Malpractice? Would you sue?

[Groesbeck Hurricane]

Your trip needs to be to the hospital's patient advocate. Request adjustment for the bill. Do nothing but smile, be friendly, be cordial. Find discounts for cash payments, ask what can be done to help you out. Never threaten to sue or seek an attorney. Ask what their rates to the insurance companies are and request an adjustment of your billing down to that level. Work the help me out angle.

Glad your wife is basically OK! Sorry she will have to go to surgery.

If something sounds wrong to you then question it. Do not agree to everything demanded if it sounds wrong. You also share responsibility for your own care.

[kaisen]

Originally Posted by mossguy

My wife got T-boned, she is fine, car is totaled, nobody got sued. All's well that ends well!

My T-bone reference was in response to Bivenator re "nothing happened, but could have".

(Should have used green font in my first post.)

I thought the analogy was clever, and I got it when I read it the first time..... then I remembered you were actually t-boned and it was funnier

[Head416]

It sounds like you have a legitimate complaint about your experience, but it sounds to me like it's of a "customer dissatisfaction" nature.

Originally Posted by bivenator

Here is where the mistakes were made. IMHO

The initial diagnosis of appendicitis was incorrect. The only symptoms that my wife exhibited matching appendicitis was non specific abdominal pain. It was peri-umbilical and when a proper abdominal exam was given the mass was palpable on the left side.

I don't see this as a mistake. The initial diagnosis is step one to identifying the problem, just like if you hear a funny noise come from your 911 you have to start with your first guess and go from there.

The NP was dead set on getting that appendix out despite many signs pointing to a different diagnosis.

You had the option to agree or disagree with the recommended treatment, or to get a second opinion. The appropriate response here is a customer feedback form.

The only time an MD saw her was when the surgeon appeared at our insistence.

You did your job here. I agree that it is annoying that it can sometimes be very difficult to talk to the people you want to talk to. I also understand that if they jumped for every patient that wants a consult that would consume all their time.

The CT scan findings were incorrect. How can you miss an 8cm mass?

I can't really comment on this part, I'm not a doctor. But I question when inaccuracy becomes malpractice. I'm guessing not until they've removed some part of your body that you should have kept.

[Baz]

I think those are valid questions, Bivenator....

It's no different then taking the car in because you hear a noise coming from the gearbox. The mechanic's helper says we need to take out the gearbox and examine the insides. He does that and then says he wants to R and R the gearbox. All the while you are saying maybe the wheel bearing is worn (?) he insists he needs to tear open the gearbox or your car will explode next time you drive it.

Then the head mechanic comes over to start work on the gearbox - looks at it - and says it's OK and does NOT need a rebuild....but let's check the wheel bearing. "Aha....that's where your problems lies. That will be $1K for diagnostics please. Then go see Ralph's Tire and Wheel down the road for your wheel bearing repair"

Couple things....is it fair to be charged $1K, under the circumstances? They are not God - and therefore are allowed to make mistakes, aren't they? So if a mistake is made....what should you be invoiced for - I think that is the question.

But wait.....you also ask what if they proceeded to R and R the gearbox and the problem was not resolved. Another good question.....is it OK because they are not God and they do make mistakes?

Where is the boss in all of this to oversee the process and ensure customer satisfaction? In a car repair business it's the owner and/or manager, right? Well who's job is it in a hospital?

Questions questions questions......

Oh and if you are not in the medical or legal profession and/or not self-insured, like Bivenator and his wife...your replies here do NOT count.

[RWebb]

Originally Posted by Groesbeck Hurricane

Your trip needs to be to the hospital's patient advocate. Request adjustment for the bill. Do nothing but smile, be friendly, be cordial. Find discounts for cash payments, ask what can be done to help you out. Never threaten to sue or seek an attorney. Ask what their rates to the insurance companies are and request an adjustment of your billing down to that level. Work the help me out angle.

Glad your wife is basically OK! Sorry she will have to go to surgery.

If something sounds wrong to you then question it. Do not agree to everything demanded if it sounds wrong. You also share responsibility for your own care.

This.

Your (her) first mistake was in dropping ins. coverage. I understand it is expensive.

You could ask a specialist to review the medical decision making here, but it seems fine.

No one is going make a perfect diagnosis all the time. That is even true when a surgeon is sitting there staring at a mass of tissue that does not match expectations.

Now, it is always possible that they ordered more and more expensive tests than they had to. That could be reviewed, again understanding that the risk distribution is highly asymmetrical.

Think about what would happen if you took a car in for diagnosis of a problem and they did too many diagnostic tests... the car would not die if they erred on the too little testing side, nor would it be in pain for life or crippled.

[Superman]

I don't think bivenator is greedily exploring a 'deep pocket' here. I think money is tight in his family and he doesn't relish having to pay for an expensive test that was fruitless. Heck....it nearly led to a fruitless surgery.

Bivenator......in the final analysis, assuming your wife's cyst is effectively dealt with, you've got an expensive bill to pay, and your family is okay. Viewed from the balcony, that's a positive outcome.

[RWebb]

I did not mean to suggest that at all.

But you need insurance & you cannot blame the MDs, PAs, NPs, etc. etc. most of the time even when something does go wrong.

[bivenator]

TEA party handbook, will just have to check that reference book. If you go back to an earlier post from me you would see that I stated that I found a lawsuit distasteful. Lawsuits do serve a purpose however and if I am not satisfied with the response from the hospital then I would consider this as an option. I will negotiate in good faith until that avenue is exhausted.

Serious mistakes were made in the diagnosis and the interpretation of the diagnostic tests and then bad information was shoe-horned to fit an outcome ending in surgery. How many times has this occurred previously? On top of poor decision making, the entire chain of command was compromised. An MD never laid eyes on the patient or reviewed any of the testing before consent was obtained and only after the surgeon was asked to review CT by the patient did the surgeon even see the CT.

I am a bit suprised by many of the responses in the vein of "all well that ends well" If you bought a hamburger and in the last bite found a hair but did not eat it. Would you want your money back? No harm done, you did not eat it. Favorable outcome, you are full. Why complain?

I have worked in medical imaging for nearly 20 years. This is an area I feel pretty comfortable in and while my level of expertise is not on par with a Dr. or NP, I still have some skills.

Thanks for taking the time to read and respond, many thought provoking answers. I will update witht the outcome.

One more thing, my wife saw the gyno today. They were very concerned about the possible rupturing of the cyst so the surgery is scheduled for tommorrow. A cash pay price of about 8k to do the surgery. The price was arrived at by taking by half what the insurance company bills.

[scottmandue]

Pardon my ignorance... what is a CT?

Thanks,

[wdfifteen]

It seems like bad practice for a hospital to allow an NP to diagnose and order surgery on her own. Why train doctors if NPs can perform the same functions? Seems like the hospital is exposing itself to a huge liability by allowing an NP to make such decisions.
I don't see anything to sue about, but a factual letter to the state medical board, the hospital, and the NP are in order.

[Joe Bob]

X-ray computed tomography, also Computed tomography (CT scan) or Computed axial tomography (CAT scan)

[ramonesfreak]

i understand your concerns. if you were consulting with me to decide whether to sue, i would tell you that i can not take the case.

look at it this way, the CT scan ruled out the possibility of a number of other causes...this motivated the doctor to search for the real source which he did in fact find. Not only that, you have peace of mind knowing that nothing else sinister is going on in that region of the body

the fact that the NP wanted to do the surgery is irrelevant. do you think a surgeon would not make that decision for himself, based on physical examination and objective tests? in what hospital do doctors take orders from nurses? none. Doctors give the orders. And in this situation, the doctor seems to have done his job perfectly and the NP probably learned something they will apply in the future

if the surgeon had started cutting based on the NP insistence, then you would have some serious negligence here. based on the facts as you stated them, i see none except for perhaps a CT that was not needed if a proper physical exam had been done first...is that a damage i would sue over? no.

at most, i would speak to the hospital about covering the cost of the CT

glad the problem was discovered

[mikeesik]

It really upsets me how Americans are cared for by their own Government.
Especially at the worst and serious of times concerning their health.

- Disgraceful and so sad.
-Hope your wife will end up well...and you as well

[sammyg2]

Sue those bastages, that'll teach em not to try to help the next time!

[Superman]

I'm sticking with my "All's well that ends well" conclusion.

First, the lawsuit would cost you lots of dough. And so, for that to make sense, then I'm guessing you ARE thinking 'deep pockets.' So perhaps my charitable interpretation of yoru motives was incorrect.

And finally, medical staff are human. Do they fuk up? Yeah. Should this be actionable? Not unless we're talking about extreme negligence. That's not what happened in this instance.

Case dismissed.

[dhoward]

I disagree. The medical profession should be held to a higher standard than the guy who missed loading a bag of mulch in your truck.
They DO fuk up. They should fuk up less.

[Tobra]

An ovarian cyst will very frequently spontaneously rupture or reabsorb. As I said before, you should be very circumspect about surgery for that. I don't know why you are surprised about the answers at all.

[RWebb]

Originally Posted by ramonesfreak

in what hospital do doctors take orders from nurses?

off topic, but as an aside, I'm aware of at least one situation at a military hospital where a member of the nursing staff outranked anyone on the medical staff....

[rusnak]

I don't think you have a case for med mal. These are based on the community standard, which probably has been met here.

You have a far lower bar if you go with PI, but even then, what is your damages? Financial? How can you prove that you would have spent less in another hospital? More to the point, would a reasonably prudent doctor order the same test?

You have very little footing for an action.

[Moses]

Too bad you're not in California. I'd do the surgery for free. But like Tobra says, might not even be necessary. Need more info.... Complex cysts are worrisome. Simple cysts much less so. Normal CA125? Your wife's age?

With a normal CA 125 in a premenopausal woman, 85% of simple cysts resolve spontaneously. But there are of course other things to consider. General health, family history, etc...

Not intending to offer medical advice over the Internet. Just info. May not apply to your wife.