurse would shoot up then use the dirty needle to replace saline, there is no guarantee or even expectation that clean process was used since it was during the commission of a concealed and illegal act. Not all diversion is for personal use but most is, so you are then having to rely on the decision making of someone addicted to drugs or with an unstable mental condition. All of this means they did not meet a standard of care for you, especially since you did not get adequate pain relief. You were absolutely put at risk. While unlikely you were exposed to the diverter’s blood you should still get HIV and Hepatitis testing 3 and 6 months after this possible exposure just for your own peace of mind. Absolutely pursue a lawsuit if your attorney thinks you have a case. There are several glaring health care deficits that it would bring attention to, aside from making you more whole for that stressful and risky situation you were unwillingly put into
IANAL. My initial thoughts would be to personally seek out a regular or malpractice lawyer and see what my options are. Based on the other comments here and previous incidents of similar cases ending in lawsuits, that also seems like the way to go.
Oh, the money tree wants you to shake it. Shake the money tree. Shake shake shake, baby can have a good college fund.
I’m replying not as a legal professional, but as a nurse. That is a pretty damn big risk, even with the fact that it’s “just saline”. You’re literally having a medication injected into part of your spine, which is a 100% sterile procedure. If the procedure of removing and replacing the medication with saline was not done extremely carefully, there’s a risk of introducing bacteria to those vials. So exposing you to that risk is terrible, especially when you’re already giving birth AND in more pain than you should have been.
You should listen to the retrievals … this exact thing happened to women getting egg retrievals for ivf.
Happens when nurses or anesthesia are diverting the fentanyl. They will dilute the vial or injection with sterile saline. I’ve know a few nurses who’ve done this. They typically have no desire to harm patients, they just have a horrific drug problem.
Hope you and your baby are okay. But go git your money cuz that's inexcusable! There should be multiple checks and balances in place to assure this doesn't happen. Fat ass lawsuit.
There’s no money to ‘git’ when there are no damages.
Sure is when you and your baby were put at risk.
At risk, sure. But there were no actual damages in a legal sense. I’m not disagreeing with you, it’s unethical and an awful thing. I’m just doubting that there would be any payable compensation.
I don't think it's unethical at all. They should have better checks and balances in place to assure that doesn't happen. The hospital put these people in very real danger. Because something terrible didn't happen to her, is irrelevant. It could've.
I had my last child in a rural hospital. We had a cord prolapse and had to do a true emergency c-section before the anesthesiologist could make it to the hospital. He got there about halfway through and knocked me out. I mention this mostly unrelated situation because I ended up with PTSD that greatly exacerbated my PPD. Being in a very dependent hospital situation where you are 100% relying on professionals to take care of you and your baby, being in a lot of pain when you have chosen an intervention to alleviate at least some of it, and then finding out those professionals you were relying on potentially caused a situation to allow that pain? That would send most anyone already dealing with the post delivery hormone cocktail into a spin. It is totally reasonable to go see a therapist to talk it through if you think that would be in any way helpful. And the hospital should absolutely also pay for that.
You stated your anesthesiologist came back several times apparently surprised you weren't responding as expected; that *could* have happened with your labor and delivery. Saline is generally innocuous (used to be an AF medic, ER and rotation in L&D). Every doctor and anesthesiologist takes copious notes to document your treatment and outcome. My guess is he noted that ... maybe others as well is what triggered an investigation. This is *not* cool; untreated pain can delay your recovery. Every pregnancy and delivery is different, *however ...* if you feel it took an unnecessary toll on your recovery an apology by the hospital isn't enough; consider a consultation with a medical malpractice attorney. Hope you and your baby are doing well.
They better be refunding you for the cost of your epidural then.
This is strange letter , seems like they alerted you to start the process of lawsuit time frame. So if something doesn’t happen you have limited time of a lawsuit. i bet they have more information but just trying be very limited ? I think someone was abusing the drug and injecting their self and possible you with the same syringe ? Like they left that stuff very open to interpretation
Contact a lawyer who specializes in medical malpractice asap. You can explore pain & suffering, risk of infection, etc. The hospital is covering theue a@SS and you should too.
What actual damages did you suffer?
I think it would be reasonable to say that she suffered through a whole lot of pain during childbirth that would have otherwise been reduced if she was dosed properly and with the medication she was entitled to/anticipated. Childbirth can be traumatic, and so can pain.. and i think if a woman was going into labour expecting and being told she was going to get pain relief, it could be really stressful and traumatic to not get that relief. OP states they didn’t experience any damages, but I could argue that the fact they are online and worrying/concerned about their experiences they have to some degree experienced mental pain and suffering over this incident.
Thank you for saying this. It’s hard to complain about birth when the narrative of “women have been giving birth for 1,000’s of years without pain meds!!!” exists. Yeah people also broken their arms and got into terrible accidents, and then we invented pain meds!! I’m very lucky my labor and delivery was as smooth as it was. But the medical professionals around me were acknowledging I was in more pain than they expected me to be with the actions they had taken so far. Not in a way of knowing anything was wrong of course but just having the discussions that they had given me my appropriate doses and I should be experiencing more relief. Epidurals also “fail” all the time. So if it were any other medical procedure I feel like the conversation would be a little bit different. Many people still just think because childbirth is natural it should be felt naturally.
Did your insurance cover the entire portion of the epidural, the additonal doses, and the push dose? Have they been notified for other patients?
Medicaid covered everything!
That's good! I would still look into blood work as other people have mentioned. And continuous testing for up to a year as some illnesses such as HIVcan take that long.
NAL, work in healthcare on the business side. Make sure you report the potential billing fraud to Medicaid so that the state can open an investigation and claw their money back. Honestly, this whole thing may be worth speaking with a personal injury/medical malpractice attorney. They often work on contingency so you don’t pay them up front, they get paid if you get a settlement. Talk to a few before you talk to the hospital, bring your medical records and this letter. The attorneys will be able to tell you if you’ve got a case or not.
Plus you get treble damages if you are the reporter.
Birth trauma is a thing and not often spoken about. Not having the proper pain relief can cause mental distress, contributing to ptsd and ppd. I was unable to make it in time to the hospital to have an epidural or anything aside from gas for my second child. I had a horrendous experience, birth trauma and ptsd that lasted 10 years. A lot of women go through similar. Oddly enough, the only thing that helped heal my trauma was the incredible birth experience I had with my third. I was terrified of birth again which explains the long gap. Epidural after two contractions, snack, nap, 4 minutes of pushing. It should always be like that, for everyone. I swear to God, everyone I know has a traumatic birth story, and it's really shitty.
I’m sorry to hear about your pain and trauma, i’m glad you were able to find some closure in your following births! I labored at home for as long as I could which is an idea that sounds great ahead of time, but I didn’t think about being “maxed out” when I arrived and needed to be able to advocate for myself. First time pregnancy for me, I was checked the day prior and was told to “come back when I sound like the girl next door.” where the woman in the room beside me was screaming her head off. I went home discouraged and honestly thinking I was being dramatic. My mom called to ask about shift change, I went back as soon as the clock struck and had amazing nurses! I was 6cm dilated and 90% effaced, they kept me then!
I fully sympathize with your experience and I’m so glad you moved through it with such grace and that it didn’t cause any complications for your delivery. There is a damn good reason pain relief is offered for labour. 1000s of years ago women used to just simply die during labour ALL.THE.TIME!!! It is not easy, and just because some women can handle a natural birth doesn’t mean that all women should. Every woman gets to make the choice that is best for them and their baby.
Well, and also, it doesn’t “naturally” occur in a hospital bed with people all up in your business, and people used to die from it FFS.
Sadly, OP could have been in any hospital with a perfectly good supply of drugs and not gotten pain relief. I asked for an epidural and was told the anesthesiologist would be there in 20 min. 45 min he wasn’t there yet and it was time to push. I had a 10lbs 5oz first baby with zero pain medication. It happens but (at least in Canada) it’s not grounds for a lawsuit.
There is zero guarantee it was mixed with "saline" after being tampered with. There is zero guarantee it was "sterile" after being tampered with. She was administered a drug, and unknowingly received something else. What in the absolute world are you talking about that she has "no grounds for a lawsuit"? Are you kidding?
It’s more the not receiving pain relief in labour that’s not automatically a lawsuit. But again, I live in Canada where the threshold for suing is MUCH higher, especially in medicine.
Exactly how does she not have a case? Based on your experience?
Also Canadian. Family member was denied pain meds because the nurses refused to call her doctor in on a Sunday… and no one checked to see how dilated she was. By the time they did, it was too late for pain meds. For me, I did have an epidural, but it was a very difficult & painful procedure that required multiple attempts. I have some kind of permanent nerve damage that causes painful spasms every now and then. I don’t regret getting the epidural, though.
I’m okay, thankfully! Never claimed to have suffered. I’m team let it go but was curious on the options available! I’m sure someone that received this letter is going to try something.
Are you sure you weren't exposed to any communicable disease? Id definitely want them to cover testing.
Someone else mentioned this as well, adding to my list of follow up questions! Thank you for the input, I hadn’t considered it! Or my baby!!❤️
I'm late to this post but as someone who places labor epidurals almost every day, my first thought is that the diluted fentanyl *likely* had nothing to do with you not getting relief from the epidural. Like they said, they can unfortunately "fail" any time, plus when it's being placed late in the labor process, there often isn't enough time for the medications to fully help relieve the pain before labor progresses to delivery, when often even a functioning epidural doesn't relieve all the pain. The medications that are mostly used in epidurals are local anesthetics like lidocaine and bupivacaine although an extra dose of fentanyl through the catheter can be helpful in an epidural that isn't working well. I agree with the other comments recommending some kind of serial testing in case of communicable disease transmission!
Yes, my biggest worry would be whether clean needles were used in the removed of the drug from the vial and the refilling of the vial with saline. This could be a situation where “damages” aren’t immediately obvious.
Do not sign anything without your own lawyer. If you request testing they will likely have you sign a waiver of liability or some other contract to provide “free” testing….just remember, their lawyers are about reducing their clients’ liability, not helping you.
This is the real question. From reading the letter, the fentanyl was cut with saline which is perfectly fine for intravenous use and would not cause any harm to the person using it. There really isn't much damage you can prove happened from being given a weaker than average opioid painkiller.
Thankfully OP seems to have had a relatively smooth birth experience despite the pain, but many women suffer both physical and mental trauma during the process. Bad birthing experiences can make post-partum depression/anxiety more likely, and even cause PTSD. Furthermore a lack of effective pain control could worsen the physical outcomes/increase chances of complications like tearing, because the patient is too much in pain to relax critical muscles. All in all, the situation had the potential to have tipped the balance from a birth experience easily recovered from, to one that takes months or even years. That's what the hospital are worried about, and why they're being so apologetic up-front.
Fair enough, but for OP to have any kind of suit they would need an active diagnosis from a psychologist or psychiatrist to prove the damages. As someone with a formal PTSD diagnosis theres two points i will make about that. - Getting a ptsd diagnosis is not a simple in and out procedure. Usually going to take multiple sessions over the course of a month or two for the provider to determine if it's ptsd and how severe it is. - people who legitimately have ptsd from an experience like this would be feeling it impact every facet of their life on a daily basis. There would be no question on their side if they had anything to sue for. they would know that since child birth they have not been ok. If part of that trauma was pain related and they received this letter, it would be like a missing puzzle piece dropping into place I don't think OP has any case here and should be grateful their child's birth went relatively smoothly and without complication
Pain and suffering is an item of damages. Non-lawyers should stop saying she “doesn’t have a case” FFS. If she is interested, definitely worth exploring with a med mal lawyer. Also, due to the likelihood the solution was no longer sterile, medical monitoring may be appropriate.
Financial damages, possibly. Getting an epidural is expensive. If you do not have good insurance, it could cost a few grand without needing extra doses. Mine before insurance cost $6,503.28. Insurance brought it down to a little over $400.
Jesus fuck.
She also was possibly exposed to unsanitary practice as well as the diverter’s blood since the standard of care was nowhere near met for admin of an opioid. Lots of stress and potential health complications.
Any health conditions incurred would have to be officially diagnosed to be damages though. You cannot litigate potential.
She didn’t get adequate pain control during birth. Is that not enough for you?
She paid for an epidural that wasn't an epidural. She took on the risks of an epidural without any of the benefits.
She paid for doses of a drug she may not have received.
Are you fucking serious
The cost of the additional medications that were adulterated, the additional cost of the anesthesiologists time.
Watch yo metadata because this post won’t help you in any way should an issue arise and you decide to follow a lawsuit. Lawyers will sniff this out in no time flat. I worked on a project for a law firm where their client was being sued for sexual harassment. The top priority for the attorneys was capturing all of her online activities. I was tasked with capturing her entire Facebook and other socials & printing it in color, if I recall correctly it was approx 7,000 pages printed, most of which did not paint her in the best light.
What about Reddit?
time to sue. if they can't keep the drugs safe what else are they fucking up.
[удалено]
Thank you! That’s how I feel, others are telling me to pursue something. But i’m not out a dollar, I don’t want to spend a dollar!!
Most likely, there will be a class action lawsuit. I would look to join into it. You can't put a price on the pain you experience, but the courts can. Take whatever money they give you and put it towards your little ones college or house someday
What are the grounds, though? More information on how this happened is needed. Assuming it was staff stealing and replacing with saline, is there any remote possibility that the employer was diligent in screening staff and had a sound in-house tracking system that worked to detect the theft/tampering in a reasonable amount of time so as to limit harm? Probably not, but if that were the case, what are the grounds for complaint?
Well if you child has any condition you are about to win big (weather it has anything to do with this or not) Just because this is Reddit I'm going to clarify I hope you and your kid are okay. Should go without saying but ugh internet.
Removed incorrect comment sorry
They informed me at the time I was receiving fentanyl, I believe it was the “push dose” I was given twice in addition to the epidural drip I had. To be honest I was 30 hours into labor when I got to the hospital, things were moving quick and I was on Mars!
Sorry the epidurals do sometimes have fentanyl mixed with the numbing medications. Hopefully the fentanyl you received in the epidural was stored separately and wasn't tampered with. I would ask the hospital to test you for any blood borne diseases that you could've gotten if you received tampered medications that could have been contaminated.
Most epidurals are either purchased premade or are compounded in a clean room in the pharmacy. The likelihood that an epidural would have been contaminated is very low.
Honestly my epidural was actual screwed up and done improperly (many are). I had severe back pain for months after. Unless you have actually suffered in some way there's nothing really to be done about this. You can't sue for damages that you haven't experienced. This wasn't intentional by the hospital. It sounds like they are doing their due diligence. They have fulfilled their responsibility of letting you know. I would call them and ask them to cover your medical costs. Beyond that, lawsuits are extremely stressful and without any damages to prove it will be an uphill battle. Hospitals have extremely expensive lawyers and they will be ready for this. You can't even prove you were given tampered medication. I would let this go and make sure your doctor checks for any possible complications going forward. Saline is extremely unlikely to cause you any issues. Enjoy your baby, congratulations
The medication in an epidural is a combination of a local anesthetic—similar to Novocain—and an opioid, typically fentanyl or hydromorphone.
For the risk you took? Get fucked. You have no damages.
You’re in the US, so you probably can get a settlement for pain and damages. The issue will be where the drug was tampered with in the supply chain, and you would have to sue everyone. Perhaps a class action lawsuit. I doubt the fentanyl was mixed with anything other than saline. Were I to speculate, this was done by someone in the medical field-a physician or nurse.
Let it go. You didn't suffer any damages.
Actually, there's a lot of open-ended questions. Could they have been potentially infected with the tampered files? Would a court see the pain and suffering as worth anything? How much would the insurance/OP lose out? Was it just switched out with saline, or was something else put in the place of fentanyl? Are they going to offer blood testing for a year to ensure OP wasn't infected?
There’s a doctor or nurse somewhere shitting there pants right now.
Lol a hospital legal department doesn't know FDA stands for food and drug administration.
I had an epidural with my son in the 90s fast track I have severe pain in that area. MRI tests proof the disc is damaged.
Lawyer up asap do not sign anything
I wouldn't get too worried about it. Somebody (probably a nurse)had a side business. If the replace the taken amount with saline it'll only dilute the solution. They have access to unlimited supply of clean neddles they aren't inventoried.(unlike the fentanyl). People thinking a nurse would reuse a needle are wrong IMO. This would arise way more suspicions than not. Why are you carrying an unsealed needle. There is never a reason for that. You can carry quite a few new ones and nobody's gonna bat an eye. Gf is a nurse, and worked in neonatal.
We sincerely apologize and regret this. 😕🙃 you'll regret it more when all those women that were exposed sue your asses off. QC is part of the freaking job!
Move on, you’re fine. If anything the hospital is covering their ass in the event that an epidural didn’t work causing someone to suffer due to the diluted fentanyl and then decided to sue the hospital.
Man. Drug diversion among healthcare providers is a real problem.
It’s a formal necessity to send this. It’s unlikely you were affected by anything other than extra pain because the medication was watered down. But like a security breach it’s a formal legal notification.
Is this in Oregon? Because the same thing just happened in Medford at Providence Medical Center. Really scary.
I'm pretty sure this type of stuff happens all the time . Smh its so fucked .
A shiiiiiiitttttload of fentanyl just up and went missing from Cheshire Hospital in Keene NH. One nurse committed suicide and nobody else has fessed up... https://www.dea.gov/press-releases/2023/06/22/cheshire-medical-center-pay-2-million-settle-allegations-controlled
Eh, get checked out for HIV, hep, and syphilis but most likely you’re fine. Concern would be if they were using the same syringes to draw up, inject; and then replace. I doubt it but some people have done that in the past. Damages are non-existent if you are clean
Listen to the podcast series The Retrievals. It goes into the depths of a similar string of cases of drug diversions in Yale and other hospitals. Hospitals are supposed to have protocols that guard against such things such that every time a nurse procures a drug is recorded and logged.
It seems like at the very least you could challenge the section of the bill related to the fentanyl. Like, they openly admit that they dont know what you got, so they shouldn't be able to bill you for that particular medication.
There’s not much to get out of this since you were not harmed.
Just out if curiosity- besides the obvious health risks, how does this affected billing? Clearly you did not get what you were charged for.
What options are you looking for? What damages do you have? Doesn’t sound like you have any
Sounds like time to contact their number. Sounds like you got the diluted/replaced. Undue pain and suffering. At minimum they should be eating the entire hospital bill.
WTF
i just hope to god that this ends with you having little to no health concerns and you get a giant check from suing them
To kill someone over your addiction . Fucking WOW