How Could They!!!!!!

[ditto]

Our State- Oregon

In June my husband was injured in cycle accident. Took him to ER around 4pm.
Everything ER did for husband and interactions with both of us was appropriate.
The xrayed for fractures, CT scans for internal injuries and massive, to me
anyway, amounts of pain meds to control pain. In less than 8 hours in ER he
received 4 shots/24mg total morphine, still in pain, they then gave him 3
shots/75mg Demeral. The ER staff included both of us in what they were doing, my
questions were answered or staff told me what was happening if I stepped away.
Their focus was truly my husband's health and well-being. Around 10pm ER Dr came
to us with news that the CT had shown something suspicious in my husband's lung.
My husband replied that years ago xray had also shown something and it was
determined to likely be childhood TB. ER Dr. stated after hearing this that a
surgeon would be in to see shortly. We waited more than hour so I asked nurse
about the surgeon. They replied "Its not an emergency, he'll be in the morning".
Ok. We both thought then that TB explanation had settled matter. We have no
medical insurance which was known to them; hospital asked at entry to ER and again
at least twice while in ER.
ER was going to admit him to hospital for observation/pain control(they had to put
him on IV Dilada drip. Possible internal injury still not ruled out. Knowing he
was to be admitted so he wanted me to go home to care for dog and call our
youngest. Comfortable with his care so far I did. Problems begin at admittance!
Arriving early, 7:15 am to his room next morning, so I would be there to talk with
Dr. I could hear him singing as I came into the nursing area-he doesn't sing.
Nurse told me I had just missed Dr. In talking with husband I immediately noticed
he was unable to relate what Dr had just said, fell asleep mid word, mixed events
for this Dr. with ER and even Dr. and surgeries from 20 years ago. He made no
sense. At 7:30 I made the first request to nurse to have Dr. see/call me and left
home & cell #'s. To make long story short attending Dr. nor consult Dr never
attempted to contact me the full day he was in hospital and I was concerned at our
not be included in his treatment, etc. Next morning I went to SW inquiring about
what to do/have ready for his recovery when released. Told her I still had not
spoken with Dr. and she notes that she called them to speak to me and left my cell
#. The only time given to me to meet/speak with them came the next day (less than
48 hours after accident) and the first thing out of attending was "Well are you
ready to go home?". When I did ask question of attending Dr about the extent of
injury to the ribs and was rebuffed with a repeat of what he'd just said, "6
broken ribs" in a manner telling me further questions would be equally pointless.
Attending refused to answer exact question from his patient immediately after I
had asked by changing subject. I was stunned and really alarmed now. Eager to
discharge but unwilling to discuss the injury to the rib, not communicating with
us at all. Consult Dr even stated in his "discharge" exam of his doubt shattered
collarbone would heal without surgery! I tried to find answers to our questions
and concerns later with admin. only to be told I couldn't see xrays, speak with
radiology, see his chart. I only agreed to let him come when I was told by admin &
records copies of everything would be sent to our Dr. that afternoon & our copy of
his complete file ready in 30 days. The discharge papers given to me at this point
had nothing listed for use/limitation of the injured side, I had and was given no
instructions in caring for his injured side nor were any signs/symptoms cited that
would tell me he needed immediate care should something happen while at home. I
felt and knew this was all wrong though I did not know why or how! We were
learned why later!

On June 28th I picked up obviously incomplete copy, per our signed request from
6/12, of medical charts containing Dr. summaries, radiology reports and couple
labs. Knowing it was incomplete I set it aside to read/research until a more
appropriate file was forthcoming. Next weekend, their patient starts reading what
was in the packet and discovered in those summaries and reports the CT had shown
possible cancer that was already spreading! The fail to tell us the extent of his
injuries even the day they discharged him but reply to our request for his records
with 4 documents citing the possibility of CANCER! This whole situation even
before we discovered what they withheld created worry and fear. Now it is even
worse! I've filed complaints with state agencies, before this last outrage, with
only 1 response seeming to take it seriously but given the wide latitude of any
rules, regs, etc. governing medical industry I don't hold much hope for even a
sanction of some sort. Did the Dr's/Hospital break laws, etc.? Ethically and
morally shouldn't they have done better than this. We're looking for answers from
them to us, accountability for what happened and I hope I'll scream long and hard
enough that safeguards will be put in place to prevent someone else from
experiencing this nightmare! Any advice is most welcome! Thank you!

[lya]

Your husband was admitted for injuries not for cancer treatment and cancer treatment can't start in the presence of bones that are recently fractured.

You rushed the medical records process and received incomplete records.

I'm sure your husband's discharge instructions included the standard statement to follow up with your husband's primary physician. Communication about the cancer would most likely have occurred MD to MD, then primary physician to patient.

I'm sure you are justifiably upset about your husband's conditon; but, you are over-reacting to everything else. I'm just as sure you are not winning friends and influencing people in the manner you need to be doing.

My advice to you is to calm down and move in a purposeful direction instead of going off on everyone. Make an appointment with your husband's primary physician and if he doesn't have one, find one. Get your husband to an MD as soon as possible.

[ecmst12]

The records said cancer is a POSSIBILITY. Not that he has it. He told the doctor what the most likely explanation for the x-ray abnormality, so the doctor felt no need to scare either of you with the less likely possibility of cancer. This is why people with no medical knowledge should not read their medical records without guidance from someone who can explain them. Right now you are scaring yourself for no reason.

[ditto]

I thank you both for replying. Given the fact they refused to answer direct questions regarding his injuries nor were we instructed to follow up with our family physician after discharge only to follow up with the MD who was the problem. I've been given better discharge instructions for an embedded sliver that was removed than we were provided here and yes those did include an instruction to see my own Dr. They failed to include any report mentioning the threat our Dr., another MD within their facility, nor was she told of it. She was stunned at our visit requesting referrals for potential cancer and insisted that I deliver to her what we had been given. At the hospital I was refused every request to speak with the treating Dr.'s and refused requests to speak with another Dr or radiologist to discuss his injuries and condition. Since they refused my request to have someone else go over the chart with me at the time who else was left to read it when the opportunity came. The care in ER was appropriate, inclusive and open and the concern was clearly my husband's well-being and for that we are grateful. Only after his care was transferred to the other doctor Dr. did the situation detiorate. Withholding their knowledge of the threat from both us and our Dr. then providing us an incomplete file in which the the reports that state the threat are all right on top was not done out concern for our well being. Without a doubt had we had insurance the situation would've been handled differently. At the very least told of the threat in person, a biopsy scheduled and more information shared regarding his injuries and caring for them. It is very sad that a profession created from the highest ideals of humanity should be represented in such a manner by any person or organization.

[longsally111]

Originally Posted by ditto

I thank you both for replying. Given the fact they refused to answer direct questions regarding his injuries nor were we instructed to follow up with our family physician after discharge only to follow up with the MD who was the problem.

They can not legally discuss his case with you. This is a violation of Hippa. Only if your husband gives consent.

I've been given better discharge instructions for an embedded sliver that was removed than we were provided here and yes those did include an instruction to see my own Dr.

You probably recieved volumes of papers and in there, somewhere, I am sure there are instructions of some sort. I say this because they are standard and printed on the papers for all patients and then the individuals particulars are added.

They failed to include any report mentioning the threat our Dr., another MD within their facility, nor was she told of it.

They did not tell you he had cancer because they did not know whether he had cancer. They did mention a lung abnormality to you and that is pretty much what they do in the ER. Noone can tell you what it is without a biopsy.

She was stunned at our visit requesting referrals for potential cancer and insisted that I deliver to her what we had been given.

I am sure she was stunned.

At the hospital I was refused every request to speak with the treating Dr.'s and refused requests to speak with another Dr or radiologist to discuss his injuries and condition.

If they discussed it with you, Hippa violation would have occurred. You do not gt access just because you are the wife.

Since they refused my request to have someone else go over the chart with me at the time who else was left to read it when the opportunity came.

Your follow up dr would read it then.

The care in ER was appropriate, inclusive and open and the concern was clearly my husband's well-being and for that we are grateful. Only after his care was transferred to the other doctor Dr. did the situation detiorate.

I am glad for that.

Withholding their knowledge of the threat from both us and our Dr. then providing us an incomplete file in which the the reports that state the threat are all right on top was not done out concern for our well being.

They did not withhold anything from you. They stated they saw something on the x-ray and again, without biopsy, noone knows.

Without a doubt had we had insurance the situation would've been handled differently.

I am sorry, I do not believe that.

At the very least told of the threat in person, a biopsy scheduled and more information shared regarding his injuries and caring for them. It is very sad that a profession created from the highest ideals of humanity should be represented in such a manner by any person or organization.

He was in the hospital for his injuries resulting from the accident. If he had cancer, believe me, 2 or 3 more days would not make a difference. They treated him for what he was in for. Now, go get the biopsy and relax. If it shows no cancer, you upset yourself for nothing. Good luck to you

[JustAPal00]

Sorry to get off the topic, but all this care with no medical insurance? Can't be! Michael Moore says people get turned away even from the most basic care for not having insurance!

[longsally111]

my point exactly. She stated that he got x-rays, ct scans, meds, great treatment and then stated that she feels they were treated differently in the end because they did not have insurance. She should call Michael Moore and see what response she gets.

[ditto]

Thank you everyone! Forgot to mention ER covered under vehicle policy. It was transfer to other Dr. that no medical insurance came in. Had Dr. even answered the simple question of how many times the bones were broken, the very same question his wife had just asked, and in a less negative manner his patient would have perhaps had confidence that he mattered to the Dr. You can't have trust where there is no communication or ability to learn what is your right to know. Failing to mention the possible cancer or inform his colleague of the threat to his patient was a lapse. Failing to communicate with a patient or the caregiver he would rely on for the next 4 weeks in regards to care or warning signs wasn't a good idea either.

I had already found a focus for addressing this early this evening. If rules and regs don't provide minimum safeguards in given circumstances then I need to address them at that angle. Better protection for both patient and Dr.! Who knows maybe one day less lawsuits=more affordable health care?

[LAWMED]

Failure to communicate with patients is the number one factor common to all malpractice lawsuits. Most are filed to get answers previously refused or because a lack of communication leads to a feeling of a "coverup". When will physicians learn?

I imagine that the "possible" cancer diagnosis came from common language used by radiologists when reading x-rays and MRI's saying "cannot rule out xyz, clinical correlation recommended" or "further evaluation recommended" etc. Often this is a CYA inclusion and the treating physician more often than not rules out the "cannot rule out" diagnosis and the patient never hears of it. If there were old chest x-rays on file, or based on the current studies AND the history given of a previous (TB) finding years ago, this may have been enough to rule out a cancer diagnosis in the physicians mind. A cancerous lesion on the lung is very fast spreading generally so a previous finding with no change can be diagnostic.