Epileptic Seizure & Broken Teeth After

[california999]

What is the name of your state? California.

I was asked to see if I can help this person. Here is his story.

This is about a 26 year old man, full time worker in a restaurant, who appears very health except the presence of an epileptic condition, has been seen in the same ER several times over the years. He apparently has had lifelong seizures. During the past two years the seizures have become more frequent though unpredictable.

The doctors and nurses have told his mother and family and have noted in his chart notes when he ends up in the ER he cannot sign himself out and must stay in the ER treatment area until someone can pick him up. The reason for this is noted because he has quite severe loss of mental capacity after a seizure which can last for hours to days. This is to the point where he is not coherent and losses the capacity to make decisions as an adult.

In May of last year he was brought to the ER via the ambulance from his work location. The last time he was in the ER, without the presence of his mother or a family member, he was released and told to wait in the ER waiting area until his mother came to pick him up – this action was in conflict with the warnings in his chart. While sitting in the ER waiting room in a chair he suddenly begun to have a seizure. His body was thrown to the floor where he injured his wrist, elbow, neck and his face was smashed on the floor, breaking several front teeth and fracturing one. He needs extensive dental work including root-canals due to the damage. Because of the damage his teeth cut into his lips. The appearance of his teeth is chipped, cracked and broken serverly – what you would imagine. He was admitted back into the ER and then released against the advice of the doctor to his family.

Basically, does he have a case against the hospital for at least the dental work to fix his teeth?

After reading some of his medical records and hearing the story from his mother. Here are some more details I think adversely affect his case against the hospital.

One, the Dr.s put him on medication for seizures. He would refuse to take the medication due to it making him sick.

Two, a blood test showed he had an anti-convulsant medication for seizures in his blood. When asked if he was taking this medication he and his mothered denied it. Though previously they had stated he was taking a prescription medication from Mexico for his seizures.

Three, after one month they obtained a lawyer. The lawyer took the case though eventually determined the case was not good and dropped it earlier this year. Reasons: the family waited too long to see a dentist and to get an evaluation of the damage, about six-months and didn’t get the results to the attorney until earlier this year. The family did go see a Chiropractor about his neck pain. The lawyer told them their best option is to write a letter to the hospital threatening a suit if they do not fix his teeth.

The family has asked me to write a letter to the hospital because they are uneducated? Can I do this, would this somehow be representing them in some way?

Four, his medical history is shady because the patient or the family was never able to make clear many answers to questions by Doctors and have lied. The family blames work stress for the seizures and the mother thinks his seizures are caused by something at his work. The doctors have considered his condition is pseudo-seizures. Doctor’s see this as conflicting with the patient saying his seizure have been lifelong.

Thanks.

[ellencee]

Originally Posted by california999

What is the name of your state? California.

I was asked to see if I can help this person. Here is his story.

This is about a 26 year old man, full time worker in a restaurant, who appears very health except the presence of an epileptic condition, has been seen in the same ER several times over the years. He apparently has had lifelong seizures. During the past two years the seizures have become more frequent though unpredictable.

The doctors and nurses have told his mother and family and have noted in his chart notes when he ends up in the ER he cannot sign himself out and must stay in the ER treatment area until someone can pick him up. The reason for this is noted because he has quite severe loss of mental capacity after a seizure which can last for hours to days. This is to the point where he is not coherent and losses the capacity to make decisions as an adult.

In May of last year he was brought to the ER via the ambulance from his work location. The last time he was in the ER, without the presence of his mother or a family member, he was released and told to wait in the ER waiting area until his mother came to pick him up – this action was in conflict with the warnings in his chart. While sitting in the ER waiting room in a chair he suddenly begun to have a seizure. His body was thrown to the floor where he injured his wrist, elbow, neck and his face was smashed on the floor, breaking several front teeth and fracturing one. He needs extensive dental work including root-canals due to the damage. Because of the damage his teeth cut into his lips. The appearance of his teeth is chipped, cracked and broken serverly – what you would imagine. He was admitted back into the ER and then released against the advice of the doctor to his family.

Basically, does he have a case against the hospital for at least the dental work to fix his teeth?

After reading some of his medical records and hearing the story from his mother. Here are some more details I think adversely affect his case against the hospital.

One, the Dr.s put him on medication for seizures. He would refuse to take the medication due to it making him sick.

Two, a blood test showed he had an anti-convulsant medication for seizures in his blood. When asked if he was taking this medication he and his mothered denied it. Though previously they had stated he was taking a prescription medication from Mexico for his seizures.

Three, after one month they obtained a lawyer. The lawyer took the case though eventually determined the case was not good and dropped it earlier this year. Reasons: the family waited too long to see a dentist and to get an evaluation of the damage, about six-months and didn’t get the results to the attorney until earlier this year. The family did go see a Chiropractor about his neck pain. The lawyer told them their best option is to write a letter to the hospital threatening a suit if they do not fix his teeth.

The family has asked me to write a letter to the hospital because they are uneducated? Can I do this, would this somehow be representing them in some way?

Four, his medical history is shady because the patient or the family was never able to make clear many answers to questions by Doctors and have lied. The family blames work stress for the seizures and the mother thinks his seizures are caused by something at his work. The doctors have considered his condition is pseudo-seizures. Doctor’s see this as conflicting with the patient saying his seizure have been lifelong.

Thanks.

The hospital was not negligent. Are you aware of what is done when someone having a seizure is in danger of falling? Nothing is done except to move anything that can be moved away from the patient. The floor can't be moved and neither can the chair that the man was sitting in. Touching or restraining the patient is a huge NO-NO.

The situation you describe is a no-win situation. The patient won't take the medications to control his seizures for a long enough time that he won't feel "sick". He needs to build up a therapeutic level of the medication. His mother does not understand seizure disorders or the medications necessary. His medical history is a mystery; no one knows the truth as the lies have, by now, become part of the "memory".

The man can't stay in the ER's treatment rooms while he waits on a ride home. He could be admitted to the hospital but maybe this isn't an option because he doesn't meet admission criteria. Who knows?

Because of his lifelong history of noncompliant treatment of the seizure disorder, "lying" about his medical history, refusal to understand his physical needs and the causes of his physical problems, etc. this man will probably never have a viable medmal claim regardless of what happens to him. It will be impossible to prove that negligence caused damage and his non-compliance had nothing to do with it.

Anyway--tell the family there is no money coming their way from the sue-your-healthcare provider-lottery and tell them if he doesn't start taking his medication(s) as prescribed and follow an actual medical/patient plan of care, he won't be alive much longer. He will die either from seizure activity or from injury resulting from a seizure. His choice.

There is really nothing you can do except encourage him to take his meds and such. Don't beat yourself up over not being able to be a real help to them. I appreciate your being concerned enough about your fellow human to have asked how you can help him/them.

EC

[longsally111]

Originally Posted by california999

What is the name of your state? California.

I was asked to see if I can help this person. Here is his story.

This is about a 26 year old man, full time worker in a restaurant, who appears very health except the presence of an epileptic condition, has been seen in the same ER several times over the years. He apparently has had lifelong seizures. During the past two years the seizures have become more frequent though unpredictable.

The doctors and nurses have told his mother and family and have noted in his chart notes when he ends up in the ER he cannot sign himself out and must stay in the ER treatment area until someone can pick him up.

The family might request this but that does not make it so. If he meets discharge criteria, he can go to the waitign room.

The reason for this is noted because he has quite severe loss of mental capacity after a seizure which can last for hours to days. This is to the point where he is not coherent and losses the capacity to make decisions as an adult.

Again, if he meets criteria, noone has to hold him

In May of last year he was brought to the ER via the ambulance from his work location. The last time he was in the ER, without the presence of his mother or a family member, he was released and told to wait in the ER waiting area until his mother came to pick him up – this action was in conflict with the warnings in his chart.

again, if he met d/c criteria, noone has to keep him. We d/c pts to the waiting room to wait for rides all the time.

While sitting in the ER waiting room in a chair he suddenly begun to have a seizure. His body was thrown to the floor where he injured his wrist, elbow, neck and his face was smashed on the floor, breaking several front teeth and fracturing one. He needs extensive dental work including root-canals due to the damage. Because of the damage his teeth cut into his lips. The appearance of his teeth is chipped, cracked and broken serverly – what you would imagine. He was admitted back into the ER and then released against the advice of the doctor to his family.

Even if he was in the back of the ER, he still would have had the seizure and it would not have made a difference. He fell foward instead of backwards. That is nature not criminal. If he was then released against the advice of the dr, the family had to sign an AMA form which releases the hospital from ANY liability what so ever.

Basically, does he have a case against the hospital for at least the dental work to fix his teeth?

NO

After reading some of his medical records and hearing the story from his mother. Here are some more details I think adversely affect his case against the hospital.

One, the Dr.s put him on medication for seizures. He would refuse to take the medication due to it making him sick.

Noone can force him to take his medicine and it is NOT the hospitals fault if he is non-compliant and his family is not making him take needed medicine.

Two, a blood test showed he had an anti-convulsant medication for seizures in his blood. When asked if he was taking this medication he and his mothered denied it. Though previously they had stated he was taking a prescription medication from Mexico for his seizures.

So he is lying to medical personnel. Forget it, case closed right there. people are responsible for their health.

Three, after one month they obtained a lawyer. The lawyer took the case though eventually determined the case was not good and dropped it earlier this year. Reasons: the family waited too long to see a dentist and to get an evaluation of the damage, about six-months and didn’t get the results to the attorney until earlier this year.

I guarantee you the case was dropped when the family signed the AMA form, when he found the patient was non-compliant with medicine and that the patient lies to people in the ER trying to help him. It had nothing to do with what you said.

The family did go see a Chiropractor about his neck pain. The lawyer told them their best option is to write a letter to the hospital threatening a suit if they do not fix his teeth.

They can write all the letters they want. They will read his chart and they will get a laugh out of the letter. They get threats like that every single day. It will not happen.

The family has asked me to write a letter to the hospital because they are uneducated? Can I do this, would this somehow be representing them in some way?

If you write a letter like that and are not an attorney, you could end up being sued!!! You had better be careful.

Four, his medical history is shady because the patient or the family was never able to make clear many answers to questions by Doctors and have lied. The family blames work stress for the seizures and the mother thinks his seizures are caused by something at his work. The doctors have considered his condition is pseudo-seizures. Doctor’s see this as conflicting with the patient saying his seizure have been lifelong.

That is already mentioned above but can you see a jury hearing that this patient does not take his meds, does not take responsibility for his condition, lies to the medical people and then saying, but your honor, he hit his mouth on their floor, make them pay? They are dreaming, sorry, this money millk is closed.

Thanks.

your welcome

[ecmst12]

Your friend is continuing to have seizures because he's not taking his medication. Every time he has a seizure it damages his brain a little. That's why his mental capacity is diminished after he has one. And the more seizures he has, the more permanent the damage is going to be. He needs to be compliant with his meds, and he needs to be under the care of a neurologist to determine what meds he should be taking and how much. If the meds are making him sick, then maybe there's something else he can try. But like EC said, if he doesn't start taking care of himself, he's going to end up seriously hurt, brain damaged, or dead.

"Work stress" does not cause seizures. It can trigger them in people who have seizure disorders, but otherwise healthy people do not have seizures just because they're stressed out.

[ellencee]

Originally Posted by ecmst12

Your friend is continuing to have seizures because he's not taking his medication. Every time he has a seizure it damages his brain a little. That's why his mental capacity is diminished after he has one. And the more seizures he has, the more permanent the damage is going to be. He needs to be compliant with his meds, and he needs to be under the care of a neurologist to determine what meds he should be taking and how much. If the meds are making him sick, then maybe there's something else he can try. But like EC said, if he doesn't start taking care of himself, he's going to end up seriously hurt, brain damaged, or dead.

"Work stress" does not cause seizures. It can trigger them in people who have seizure disorders, but otherwise healthy people do not have seizures just because they're stressed out.

While you are correct, kind of, in what you've said, I believe the diminished mental capacity to which the OP is referring is the post-icteral state that follows most seizures. Post icteral states can last from seconds to days and vary in severity of depressed mental function. Some patients are disoriented for a few seconds or minutes while others may be "comatose" for hours after a seizure. During the post icteral stage it is important that the patient be left alone under someone's watchful eye but not stimulated in anyway, not by light or noise or being offered something to drink or turned over or bathed or anything else. To stimulate a person in a post icteral state is to invite more seizures, possibly worsing seizures or seizures that will not stop without emergency medical intervention, and can lead to imminent death.

EC

[longsally111]

Originally Posted by ellencee

While you are correct, kind of, in what you've said, I believe the diminished mental capacity to which the OP is referring is the post-icteral state that follows most seizures. Post icteral states can last from seconds to days and vary in severity of depressed mental function. Some patients are disoriented for a few seconds or minutes while others may be "comatose" for hours after a seizure. During the post icteral stage it is important that the patient be left alone under someone's watchful eye but not stimulated in anyway, not by light or noise or being offered something to drink or turned over or bathed or anything else. To stimulate a person in a post icteral state is to invite more seizures, possibly worsing seizures or seizures that will not stop without emergency medical intervention, and can lead to imminent death.
EC

This is why the family was asking about this pt staying in the back of the ER, why they were sent to the waiting room. If the post ictal state was over, however, and the pt was A&OX3, there is no reason why he should not be d/c'c. If we kept every seizure pt in the fear of another one, they would never leave the er.

[ecmst12]

My brother has epilepsy so I'm going on what he's told me that his doctor told him. After he has a seizure, he's in a kind of dazed and disoriented state for a few days to a week - similar to what it feels like after a concussion. And that is how his neurologist explained it to him. He was never told anything about avoiding stimulation for that long; his post-seizure symptoms seem relatively mild compared with what you've described. He can function, just a little "out of it". But I didn't talk directly to the doctor so it's possible something got lost in translation.

The other thing that he was told is that the more seizures he has, the more susceptible he becomes to having more. Hearing this did make him more compliant with his meds!

[panzertanker]

postictal

Time frame after seizure.

[california999]

Thanks a lot everyone.

[ellencee]

Originally Posted by panzertanker

postictal

Time frame after seizure.

ROFLMAO! thanks for the subdued correction! I hear it pronounced icteral so much, my fingers typed it while my brain was on break.

EC

[panzertanker]

Originally Posted by ellencee

ROFLMAO! thanks for the subdued correction! I hear it pronounced icteral so much, my fingers typed it while my brain was on break.

EC

Welcome. I hear it pronounced so MANY different ways... thought a correct spelling was all that was necessary.

Originally Posted by ellencee

While you are correct, kind of, in what you've said, I believe the diminished mental capacity to which the OP is referring is the post-icteral state that follows most seizures. Post icteral states can last from seconds to days and vary in severity of depressed mental function. Some patients are disoriented for a few seconds or minutes while others may be "comatose" for hours after a seizure. During the post icteral stage it is important that the patient be left alone under someone's watchful eye but not stimulated in anyway, not by light or noise or being offered something to drink or turned over or bathed or anything else. To stimulate a person in a post icteral state is to invite more seizures, possibly worsing seizures or seizures that will not stop without emergency medical intervention, and can lead to imminent death.

EC

Postictal is the state lasting 5-30 minutes (max) following a seizure. The disorientation, confusion, etc is more likely due to lack of oxygen to the brain while he is in seizure. The more frequent the seizures, the more often the brain receives a diminished amount of oxygen.

If the person is having pseudoseizures there is no postical state. Period. The basis for pseudo- obviously. Persons who have pseudoseizure have some type of psychiatric disorder- somatic, PTSD, etc.

[Be_content]

Originally Posted by california999

What is the name of your state? California.

I was asked to see if I can help this person. Here is his story.

This is about a 26 year old man, full time worker in a restaurant, who appears very health except the presence of an epileptic condition, has been seen in the same ER several times over the years. He apparently has had lifelong seizures. During the past two years the seizures have become more frequent though unpredictable.

The doctors and nurses have told his mother and family and have noted in his chart notes when he ends up in the ER he cannot sign himself out and must stay in the ER treatment area until someone can pick him up. The reason for this is noted because he has quite severe loss of mental capacity after a seizure which can last for hours to days. This is to the point where he is not coherent and losses the capacity to make decisions as an adult.

In May of last year he was brought to the ER via the ambulance from his work location. The last time he was in the ER, without the presence of his mother or a family member, he was released and told to wait in the ER waiting area until his mother came to pick him up – this action was in conflict with the warnings in his chart. While sitting in the ER waiting room in a chair he suddenly begun to have a seizure. His body was thrown to the floor where he injured his wrist, elbow, neck and his face was smashed on the floor, breaking several front teeth and fracturing one. He needs extensive dental work including root-canals due to the damage. Because of the damage his teeth cut into his lips. The appearance of his teeth is chipped, cracked and broken serverly – what you would imagine. He was admitted back into the ER and then released against the advice of the doctor to his family.

Basically, does he have a case against the hospital for at least the dental work to fix his teeth?

After reading some of his medical records and hearing the story from his mother. Here are some more details I think adversely affect his case against the hospital.

One, the Dr.s put him on medication for seizures. He would refuse to take the medication due to it making him sick.

Two, a blood test showed he had an anti-convulsant medication for seizures in his blood. When asked if he was taking this medication he and his mothered denied it. Though previously they had stated he was taking a prescription medication from Mexico for his seizures.

Three, after one month they obtained a lawyer. The lawyer took the case though eventually determined the case was not good and dropped it earlier this year. Reasons: the family waited too long to see a dentist and to get an evaluation of the damage, about six-months and didn’t get the results to the attorney until earlier this year. The family did go see a Chiropractor about his neck pain. The lawyer told them their best option is to write a letter to the hospital threatening a suit if they do not fix his teeth.

The family has asked me to write a letter to the hospital because they are uneducated? Can I do this, would this somehow be representing them in some way?

Four, his medical history is shady because the patient or the family was never able to make clear many answers to questions by Doctors and have lied. The family blames work stress for the seizures and the mother thinks his seizures are caused by something at his work. The doctors have considered his condition is pseudo-seizures. Doctor’s see this as conflicting with the patient saying his seizure have been lifelong.

Thanks.

You can help this person, in a way that is more important than financial restitution, encourage him to take his drugs as perscribed. It takes approxiamately 2 weeks before the upset stomach, tremors, a feeling of being unbalanced or other symptoms to subside. Also, let these people know to always, that is ALWAYS tell the truth about their medical condition. If I was sitting on a jury and had to listen to this sad story....well, as a parent of a severly epileptic teenager I would also feel anger, that every lawsuit against physicians and hospitals...... when pursued by someone who obviously does not take accountability for their own lack of responsibility..... makes it more difficult for those of us who diligently do the best to assure the best possible outcome in a worst possible situation. A child with uncontollable seizures.

I have sympathy for these people, put they did not do the simpilist thing.....tell the truth. Even an uneducated person knows how to do that.

[Zigner]

Originally Posted by Be_content

You can help this person, in a way that is more important than financial restitution, encourage him to take his drugs as perscribed. It takes approxiamately 2 weeks before the upset stomach, tremors, a feeling of being unbalanced or other symptoms to subside. Also, let these people know to always, that is ALWAYS tell the truth about their medical condition. If I was sitting on a jury and had to listen to this sad story....well, as a parent of a severly epileptic teenager I would also feel anger, that every lawsuit against physicians and hospitals...... when pursued by someone who obviously does not take accountability for their own lack of responsibility..... makes it more difficult for those of us who diligently do the best to assure the best possible outcome in a worst possible situation. A child with uncontollable seizures.

I have sympathy for these people, put they did not do the simpilist thing.....tell the truth. Even an uneducated person knows how to do that.

This thread is two years old. Please don't necropost.

[Antigone*of*Greece]

Thank God Be Content was here to help. I'm not sure if this forum can continue without his ever so knowledgable and extremely to-the-minute advice