Placenta registry kept women’s tissue without their knowledge

Published 9:00 pm Sunday, February 12, 2006

PORTLAND, Ore. – As many as 700 women along the West Coast were not told that an institute financed by the insurance industry kept their placentas after they gave birth in order to protect doctors and hospitals from potential lawsuits, according to a newspaper report.

Some learned about the Cascadia Placenta Registry only after they had filed lawsuits.

The Oregonian newspaper reported in its Sunday editions that Cascadia appears to be the only such organization nationally, and medical experts – including ethicist Arthur Caplan at the University of Pennsylvania School of Medicine – criticized Cascadia for failing to inform patients.

Legal experts, however, said there was no apparent violation of state or federal laws. The registry collected placentas from patients in Oregon, Washington and California.

Angela Desbiens, who is suing a Portland hospital, said she and her husband, Scott, were shocked when they learned about Cascadia.

“I feel so deceived,” Desbiens told The Oregonian. “You just assume the doctors and the hospital are going to do the right thing.”

She and her husband are among those caught up in the battle between doctors and lawyers who use placental exams as a legal weapon when parents go to court to assess blame for injuries or deaths at birth.

Hospitals, doctors and insurance companies have fought back to find ways to prove that problems often occur before labor and delivery.

Their defensive strategies arise from skyrocketing malpractice insurance rates that have driven some hospitals and obstetricians out of the business of delivering babies. Settlements or verdicts can reach millions of dollars in cases where injured children need a lifetime of round-the-clock care.

Placentas from as many as 700 women from hospitals throughout Oregon, California and Washington were sent to Cascadia from 1996 to 2003.

Several Oregon hospitals and their parent corporations helped finance Cascadia and sent placental materials there, including Providence Health System, Legacy Health System, Adventist Health, PeaceHealth, Kaiser Permanente Northwest and Good Shepherd Health Care System. Many of the women whose placentas were sent to Cascadia were unaware of the practice.

“It seemed very underhanded to me that the hospital was trying to protect itself and not the patient,” said Ann Morton, who discovered after she sued Sacred Heart Medical Center in Eugene that her placenta had been studied by Cascadia. Her son, 31/2, has cerebral palsy; Cascadia’s report blames an infection, Morton said.

Officials at Providence and the other Oregon hospitals involved defended using Cascadia, saying the placental analyses were conducted for “patient care.” Consent forms signed by patients when they were admitted gave the hospital authority to perform any necessary pathological exams, the hospital officials said.

Although hospitals commonly conduct tissue examinations for patient care purposes, the fact that Cascadia was created and financed by malpractice insurers and providers sets it apart. Among doctors, lawyers, pathologists and medical experts contacted by The Oregonian, only one could cite a similar organization in Ohio that is now defunct, said Dr. Carolyn Salafia, a nationally known perinatal pathologist in New York.