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CP “Prevention” Enzyme Holds Promise, But Reducing Errors Should be First Priority

Posted by Howard Janet on Nov 29, 2011 in Legal Library

Washington University Medical School researchers report that an enzyme in the body that protects against brain cell death may help prevent cerebral palsy that results from oxygen deprivation during labor and delivery.

As exciting as this is, I can’t help wonder – again—at all the effort by medicine to address cerebral palsy in the laboratory and its general reluctance to lower instances of cerebral palsy by reducing hospital and doctor mistakes during the birth process.

Initial Results Promising

The report, as described in an article in Riverfront Times, explains that when an infant’s brain is deprived of oxygen immediately before or during birth, cells begin to die as the result of a process called necrosis. The cells swell and explode, causing permanent damage. The report was previously published in the Proceedings of the National Academy of Sciences

Using mice, post-doctorate graduate student Phillip Verghese tested the impact of an enzyme called Nmnat1 on protecting brain cells against necrosis. It worked to a large degree. Now his research will focus on how to get human cells to produce more Nmnat1 when it needs to. Although practical results are a long way off, it’s a promising line of study.

Some Doctors Resist Prevention Tactic

Meanwhile, hospitals across the country – prompted by a number of major studies showing they work– are adopting “check lists” to help doctors and hospital staff avoid common medical errors.

Not surprisingly, at least one article in Critical Care Times notes that doctors dislike being reminded they are as prone to making errors as the rest of us and they may need tools to help them. “In medicine, physicians have largely resisted using checklists. Some feel that relying on a checklist insults their intelligence, whereas others doubt that a document with check boxes will prevent a medical mistake. Physicians believe they know their job and do not need a prompter to guide or remind them,” the authors write. “However,” they add, “modern medicine has become exceedingly complex, specialized, and interdisciplinary, offering hope for fantastic cures, but also inadvertently introducing potentially devastating risks.”

While doctors debate the pros and cons of safety checklists, those of us who are patients can use lists of our own to help prevent medical mistakes.

How Consumers Can Take Action

In my law practice, I have reviewed more than 15,000 cases on behalf of parents who suspected medical errors caused their child’s cerebral palsy, so I know what can happen and what might have been done to prevent them. In my publication, Going Beyond Birthing Classes: How Parents can Help Prevent Brain Injury in Infants during Pregnancy, Labor & Delivery© , I provide a “Hospital Birthing Plan,” that lays out “best practices” for obstetrical care. It is, in effect, a safety checklist for parents-to-be.

Every woman expecting a baby should present this checklist to her obstetrician with the goal of obtaining his or her commitment to use it as a tool to help ensure a safe delivery. If your doctor refuses, serious consideration should be given to finding a doctor who is willing to embrace this checklist. Preventing medical errors should be every doctor’s top priority.

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