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Malpractice insurance crisis threatens doctors, only obstetrics clinic in Northern Neck Date published: 12/21/2003
Still in his scrubs late in the day, Dr. James F. Hamilton talked about crises: one acute, the other chronic, both potentially fatal. The acute crisis involved the survival of a Northern Neck baby. The chronic crisis is a nationwide lack of affordable malpractice insurance that now threatens the survival of Hamilton's obstetrics practice and the well-being of mothers and babies in the Northern Neck. That morning, Hamilton said, a mother was in labor at the Maternity Center of Rappahannock General Hospital next door to Hamilton's Rappahannock OB-GYN office in Kilmarnock. About 10 a.m., a maternity nurse called Hamilton to report a prolapse of the baby's umbilical cord. "Nobody knows why it happens. It just happens in about one in 200 births," Hamilton said. In normal births, he explained, the umbilical cord follows the baby. In a prolapse, the umbilical cord is delivered ahead of the baby. Pressure on the cord can then strangle the baby in 10 minutes or less. Hamilton ran across the parking lot to the hospital's operating room. Eighteen minutes later, with the help of nurses and other doctors, he had performed a successful emergency Caesarian delivery of a healthy 7-pound, 8-ounce girl. "If we hadn't been here, that baby would be dead. There's no way she would have survived an hourlong trip to a hospital in Richmond," Hamilton said. Hamilton, 56, has delivered more than 4,500 babies in his 21 years of practice. He and his partner, Dr. Mathew F. Vogel, are the only two obstetricians in the Northern Neck, a rural and remote region lacking in prenatal care. Now Hamilton is worried that their obstetrics practice may end March 1, the day his medical liability insurance coverage expires. Without that malpractice coverage for Hamilton and Vogel, the hospital's maternity ward may also close, forcing many Northern Neck mothers to travel long distances for prenatal care and delivery of their babies. A temporary reprieveHamilton's malpractice coverage almost expired this month.
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