Inappropriate handling at the hospital

[dncr]

What is the name of your state? California

I hope this is the right place to post this! This incident happened last October and I should have done something then, but I just haven't.

Husband has a history of kidney stones and gout (related) and diabetes. We had recently moved, our general practitioner had retired and we didn't have a replacement yet but had decided to leave the medical group we were using (we'll say UC Doofus to protect the...well, them) and find a private practice doctor. We have insurance, a PPO which allows us to be seen by anybody at any time.

One night we have to go to the emergency room at the local private hospital for a kidney stone attack. Typical wait, get into a room, get put on an IV for pain, blah blah blah. They move us out into the hall (by the ambulance bay door on a cold night...we won't even get into all the examples of bad service we received), do a CT scan, etc. They have us in the hall for five hours (in addition to the 5 hours we had spent in the waiting room and exam room), then at 5am the doctor informed us that they had to transfer us to the UC Doofus med center. We assumed this was so that they could perform a lithotripsy on the very large kidney stone, and having been up all night weren't of sufficient mind to question it.

At this point, I went home to try to get some sleep and my husband was transported via ambulance to UC Doofus. There he is put at the end of the waiting room waiting list just like any other patient coming in the door. After another three hours, an intern takes a brief look at his chart, presented him to the urology staff, then sent him home with a prescription for pain meds, claiming that being diabetic he was too high of a risk for lithotripsy.

1. We found out later that the ONLY reason he was transported to UC Doofus was because our last doctor (whom we hadn't seen since he retired) was in that medical group. This was not explained to us, and as I said we were up all night and to tired to suspect that we needed to question being moved to another hospital.

2. We found out from his urologist, who we hired and saw the next day, that the whole thing was ridiculous. No reason to move him, no reason not to do the lithotripsy.

3. We were charged for the ambulance ride and emergency room visits for both hospitals (including the second one where they essentially did nothing).

Do we have any legal recourse here? I feel the original hospital should have to reimburse us for the ambulance ride and the second emergency visit as it was entirely superfluous and they didn't explain why they were moving us. Thank you for reading this extremely long post!

 

[purple2]

at 5am the doctor informed us that they had to transfer us to the UC Doofus med center. We assumed this was so that they could perform a lithotripsy on the very large kidney stone, and having been up all night weren't of sufficient mind to question it…We found out later that the ONLY reason he was transported to UC Doofus was because our last doctor (whom we hadn't seen since he retired) was in that medical group. This was not explained to us, and as I said we were up all night and to tired to suspect that we needed to question being moved to another hospital.

No doubt your spouse signed a form to consent to the transfer. The form definitely should have stated what the reason for your transfer was. This is very important—what was the reason listed on the form? How did you come to “find out” that he was transferred was due to the physician’s preference?

After another three hours, an intern takes a brief look at his chart, presented him to the urology staff, then sent him home with a prescription for pain meds, claiming that being diabetic he was too high of a risk for lithotripsy… We found out from his urologist, who we hired and saw the next day, that the whole thing was ridiculous. No reason to move him, no reason not to do the lithotripsy.

This may very well represent differences in medical opinions, not malpractice, if that’s what you’re thinking. No one could tell you for certain without professional review of the medical record.

We were charged for the ambulance ride and emergency room visits for both hospitals (including the second one where they essentially did nothing)… I feel the original hospital should have to reimburse us for the ambulance ride and the second emergency visit as it was entirely superfluous and they didn't explain why they were moving us.

Pay whatever you are billed in order to protect your credit rating. If you decide to sue or negotiate a discount on these services at a later time, you can do that. (I'm not saying you have a case here, I'm just saying the monetary issues can be worked out later. Don't delay payment and ruin your credit because you dispute how your spouse's care was handled.)

Do we have any legal recourse?

Possibly. Depends on what the form said.

 

[dncr]

Thank you so much for your reply!

I'll have to call the hospital and get them to send me a copy of the form. I forget how we found out why he was transferred...I think the urologist may have told us from the hospital records or something. The hospital we were at first is fully capable of performing a lithotripsy, so there really was no other reason. Are we out of luck regardless, because we signed?

I wasn't at all thinking of malpractice, I just didn't know where else to put this question! We paid the bills, I just don't think should have to because we shouldn't have been transferred.

 

[purple2]

Some hospitals give copies of the forms to the patient at the time they are signed. I thought you might have one. The form would provide documentation as to what reason you were given for the transfer.

Let me preface all of this by saying that I am a healthcare administration/regulatory compliance professional, not an attorney. Therefore, I will not advise you on the feasibility of suing the doctor or hospitals involved.

What I can tell you is there are regulations/laws that prevent transferring patients in certain circumstances, and there are penalties to punish hospitals that violate them. One that comes to mind is the Emergency Medical Treatment and Active Labor Act (EMTALA); it prevents hospitals from transferring patients with emergency medical conditions before they are stabilized. It sounds like your husband may have been considered stabilized before transfer. Transfers from an ER to a different hospital just because of a physician's preference are inappropriate. Without reviewing your record, no one can properly advise you as to whether or not the law was violated.

I guess you'd need to decide what outcome you're looking for out of all of this. If an attorney advises you that you have a case to sue the providers, and that's what you want to do, then follow whatever advice you’re given, and don’t act on your own. If you are looking to have the authorities investigate the hospital for inappropriate transfers, then you could report it as a potential EMTALA violation. A lawsuit and reporting an EMTALA violation are 2 separate things.

OTOH, if you’re looking only to be reimbursed for the ambulance ride from the first hospital to the second, that’s a different story entirely. It’s very unlikely the hospital would reimburse you for that without suing them.

 

[dncr]

Thank you so much for all of the information; you've given me a lot to go on. I do want to find (or get) a copy of the transfer paperwork to find out for absolute sure, then I'll contact a lawyer. Maybe with a letter from a lawyer I won't have to sue them!