California. In September 2005 I got a stress fracture that involved a joint in my foot. At the time, all I knew was I was in pain. I saw my regular MD as required who could not diagnose the problem. She referred me after a couple weeks to an orthopedic generalist. I finally got to see him about 1 month later. Xrays were taken; he poked and prodded and ultimately decided he didn't know what the problem was. Since he was the go-to specialist within the group I petitioned the medical group to see an orthopedic foot specialist outside the group. Since it was urgent, they promised me they would authorize it within 24 hours. I heard nothing from them until two weeks later I received notice that they were going to send me to a podiatrist. I said absolutely not, I wanted to see a REAL doctor. They refused to authorize this. I went to the specialist on my own dime (who did diagnose the problem), but because of the major delays of the HMO group -- 4 months total -- the injury had now caused permanent damage. A grievance was filed with Blue Cross who seems to agree many errors were made. After the fact the HMO group did authorize my seeing this doctor. There is a surgery he can do to repair the damage that was done, but it is major and requires a 5 month recovery period. It's possible I would not be able to work during this time, or only on a limited basis, so I would lose my health insurance, my pay, and possibly my seniority or my job.
Is there a malpractice case here?
Is there a malpractice case here?