responsible for hospital bills

What is the name of your state? What is the name of your state? What is the name of your state? OREGON

im writing on behalf of my parents.
they are too damn stubborn to seek any help so i am doing it for them!
my father took my mother to the er at a local hospital. She was severely dehydrated and suffered with hypothyroidism. she spent several days there and was sent home the following day directly out of ICU. I arrived that same day. I noticed she was not the mom I remember. she was forgetful she rambled, she would fall asleep mid sentence. She had a very hard time walking.
The following day she got worse. my father asked if he should take her back. she apparently had an appointment for the next saturday. I upped it to that afternoon. She came home and only took a urine test. I went down to the hospital to find out what if anything i should or should not be doing for her. THEY refused to tell me anything about her case some new privacy law. i argued but no luck. by the time i returned home my father said she isnt right... i called the ambulance. Back to the hospital again. They did tests just as before and stated that they were fine. I really am not sure if these tests were done. The ER doctor stated she was stressed out and needed to rest no one pushing her to get up, which is what we were forcing her to do because the hospital wouldnt give us any aftercare instructions. She again was released that next morning. when she was home all she did was sleep i needed her to take the pill she wouldnt wake up. I called the ambulance again, but this time i demanded the other hospital in town. Although it took a day or so to find out what the problem was she remained in icu for over a week. She was finally diagnosed with Hashimotos disease AND her brain was swollen (the whole time obviously by her actions).
My mom is finally home and is not 100%. she probably will recover in some time i hope. But they are now faced with a Hospital bill they cannnot pay after they paid the first one. You see my mom was uninsured. I feel as though they did not give her the treatment she should have gotten no matter what. my father paid that hospital bill. But due to their negligence in misdiagnosing her not once but twice and sending her home she would not have that second hospital bill. My parents dont want anything. they are considering bankruptcy. this is not right!
I want to be able to let them know of any possibility of a lawsuit filed against the 1st hospital to pay the second ones bill. this bill is $60,000.00 She should not have been discharged the first let alone the second time.
Also i dont want to even imagine what would have happened had i returned her to the first hospital instead of the second one.
Please tell me do they have any chance of getting this bill paid. they are honest people and work hard. they dont deserve this on top of my moms disease she will never overcome and she is only 62.
any one do they have a chance?

[ellencee]

cmycutetoes
(no, I don't; but, I'll take your word for it!)

As for your question--Hashimoto's disease, aka Hashimoto's thyroiditis, is an auto-immune hypothyroiditis. You stated your mother was already diagnosed with hypothyroidism, which is characterized by the very symptoms that you describe and question as ignored symptoms of Hashimoto's disease, ie. sluggishness of all functions and depressed muscular activity. Why then, would you assume that it was negligence, fail to diagnose Hashimoto's thyoiditis (disease)?

Your question may be a question of 'which came first?' You may find medical experts that will say when the diagnosis of hypothyroidism was made, the diagnosis of Hashimoto's should have been ruled out. You may find medical experts that will say that the hypothyroidism's effect on the body's systems led to a deficiency in the immune system, causing the immune system to 'short-circuit' and develop the auto-immune disease, Hashimoto's thyroiditis.

The treatment is the same for each disease--life long thyroid hormone replacement therapy. The potential sequelae of each disease is the same and includes cerebral edema during times of increased thyroid deficiency.

It may be possible that your mother should have remained in the first ICU for a longer period of time or should have remained in the hospital for a longer period of time instead of being discharged to home. It is unlikely that the disease's course of events would have altered.

At the most, I think the ambulance trips would be all that your parents would be able to recover if it should prove that she should have remained in hospital longer, maybe the expense of the additional admission costs. That translates into a potential claim of what? $2,000? I doubt a medical expert would review both sets of records and your mother's usual physician's records for less than $2,000.

About the best that could come of this would be for the first hospital to refund to your mother the additional costs of the ambulance transports.

I will research the diseases and courses of treatments and if I find any information that may be of use to you, I will post it.

Best wishes,
EC

You can thank the insurance industry for the recent Bush et al supported secrecy in the medical care delivery industry.
Run your case by a medical malpractice lawyer. The emergency department of that first hospital saw that it was not going to be paid, so the second visit was a waste of time. Rather than care for your mother they dumped her on the loading dock as you saw. Like you, I suspect no lab tests were run, and nothing else was done. Despite Hill Burton rules covering emergency department care for the indigent, that hospital failed to offer treatment. Patient dumping is a legitimate reason to file a lawsuit.
The second hospital bill may be yours to pay. If you file a malpractice lawsuit against the first hospital, you may still be required to pay the second hospital bill. If your lawyer can show that the second bill results from the failure of the ER at the first hospital (and this is likely) then that hospital may be liable. It is worth a try, and a gutsy lawyer may enjoy taking the case.
Otherwise, bankruptcy laws will protect your parents. Look into that too. 60k hospital bills today may seem common and ordinary, but to me they are excessive.

I thank you both for your posts in response to my question...
I did in fact go through the archives of this board to see if i could find similiar situations.....and possible outcomes....
I have given what you said to my parents and then i gave them my opinion...Mine wasnt professional or experienced.
I know my parents will probably do what they feel is best.

and i may or may not agree but i sure as hell am not going to let the PRIVACY ACT THING off so easily..... I read the act and the hospital was WRONG. they should have given me any information on her aftercare. If you had been me you would feel as helpless as I did not knowing what to expect from her and not knowing why she didnt recognize me or couldnt speak. They screwed up and nearly cost my mom her life. They have not heard the last of me thats for damn sure.

Doctors can be replaced with more qualified Doctors!
Administration of hospitals need to read the damn papers they sign when they sign them and know what the hell they are talking about when the time comes and they are questioned.


I know my job. I dont screw it up. If I did i am sure I would hear about it..... and it doesnt pertain to life or death.

again......Thank you both for your advice

[lkc15507]

jack: I don't know of any health insurance provider that was in favor of that law. It has played hell with the industry. It started as a bill in the financial world. Trickled over into the health insurance industry.

poster: I don't think from what I read that the provider was "wrong" (under the current law) in not providing you that aftercare information. A bit obtuse and stupid perhaps, but I doubt it worth your effort to prove that. Focus on your Mom and her care now. (Your Dad was the only one really entitled to that info if your Mom was incapacitated--given current interpretation of the law.) But, I really, really agree that morally, ethically, reasonably, and yes, legally, you could have had that information. Send a letter to your states board of insurance and the department of labor. The law is reviewed on a complaint by complaint basis. You, the consumer are integral to changing that goofy law. The new HIPAA privacy law sucks and should be amended. Most providers (worth their salt) already practiced "reasonable" confidentiality.

As far as care for your Mom is concerned, I have to think it difficult that standards of care were breeched. We all expect much of health care providers, and rightly so, but as a health care provider, I did not see in your post a breech of standard of care. Yet, as I always say, without the whole picture and medical record, one cannot be definitive. By all means, have a med-mal attorney review the records, but the costs are likely prohibitive.

I wish the best for you,

lkc15507

[ellencee]

cmycutetoes
I am going to provide you with some information and some comments and want to forewarn you that I am not in anyway questioning your motives as regards your intentions to help your mother. This is a free legal advice site and I am going to post to you from the standpoint of legal vs emotional and good intentions. My goal is to help you understand what happened and why. You do not have to agree with the law, but the law will prevail against your personal opinion(s). Here goes...


[quote] I arrived that same day. I noticed she was not the mom I remember. she was forgetful she rambled, she would fall asleep mid sentence. She had a very hard time walking.
The following day she got worse. my father asked if he should take her back. she apparently had an appointment for the next saturday. I upped it to that afternoon. [quote]

--You did not explain how you 'upped it to that afternoon'. If you called the hospital (?) or the doctor (?) and they agreed to see her that afternoon and she was taken to that afternoon's appointment,the provider (hospital or doctor) met the required element of duty to your mother without breaching HIPAA.

[quote] She came home and only took a urine test. I went down to the hospital to find out what if anything i should or should not be doing for her. THEY refused to tell me anything about her case some new privacy law. i argued but no luck.[quote]

--Your mother may have only provided a urine test, but you can bet an assessment was done, a diagnosis or an opinion was rendered, a plan of care was carried out (the urine test), and each of these events was documented. Your mother was billed for each of these; therefore, the documentation exists in one form or another.

[quote] I went down to the hospital to find out what if anything i should or should not be doing for her. THEY refused to tell me anything about her case some new privacy law. i argued but no luck. [quote]

--Here's why: HIPAA is a federal law that must be met and can not be changed or modified or overruled by a state or local law. Here are some of the specific components of the law and the justification for refusing to discuss her case with you:

Criminal Penalties: A person who knowingly discloses individually indentifiable health information in violation of HIPAA faces a fine of $50,000 and up to one-year imprisonment.

For notification and other purposes: A covered entity (the hospital) may rely on an individual's informal permission to disclose to the individual's family, relatives, or friends, or to other persons whom the individual identifies, protected health information directly relevant to that person's involvement in the individual's care or payment of care. This provision, for example, allows a pharmacist to dispense filled prescriptions to a person acting on behalf of the patient.

--This is why you were allowed to 'up' the appointment to that afternoon. You acted on behalf of your mother in making the appointment.

Incidental Use and Disclosure: must be kept to 'minimally necessary'. The minimally necessary requirement is not imposed in any of the following circumstances (for brevity, I am skipping to your status)...b) disclosure to an individual who is the subject of the information, or the individual's personal representative.

Other Provisions: Personal Representatives and Minors: A personal representative is a person legally authorized to make certain health care decisions on an individual's behalf or to act for a deceased individual or the estate.

--You did not have a legal Power of Attorney that allowed you to make health care decisions on your mother's behalf. The hospital (entity) is prohibited by Federal Law (HIPAA) from discussing her care with you. As your father was the one who admitted and accepted responsibility for her at the time of her discharge HE could have been provided with this information. You were lawfully denied the information.

EC

[ellencee]

cmycutetoes
Here's the part that I believe is the defensible aspect of your claim that your mother failed to receive proper treatment, including the diagnosis of a similar disease requiring identical treatment:

Your mother was twice taken to the hospital because you and your father refused to follow doctors orders and allow your mother to rest. By failing to allow your mother to progress under the direction of her physician, you deprived your mother of the benefits of rest and recovery and placed her body under considerable more physical and emotional stress than her body was able to withstand thereby CONTRIBUTING to her physical decline in health.

Although the next hospital did admit her ICU, it did so after your mother's status deteriorated, which was brought on at least paritally by your contributing to the deterioration.

Although the next hospital did diagnose Hashimoto's thyroiditis (disease) and did treat the cerebral edema, your mother was discharged at essentially the same level of functioning and physical status as at the time of her first discharge and her prognosis is essentially the same now as it was at the time of her first discharge.

Therefore, it can be argued that if you had not interfered and had allowed your mother to rest and recover, she may not have required admission to the ICU in the next hospital.

Your mother did not suffer any significant physical damage that would translate into a monetary award. The economic damage that occurred from ambulance transports and admission to the next hospital are in part due to your actions.

I am not sure whether or not your state allows a percentage of contributory negligence or if any contributory negligence is an automatic denial of any claim of liability or negligence.

All this being said, I feel almost certain that if I thought my mother's health was in jeapordy, I would have reacted emotionally and with intent to gain appropriate medical care. The difference would have been in my understanding of the legal aspects of medical care, my understanding of disease processes, my ability to provide in-home care at a level above that of non-medical professionals, and my ability to assess physical status and responses to treatment and to relate my professional assessment and concerns to the medical care providers. (HIPAA does not bar any person, such as a family member, from providing information to the medical care provider, ie. as in my relaying my concerns to my mother's physician.)

This is the HIPAA site that I used for replying to you:
[url]http://www.hhs.gov/ocr/privacysummary.rtf[/url]

This site provides a section on how to file a complaint with HIPAA. The complaint does not have to be against a facility, or entity as they call it, but can be your personal opinion of the ***** law.

I hope that helps you in some way!
EC

im not surprised you didnt really understand my post. just as hospital administration doesnt read very well, it is frightning nurses dont either.

Your mother was twice taken to the hospital because you and your father refused to follow doctors orders and allow your mother to rest. By failing to allow your mother to progress under the direction of her physician, you deprived your mother of the benefits of rest and recovery and placed her body under considerable more physical and emotional stress than her body was able to withstand thereby CONTRIBUTING to her physical decline in health.

My Father was an emotional wreck when I arrived. He had just arrived home with her the day I arrived. He could not remember anything except her prescription which he did get. When I arrived my mother was sitting up but she didnt finish her sentences nor could she walk without help. She slept the rest of the day and night. The next day we got her up to take her medication and she spit it back out. (vomited). I got on the phone called the hospital and asked for her physician. I learned it was not a physician at all but a nurse practioner. They stated she had an appointment at the end of the week. I asked that she be seen that day. They agreed to and my father took her in.
(apparently they claim she had a bladder infection while in the hospital I just learned that when they returned from the appointment which turned out to be a lab and all they did was recheck her for a bladder infection.) That was not a appointment with a doctor. she seemed to be more cohearent but once she was resting she started mumbling and seeing things. That is when I got in my mothers car and drove down to the hospital.
I went to information and requested her doctor. They stated they could not give me any information about her because of the privacy act. I angrily stated that my mother is home and I dont know what to do to care for her. She still refused to help me. I asked to see someone else. Security escorted me to the nurse in the ER check in area. She was just as ignorant as the infomation attendee. She said she was sorry the only thing they could do was if my mother was there she could tell me what to do. I was Pissed. I returned home to find my mother worse. That is when I called 911. From that point on I did everything i was told by the 2nd Emergency room doctor who cared for her.EXCEPT bring her back if needed.
The doctor asked her questions and she answered some but half she didnt answer something as simple as what day is it. He said he would do another catscan to check for stroke.
We waited a short time and he returned stating she seemed to be stressed about something and stated that when my father and I were not in the room she opened up to him that she was worried about my neice and some other family member. He then said it appears to be stress and to give her complete rest and they had given her a shot to relax her. (what the hell for i dont know). We returned home and followed HIS orders. The following morning I got her up to take her thyroid pill and she went back to sleep. THAT night she woke up and just mumbled i could not get a word out of her. she had not eaten or drank all day and i was trying to feed her. she vomited again and COULD NOT ANSWER ME. I dialed 911 again the paramedics had to carry her out. I requested she be taken to the other hospital in town.
In the ER I stayed with her until my father could return from work. The doctor who was EXTREMELY young questioned me for quite some time. while we were speaking she vomited again. He ordered every test imaginable. and said they were admitting her.
all that day she would not respond to anyone or speak she slept.
off and on. the following day still running tests on her she started having seizures. Later that day they found the brain swelling. from that point on until the swelling was gone a nurse was in her room with her and did not leave.

Now if u read what i said then i am sure u understand and i hope u agree that the first hospital was not only negligent once but twice in their responsiblity of giving my mother the care they state in their patients rights they are required to give.
Her brain had obviously been swollen the entire time even after the 1st release because she was so incohearent.

But i would expect a nurse to defend their own.

We ordered the records from hospital one and I believe we got a case.
I spoke to my mother on the phone. Her thought process is not the same. She couldnt remember anything and still has problems walking. she also has a problem with remembering how to cook a meal she has prepared for years.

And I unlike my parents can pay to have an attorney look at the case.

Ellencee how dare u blame me for what happened. I hope to god I never encounter you in life.
Do everyone a favor go to law school before u start advising others on what their legal rights are.

you want research.. see my next post....

I WAS DENIED THIS RIGHT!


Does the HIPAA Privacy Rule permit a doctor to discuss a patient’s health status, treatment, or payment arrangements with the patient’s family and friends?

Yes. The HIPAA Privacy Rule at 45 CFR 164.510(b) specifically permits covered entities to share information that is directly relevant to the involvement of a spouse, family members, friends, or other persons identified by a patient, in the patient’s care or payment for health care. If the patient is present, or is otherwise available prior to the disclosure, and has the capacity to make health care decisions, the covered entity may discuss this information with the family and these other persons if the patient agrees or, when given the opportunity, does not object. The covered entity may also share relevant information with the family and these other persons if it can reasonably infer, based on professional judgment, that the patient does not object. Under these circumstances, for example:

- A doctor may give information about a patient’s mobility limitations to a friend driving the patient home from the hospital.
- A hospital may discuss a patient’s payment options with her adult daughter.
- A doctor may instruct a patient’s roommate about proper medicine dosage when she comes to pick up her friend from the hospital.
- A physician may discuss a patient’s treatment with the patient in the presence of a friend when the patient brings the friend to a medical appointment and asks if the friend can come into the treatment room.


B]Even when the patient is not present or it is impracticable because of emergency circumstances or the patient’s incapacity for the covered entity to ask the patient about discussing her care or payment with a family member or other person, a covered entity may share this information with the person when, in exercising professional judgment, it determines that doing so would be in the best interest of the patient. See 45 CFR 164.510(b). [/b]

READ all of the privacy act not just the fines you will incur..

i wish they had fines for stupidity.....and ignorance.

im done.[

[ellencee]

cmycutetoes
Your mother or her legal representative should see a medmal attorney in her area. I am not emotionally involved in this matter and can only see it from a clinical point of view and a legal point of view as regards HIPAA. I can not provide you with the answer that you want. Only the opinion of a medmal attorney and a medical expert paid to review the records and render an opinion will be of any value to you, your mother, or your father.

Best wishes,
EC