MALPRACTICE_A Gynecologist

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Her name is Dr. Pinkan, a female obstetrician, who also serves as a postgraduate lecturer. She was visited by two of her students. Two students who were taking a specialist obstetrics degree program. The two students came all the way from outside the province, named Dr. Herry and Dr. Jeffry.

"Ma'am, we have mastered the theory of cesarean surgery. Do you have any patients who are undergoing cesarean surgery today? Let us see the operation directly, so we can learn directly from you," said Dr. Harry.

dr. Herry and dr. Jefry were in dr. Pinkan's practice room. It happened that the outpatient check-up patients had run out, so the three of them were free to chat. The time was 10 pm.
"Wow, not yet. The hospital called earlier, there was one of my patients. But, it seems like the birth was normal. However, I can condition it as an emergency, so that a cesarean section can be performed on the patient. So you can witness how the cesarean section process works." said dr. Pinkan.

"That's it, Ma'am. Don't disappoint us for coming all this way." Said Dr. Jefry.
"Okay, let's go to the hospital! The midwife called earlier, the patient is already 3 cm dilated." Said Dr. Pinkan.
The three of them immediately headed to the hospital. Upon arriving at the hospital, the three of them immediately headed to the delivery room. A young mother was seen holding her stomach while lying on the bed.
"How is the patient?" Asked Dr. Pinkan to the senior midwife who was taking care of the patient giving birth.
"The patient's condition is a little weak. She has been given an RL infusion to strengthen her stamina." The midwife replied.

"Immediately take the patient to the operating room. The patient will have a cesarean section." Said dr. Pinkan.
"But, Doc. I think the patient is able to give birth normally." The midwife snapped.
"Which doctor, you or me?" said dr. Pingkan angrily. dr. Herry and dr. Jefry who were beside dr. Pinkan smiled.
"Yes, ma'am." The midwife answered softly.
"Please contact dr. Ali, the anesthesiologist to perform the anesthesia." Said dr. Pinkan.

"But, the risk is high, Doc. The patient's water has broken." The field snapped again.
"Don't you teach me. I have 8 years of experience as an obstetrician. I know what I'm doing. This is the anesthesia order. Call Dr. Ali, so he can come here quickly to perform the anesthesia!"
Dr. Ali, the anesthesiologist, came. However, before performing the anesthesia, Dr. Ali had something he wanted to ask about the patient's condition.

"Dr. Pinkan, I think the 35mg of anesthetic recommended to the patient is too high a risk. I think 25 mg is enough." Said Dr. Ali.
"That's my responsibility, Dr. Ali. I know what I'm going to do. Quickly administer anesthesia, the patient's condition requires immediate medical action!" Said Dr. Pinkan.
"Okay, if anything happens I don't want to be responsible. But, once again if possible, Dr. Pinkan, think about it! It's written here in the patient's status, the patient, although weak, is able to give birth normally. Has the patient's family been informed and asked for their signature?" Said Dr. Ali.

"Anyway, I'm responsible. Please, Dr. Ali, just follow the anesthesia order! Regarding the notification and consent of the patient's family, that's my responsibility too."
"Okay." Dr. Ali said. He glanced at Dr. Herry and Jefry with a frown. Disliked. There must be something wrong with this, Dr. Ali muttered to himself, acting all wrong.
The cesarean section was then performed. The operation took a while, because Dr. Pinkan didn't seem like she was going to have a cesarean section, but rather like she was giving a lecture, explaining how the cesarean section process works to her two students. Explaining the parts of the stomach that would be cut. The position of the incision.

Pay attention to the condition of the mother's stomach and the position of the baby, then what kind of incision will be made.
Dr. Pinkan made an incision in the abdominal wall. The baby was taken out. There was something strange, the blood that came out was not red, but blackish. A sign that air had entered so that the blood vessels were refluxed. The patient's heart rate was between 160-180 per minute. There was an "embolism" (blockage of blood vessels by a substance such as blood, amniotic fluid, air, fat, thrombus and other components). The embolism attacked the heart so that the patient stopped breathing. Then died.

The three doctors were shocked. Dr. Pinkan asked the nurses and midwives who were involved in the operation to leave.
"What, ma'am. The patient died." Dr. Herry said worriedly.
"Relax, we can make a medical record, make a medically acceptable reason that the patient died." Dr. Pinkan said.
"Ma'am, the patient's family has not been informed. They haven't asked for approval and signature." Dr. Jefry said.
"Make a sign of approval in the form of a thumbprint, signature or whatever, that this operation is approved directly by the patient!" Dr. Pinkan said.
"What if the patient's family sues?" Dr. Herry said worriedly.

"Relax, we can make a medical record, make a medically acceptable reason that the patient died." Said dr. Pinkan.
"Ma'am, the patient's family has not been informed. They haven't asked for approval and signature." Said dr. Jefry.
"Make a sign of approval in the form of a thumbprint, signature or anything, that this operation is approved by the patient directly!" Said dr. Pinkan.
"What if the patient's family sues?" Said dr. Herry worriedly.
"Relax, we will make a medical reason. With that reason, the patient's family will definitely understand and will not sue. Relax, bro, we are doctors. Besides, the patient is poor and stupid, how could they possibly sue." Said dr. Pinkan.

"Yes, ma'am. Thank you. We are afraid that this incident will disrupt our study program. We will be hampered in becoming obstetricians." Said dr. Herry.
"Relax. You patients demand that we are definitely safe. We have IDI. We have POGI (Association of Obstetricians), they will definitely not remain silent. Helping. And we have money. We can bribe anyone. We are also the decision makers of medical records." Said dr. Pinkan.