Does a hospital have the right to do this?

[LAWMED]

I felt I had to address risha222's post which has been closed. Here is the original post:

Does a hospital have the right to do this?
What is the name of your state (only U.S. law)? Texas
My step father went to the emergency room without insurance for kidney stones (he also has a serious heart condition and was in severe pain causing his BP to raise). He was held in the hospital for two or three days while they refused to give him his BP medication on time causing his BP to fluctuate severely. After two or three days they decided to transfer him to a hospital in Austin a larger city to have a procedure done where he would be placed in a tub with some kind of sonic waves that would shatter the kidney stones. When he arrived at the new hospital his BP was still very high and he was told that he was not in fact going to have that procedure done that he would be having surgery. He was told no food no drinks and 24 hrs later he was placed under anesthesia and had a stint placed in his you know where. He was told to return to the hospital in one week to have it removed. He was kept until the anesthesia wore off and then released with two prescriptions, one for pain, and one for his bladder I believe. He went today as scheduled to the hospital to have the stint removed and they told him that because his surgery bill and hospital bill was so high that he must come up with three hundred dollars to have the stint removed. When he said that's a lot of money it will take a while to come up with that can't we work something out? The nurse informed him it could stay in for six weeks without causing any serious repercussions and that was plenty of time to come up with three hundred dollars. My step father is disabled, he can barely walk around our yard without his heart acting up and turning ghostly white. Even with BP medications he has never been able to maintain a healthy BP. He has applied for SS Disability but it's a process and a very timely one. Can they really just leave that thing in him? It's TWO FEET into his body!! That cannot be okay to just leave in there. What are his options legally? Or has our medical society become so unraveled in money that they just don't care how they leave there patients as long as they get there money? I am shocked and outraged by this, if the doctor thought the stint should stay in for up to six weeks, why did he demand scheduling the removal 7 days later before dismissing him from the hospital? Please help, my step dad is really upset and afraid he is going to be stuck with a permanent super sized tampon until he can afford in this economy to pay three hundred dollars!What is the name of your state (only U.S. law)? TEXAS

The consensus was that the hospital did not have to remove the stent. I'm sorry but that is DEAD WRONG. You CANNOT be denied standard post operative care because you cannot pay....this is called medical malpractice. Absent any valid medical reason, the stent must be removed in the manner and time frame dictated by competent medical care. The original poster is due an apology for being bashed if you ask me.

 

[ecmst12]

The poster first needs to learn the difference between a catheter and a stent, IMO. If you're going to post for someone else, at least make sure you have all the facts first.

 

[LAWMED]

All we know is that some sort of device is hanging 4-6 inches out of his penis. Two possibilities: it is a foley catheter or the stent has migrated down and out. IF the patient went home with a bag attached to the tube in question to collect urine, obviously it is a foley. Having a foley however does not preclude also having a stent. Stenting after this procedure is very common...majority have it. The vast majority of stents are removed within 7 days unless there was a complication such as ureteral perforation, then it is left in 5 weeks or so. The longer it is in the more likely that complications will develop. It is not something you leave in without a medial reason.

Lithotripsy is appropriate for kidney stones which are less than 2-3cm in diameter. Larger stones must either be removed by cystoscopy using a long 'grabber' snaked up the ureter to grab and pull it out, or by Percutaneous Nephrolithotomy which requires a skin incision over the kidney.
Cystoscopy, as in this case, is very irritating to an already inflamed ureter so the stent is placed post-op to prevent the ureter from swelling shut and preventing the kidney from draining urine.

If the stent is till in, and there was no complication during the procedure, the stent should be taken out without delay. It is a simple, 5 min office procedure.

 

[lealea1005]

Lithotripsy may not be appropriate in patients with hypertension, especially uncontrolled hypertension.

Stents should be changed periodically, but could remain inserted for up to 6 months. I would suspect, due to the increased risk caused by all of his medical issues (hypertension, cardiac, etc) and as a precaution, OP's SF would have the stent removal done at the hospital, not the surgeon's office.

I could find no studies indicating a stent must be removed 7 days post op. Perhaps Lawmed has access to such a study/literature and can share it.

 

[LAWMED]

I did not say it MUST be removed within 7 days. I said that absent any complications, the vast majority are removed within 7 days after cystoscopy for renal calculi removal.

Ureteroscopy is typically performed as an outpatient day surgery procedure. If a stent is left indwelling, it is typically removed 3 to 10 days after the procedure. Postoperative radiographs are obtained within 1 to 2 weeks to determine the success of the procedure. Small stone fragments (<4 mm) normally pass after the stent has been removed because of the passive ureteral dilation that occurs from stenting. Campbell-Walsh Urology, 9th ed.,Saunders 2007, Chapter 45 – Ureteroscopy and Retrograde Ureteral Access, Post-Operative Care

Stents are removed with a flexible cystoscope under topical anesthesia. There is no reason to do it in a hospital unless a difficult removal requiring heavy sedation or general anesthesia is anticipated.

 

[barry1817]

hospital

I felt I had to address risha222's post which has been closed. Here is the original post:

Does a hospital have the right to do this?
What is the name of your state (only U.S. law)? Texas
My step father went to the emergency room without insurance for kidney stones (he also has a serious heart condition and was in severe pain causing his BP to raise). He was held in the hospital for two or three days while they refused to give him his BP medication on time causing his BP to fluctuate severely. After two or three days they decided to transfer him to a hospital in Austin a larger city to have a procedure done where he would be placed in a tub with some kind of sonic waves that would shatter the kidney stones. When he arrived at the new hospital his BP was still very high and he was told that he was not in fact going to have that procedure done that he would be having surgery. He was told no food no drinks and 24 hrs later he was placed under anesthesia and had a stint placed in his you know where. He was told to return to the hospital in one week to have it removed. He was kept until the anesthesia wore off and then released with two prescriptions, one for pain, and one for his bladder I believe. He went today as scheduled to the hospital to have the stint removed and they told him that because his surgery bill and hospital bill was so high that he must come up with three hundred dollars to have the stint removed. When he said that's a lot of money it will take a while to come up with that can't we work something out? The nurse informed him it could stay in for six weeks without causing any serious repercussions and that was plenty of time to come up with three hundred dollars. My step father is disabled, he can barely walk around our yard without his heart acting up and turning ghostly white. Even with BP medications he has never been able to maintain a healthy BP. He has applied for SS Disability but it's a process and a very timely one. Can they really just leave that thing in him? It's TWO FEET into his body!! That cannot be okay to just leave in there. What are his options legally? Or has our medical society become so unraveled in money that they just don't care how they leave there patients as long as they get there money? I am shocked and outraged by this, if the doctor thought the stint should stay in for up to six weeks, why did he demand scheduling the removal 7 days later before dismissing him from the hospital? Please help, my step dad is really upset and afraid he is going to be stuck with a permanent super sized tampon until he can afford in this economy to pay three hundred dollars!What is the name of your state (only U.S. law)? TEXAS

The consensus was that the hospital did not have to remove the stent. I'm sorry but that is DEAD WRONG. You CANNOT be denied standard post operative care because you cannot pay....this is called medical malpractice. Absent any valid medical reason, the stent must be removed in the manner and time frame dictated by competent medical care. The original poster is due an apology for being bashed if you ask me.

I believe that we can give feedback only to what a poster presents, but can offer alternatives if we think that the poster may be mistaken about an item. Normally a person comes to a web site for help, and they present what they know.

Asking a poster to do research about an item before posting is like asking a responder not to respond if they want to criticize a person in need. Probably won't happen on either end of the spectrum

 

[lya]

Somewhere in the chronicles of this site, the OP's question has been asked and answered; and, the consensus was that one cannot initiate treatment with a short-term device that requires removal and then refuse to remove the device by changing the terms of the contract/duty.

I believe JCAHO would be very interested in learning that the provider initiates treatment while having full knowledge of the patient's inability to pay and subsequently refuses to remove the device because of the patient's inability to pay.

If the patient is refused removal of the device in accordance with the standards of care and damages result, I believe the patient has cause to seek legal remedy.

 

[lealea1005]

Maybe OP should contact the Physician directly. From what she stated, the alleged refusal to treat came from the "nurse" at the hospita. Just a thought.