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MJDavis

Junior Member
What is the name of your state? Pennsylvania

Hello. I was hoping that someone would be able to advise me. ***Warning***This is a long post with a thourough explaination.

I live in PA and the situation occurred in PA. September of 2000 I underwent abdominal wall reconstruction and hernia repair with a certified plastic surgeon. This procedure was approved by my insurance and covered. Still, the doctor and his wife, his office manager, explained to me that there was an extra 'surgeon fee' of $3000. I had to pay upfront because the insurance required it as they didn't pay that portion.
So I paid and had the surgery.
There were complications.
I spent most of 3 months hospitalized undergoing various surgeries and treatments.
When the infection first started his office just let me go because he was vacationing in CA according to them and they said that no other surgeon would be willing to do anything. By the time he returned I could fit most of my hand into my incision that had opened. The dr admitted me for surgery the day he came back.
During this time things were mentally and physically aweful for me. At the time I had 2 children under 3 and my husband was working full time.
At one point, I still needed an IV but the insurance would not cover me being hospitalized for any longer so I was admitted to a nursing home for care.

After all was said and done the dr told me to expect a full heal in about 2 years. Funny way to get around the 2 yr stat of limitations, huh? Well, I have been having complications since. I didn't realize the full impact until the past 1-2 yrs though.
I had decided to have my tubes tied because it was advised not to become pregnant again due to my past surgery/complications.
Well, I signed the papers at my ob/gyn for release of medical records and try as they might the dr's office never got the original reports to them so they refused to do the surgery. The surgeon only sent them very limited or notes on the follow up surgeries.
Of course in the course of all of this I ended up having 2 more children. In desperation, I found another ob/gyn who immediately after my last child would attempt the surgery without the inital reports. Well, after undergoing 'surgery' the ob could not even get through to my reproductive organs so nothing was done and he ordered a CAT scan. After showing me the results you can see that my intestines were relocated at some point and placed over those organs, etc. He said further surgery would be highly life threatening.
This set of final events occurred Dec 2003.

Since my original surgery I have had complications. I can go on to list them but this is a lenghty post to start with. Nothing can be done save more surgery. I approached the surgeon with my complaints and he wanted to 'redo' the surgery at full cost to myself.
I said 'no'.
Due to all of this and the complications I frequently get ill which has caused significant problems with my employer.

Just recently, I ran into an old acquaintence who shockingly enough, shared about the same horror story with me. I thought something like this should be rare. She has the same insurance co. as I had at the time and she said that according to what the co. told her the dr had no right to charge the extra fee and they were going to be investigating into that.
So basically, I was also ripped off for this mess.

In keeping with the discoverence of fact they have in PA does this seem like anything I can persue? Truthfully, I do not have the money to go from lawyer to lawyer paying consult fees to see where I stand. I would just like my $3,000. back and to make sure this dr doesn't continue to do this to other unsuspecting people.
My life and how I am able to work and support my family and even interact with them because certain pain limits things at times is permanently changed.

Thanks,
Melissa
 


J

joeyblow

Guest
1. Malpractice

The complication you suffered may have been the result of malpractice or just bad luck. Your records require medical review to make this determination. You do not have to "go from lawyer to lawyer paying consult fees". A malpractice attorney will consult with you for free and arrange expert review if your case has legal merit.


2. Extra fees

The surgeon can charge you whatever he wants unless he is contracted with your insurer.
 

MJDavis

Junior Member
Thanks for the response.
Yeah, he was contracted with the insurance co. They were the ones who informed my associate that he has been taking money from pts that was already paid for by the insurance co and that he was not reporting it for taxes. They want me to fax my receipts from him tonight so they can review them.

Thanks again
 

vrzirn

Senior Member
Unfortunately, the complications you describe are enumerated in your consent for surgery.
Playing devil's advocate for a moment I will say the initial procedure, as you described it, is usually performed by a general surgeon. The fact you had it done by a plastic surgeon strongly suggests "tummy tuck"(a cosmetic surgery) and he threw in the hernia repair so insurance will cover a portion of your bill.
You may or may not have a case. Have an attorney look over the files. It could be that adhesions are causing many of your complications. I doubt he "rearranged "your organs.
Whether the doctor paid taxes or not is another issue entirely.
The surgeon did not make you pregnant-twice! You and your husband conceived those extra kids. Having children sure pushes your insides around.
 
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