Is this a case worth persuing?

[DomesticPtnr]

What is the name of your state?What is the name of your state? New York

Our general practioner (an internist) was asked last summer if my partner, a then 57 year old diabetic woman with a strong family history of stroke, should have a carotid artery screening. This question was prompted by our receipt of an advertising flyer in our local paper. This doctor was the patient's regular doctor of long standing.

He stated that she didn't need the screening.

Subsequently, she has had a stroke. It was determined that one carotid artery was completely blocked and the second carotid artery was 90% closed. Neurovascular stent insertion was recently sucessful, and she is no longer at extreme high risk for deadly second stroke.

She has some neurological damage from first stroke, but not profound. She can walk, talk, and since the stenting, is much more mentally alert than she had been. This is why I wonder if there is a case here. She's not profoundly injured. Also, as a 50+ year old diabetic, .... well, in a wrongful death type of case, I could see that there could be arguements that her life expectancy was not as strong as if she didn't have the condition. However, it's not a wrongful death situation. Here's more about the situation.

The stroke was diagnosed because I felt she was effectively disabled (from combination of diabetes, high blood pressure and colesteral meds, I thought.) and wanted her to persue a SS disability case. Her primary symptoms were memory impairments, physical weakness, and profound tiredness - falling asleep during day, etc., (all of which had been previously reported to this doctor). He appeared quite sceptical, stating that she wasn't disabled, she was retired, and wouldn't certify her disabled without a neurologist's evaluation and a sleep study first. (She had retired early from teaching at age 55 - but I never saw that that had any bearing on a medical diagnosis of physical disability - but never mind.) Knowing her condition I said - perhaps to his surprise - well, let's do it, because she definately couldn't hold down a job in her present condition.

The neurologist's exam lead to the diagnosis of the past stroke and the (then) extreme risk of a second (most likely deadly) stroke. Emergency scheduling of the recently successful stent proceedure followed. While we were waiting for the neurological scans that diagosed the stroke, a sleep study was held. That study diagnosed severe obstructive sleep apnea.

We are quite angry, as the forgone screening could very likely have prevented the first stroke. And a referal for a sleep study could have dignosed the apnea, probably years ago. I can't believe that we discovered all these treatable conditions due to my pushing for a disability diagnosis that he didn't want to give!

This doctor didn't visit or call while she was in the hospital, nor has he called since the surgery. We think he's running scared.

While I believe that I have no legal standing in the case under current NY law, even though we've been registered domestic partners since NYC allowed registration (that I couldn't sue, for wrongful death, for instance) since she's alive (thank god!) she can persue her own case. She takes my advice in financial and legal matters, so she has asked me to recommend whether, and if so how, to persue a case.

Is this a case worth persuing? We have young children we are raising together, and I just spent a week thinking that I was next door to becoming a single parent. If we could get some money damages it could go along way towards improving their well-being. I don't know if we should responsibly walk away from a potential recovery. However, given the stress and agravation potentially involved, if the case is not likely to be successful, perhaps we should just find another doctor and move on.

Thanks, in advance, for sharing your thoughts in this matter.

DomesticPtnr

 

[ellencee]

She could have gone to another MD if her usual MD didn't want to order the test if she truly believed it was something she wanted done. She had the advertisement for a physician who would do the procedure; I don't see a problem.

I don't think you can hold responsible any physician for the stroke that she suffered and that left her with symptoms so vague that you and she did not even suspect a stroke.

As for disabililty, one has ten years from the last period of employment in which to file for disability but one also has to be attempting to return to work and unable to do so because of the qualifying disability.

Medical malpractice is not intended to be a form of supplemental income or the next best thing to winning the lottery. It is meant to provide some measure of compensation for those who have been injured through preventable errors in the delivery of healthcare. Your partner does not qualify.

EC

 

[rmet4nzkx]

There is no way to tell when she had the stroke and with her health, it could have happened years ago before they had stents. The referal to the neurologist was appropriate thus there is no cause of action, be thankful for modern treatments for CAD and CVA. I suggest you consult a family law attorney and estate planner insofar as your other concerns re your joint assets and custody issues. She can aply for disability but it is very difficult to get, sometimes the letter qualifying disability from an IME qualified neuropsychologist will do the trick, also the minor children will be eligible for dependent benefits if she is eligible for SSDI.

 

[panzertanker]

What is the name of your state?What is the name of your state? New York

Our general practioner (an internist) was asked last summer if my partner, a then 57 year old diabetic woman with a strong family history of stroke, should have a carotid artery screening. This question was prompted by our receipt of an advertising flyer in our local paper. This doctor was the patient's regular doctor of long standing.

How frequently did she visit this internist?

Subsequently, she has had a stroke.

How "subsequently" of a time frame?

She has some neurological damage from first stroke, but not profound.

First stroke? Did she have multiple?
How do you know when this "first stroke" took place?

The neurologist's exam lead to the diagnosis of the past stroke and the (then) extreme risk of a second (most likely deadly) stroke.

So she was appropriately referred to a neurologist for having some type of neurological deficits.

We are quite angry, as the forgone screening could very likely have prevented the first stroke. And a referal for a sleep study could have dignosed the apnea, probably years ago. I can't believe that we discovered all these treatable conditions due to my pushing for a disability diagnosis that he didn't want to give!

You do not know when she HAD that stroke, so you do not know if it would have been preventable or not.
OSA is usually brought to the attention of the provider by other clinical symptoms, but they may have been masked by her neuro problems.

This doctor didn't visit or call while she was in the hospital, nor has he called since the surgery. We think he's running scared.

Or he may not be participating in her care since Neurology has taken over.....

 

[DomesticPtnr]

It's pretty clear that we don't have a case, and will not try to persue one.

However, we're still angry.

The thing that we are most angry about, is that rather than the medical expert directing her care, *I* was the driver behind her getting these diagnoses. If it had been left up to him, she'd most likely have died without any of these referals or the care they are generating.

These diagnosis came about when he stated he would not find that she was disabled without supporting documentation. We feel that he referred her for these exams, not based on his professional opinion that they were needed for her care, but because they were, in a sense, requested by us. At the time the appointments were scheduled, we very much felt we were being 'humored.'

And then the results started pouring in. I'd feel vindicated, if only I weren't so angry.

You should have seen the expression on the face of the neurovascular surgeon when we told him that we'd asked about her having a carotid artery scan last summer, and had been told she didn't need it. While he didn't say anything directly negative, boy was his expression telling. He said 'well, I won't say anything.' And when you can't say anything nice .....

Quote:
So she was appropriately referred to a neurologist for having some type of neurological deficits.

Only upon our request.

Quote:
OSA is usually brought to the attention of the provider by other clinical symptoms, but they may have been masked by her neuro problems.

He was not concerned enough about these symptoms to make a referal to a neurologist on his own. Interesting that those symptoms are a defense in this consideration.

We feel that he exhibited poor judgement in recommending against the carotid artery scan as 'not needed', in not referring her to a neurologist when neurological symptoms were first reported, and not referring her to a sleep study when OSA symptoms were first reported. However, apparently it's not bad enough to be classified as malpractice.

Pretty much as I had expected. Thank you for your comments,

DomesticPtnr

PS. Her condition is improved enough that she can probably work.
We no longer have a reason for, or an interest in, a SS disabilty case for her. We expect that she will soon be able to get a part-time job to supplement her pension.

 

[ellencee]

I find it disturbing that anyone would think the medical profession has the duty to asume responsibility for directing anyone's personal heathcare. The poster's actions in caring for his or her partner's health is exactly what partners or family members do for each other.

If the poster is seeking applause for having been concerned, caring, aware, and effectively assertive in caring for a loved one, then here it is--way to go!

EC

 

[DomesticPtnr]

Quote:
I find it disturbing that anyone would think the medical profession has the duty to asume responsibility for directing anyone's personal heathcare

Why consult expert advisors, if they are not to be relied upon to provide direction? Are we all to become qualified in every profession?

 

[rmet4nzkx]

Any provider needs documentation to support a Dx of "disabled" for SSDI.

 

[DomesticPtnr]

Quote:
Any provider needs documentation to support a Dx of "disabled" for SSDI.

True.

And very much beside the point. We're just lucky. Lucky we asked, lucky that any provider would need them. I thank God that they were needed. They've most likely added years to her life. They've certainly improved the quality of her life.

What I don't get, is that no one here seems to find any fault with the doctor.

After reading about both sleep apnea and stroke, I don't see how he could not have recognised that her symptoms, reported to him on several occasions independantly and well in advance of any disability related inquiry, warrranted referred for additional testing.

She was under his regular care. She saw him in his office often, for blood workups, when she had a cold, for flu shots, whenever there was any question. She told him about being tired all the time, about sleeping during the day, about experiencing short term memory loss, weakness in her hands, about her family history of stroke, about all her neurological symptoms ..... Among other things, we consulted him about whether to schedule a carotid artery screening. He was the doctor we went to when advised to 'consult your doctor.' We believed we were getting good care. We were wrong.

He dropped the ball. Symptoms were either ignored or discounted. The thing that really burns me up is that we though that she was doing as well as could be expected, given her conditions and medications - which has proven not to be the case at, by far. I thank God she's doing better.

But, is this the level of care you'd be happy with from your doctor? For yourself, or your family?

You may fault me - for not being more sceptical, and getting a second opinion - I certainly fault myself. But do none of you think that the doctor was at any fault? Not malpractice worthy fault, perhaps, but ....... some level of fault? To have missed so much?

 

[panzertanker]

You may fault me - for not being more sceptical, and getting a second opinion - I certainly fault myself. But do none of you think that the doctor was at any fault? Not malpractice worthy fault, perhaps, but ....... some level of fault? To have missed so much?

Of course, but you must realize that we did not examine the patient, therefore we do not know that these findings were "missed".
I sympathize with you, applaud that you were tenacious enough to get the final diagnoses, and am happy that your partner is able to return to work.
Good luck.