VA and Tricare at fault?

[madveteran]

My wife and I are Disabled Veterans in the state of Texas. We both get our care from the local VA, and my wife is also medically retired so we also get Tricare outside of the VA.

We have 2 children already but we were trying for more, my wife has had 3 miscarriages and to prevent further she went to the VA and talked to a doctor who said she needed to try a medication to prevent future miscarriages, this was a few months back. Now fast forward to 3 weeks ago she found out she was pregnant yay!! so she wanted to go in to the VA and get the medication, but was told no, and that the medication had to be prescribed by an OB doctor, which the VA doesn't have. Pretty much was given the run around and low and behold we end up in the local ER and my wife miscarries. Now we come to find out that things weren't done in a timely matter (my wife stressed importance but no one seemed to care) and we find out that the VA has the medication in the pharmacy and is able to be prescribed by many people in the VA. My question is what recourse do we have legally against the VA and Tricare? because of the inability of them to help us and or the fact that they straight up ignored our situation pretty much guaranteed the fact that my wife would miscarry again.

How can 1 VA doctor say that she needs a medication and then another says she can't get it?!?! im just really mad and want someone to pay for them ignoring us.

madveteran

 

[FlyingRon]

In a word, no. You've lost me. Why wasn't your wife under the care of a OB? TRICARE covers this even though the VA doesn't have them.
You've left out details. What things not done in a timely manner? Why should a physician who is not qualified in obstetrics prescribe whatever drug you think would have made a difference here. Ante-natal drugs are problematic and anti-miscarriage drugs have an even worse history.

 

[ecmst12]

It is very likely that the medication would not have prevented the miscarriage. Your wife needs further testing to attempt to find out the cause. VA and tricare may not cover this testing, but if you're serious about getting a healthy pregnancy, it's worth it.

 

[madveteran]

Tricare was involved but didn't feel the need to expedite anything, and to see an OB we still need a referral from Tricare it still needs to be approved cause we can't just go and see any OB. The drug in question is Progesterone, which has shown results in preventing miscarriages. The test for this is taking blood and analyzing the levels in the body. If the level is below 13 then the drug can help a lot, my wife's level was 5 way below the number needed to have the Rx.

The doctor that said the medication would be needed was from a Perinatal Specialist that my wife had seen and was a referral FROM Tricare, so knowledge and records were formed from this appointment.

The labs that were asked to be express were not done as such.

I know things might be missing and I can update as needed but I still feel that they are at least responsible and the way they handled it was questionable

 

[OHRoadwarrior]

As other Vets, you may not be able to receive all the benefits you wish from the VA free and her miscarriage is a long step from that. See a local Med Mal lawyer to see if he feels there is a case to take on the money of uncle sugar in Federal court.

 

[ecmst12]

That medication is fairly cheap, you could have just paid for it out of pocket. But there's a lot of controversy over whether low progesterone is a cause of miscarriage or a symptom of a non-viable pregnancy; you can't be sure that the pregnancy would have been saved even if she'd had the medication.

 

[FlyingRon]

That medication is fairly cheap, you could have just paid for it out of pocket. But there's a lot of controversy over whether low progesterone is a cause of miscarriage or a symptom of a non-viable pregnancy; you can't be sure that the pregnancy would have been saved even if she'd had the medication.

She can't just write herself a prescription. What she needed to do is get to a proper prenatal care provider who could evaluate what the correct course of action she was in. Unless she's the one in the service or in TRICARE PRIME she doesn't even need a referral. Even if she needed a referral, theres no requirement that she see the VA. She should have called the TRICARE regional to get it. I've never heard of a PCM not providing a referral for antenatal services. It's routine. It's certainly not the VA or TRICAREs fault.

 

[CJane]

I'm trying to figure out why, after several miscarriages, she's not under the care of an OB while attempting to get pregnant.

 

[OHRoadwarrior]

Because this is about a lawsuit and money, not another miscarriage.

 

[RRevak]

Because this is about a lawsuit and money, not another miscarriage.

Or because they don't have the finances for an OB?

 

[FlyingRon]

Or because they don't have the finances for an OB?

That's neither VA nor TRICARE's fault.

 

[OHRoadwarrior]

Having children you cannot afford, especially ones that you know are in the high risk category, is your own decision and fault, not everyone elses financially.