Is this a case of medical negligence? Acute renal failure requiring dialysis

[Oubliette331]

I don’t know why you get the impression that I don’t take this whole ordeal very seriously. My issue is that the hospital didn’t take it seriously enough.

 

[ecmst12]

You misunderstand the ER's obligation. All they have to do is make sure she's stable. I am certain that her discharge instructions included following up with her PCP - If she chose not to find one and make an appointment, that's on her. The hospital has no obligation to find her a doctor or make sure that she follows up.

 

[justalayman]

To clarify for the above poster, she is not addicted to heroin or opiates. She is not physically dependent on narcotics. She does have depression and often self medicates, usually with alcohol. In this incident, she was discovered by her roommate unresponsive in bed and told the Hospital that she had taken alcohol, Xanax, cocaine, and heroin (noted in her record). The Hospital assumed she was a heroin addict and diagnosed it as an “intentional heroin overdose.” Despite labeling it as intentional, they did no psych evaluation to find out whether she was suicidal or a danger to herself and offered no mental health or rehab resources, which I believe they ususally would in that kind of situation. They didn’t run a toxicology to find out what levels of what substances were in her system at a toxic level.

The medical record includes zero commentary or diagnosis for the blood results which included abnormal levels for WBC, HGB, HCT, RDW, GRANULOCYTES, IMM GRAN, LYMPHS, ABS NRBC, and ABSOLUTE GRAN. Plus low CO2, high glucose, high creatinine, and low GFRE. No toxicology, no urinalysis. Additional lab tests had been ordered but were cancelled before the results came back after they discharged her. She doesn’t have a primary care physician. We were told by another doctor at the hospital that they are supposed to provide a contact for an on-call hospital doctor for follow up care in that situation. The discharge instructions actually have “fill in the blank” sections where the physicians names are supposed to be and were left blank. They didn’t explain her lab results to her, didn’t inform her of any symptoms which should warrant a return to the ER or possible complications that could develop.

a person that takes cocain AND heroin is not a newbie to the game.

I’ve been told by more than one heroin user that you are addicted upon first use. The comfort it provided was simply irresistible

And I see you’ve obtained all of her medical records. Now get on the phone and crack open your wallet and find a lawyer that’s interested. You said why her discharge papers didn’t say but did they say; follow up with concerns and questions with your physicisian.

And then have her sign it?


And again, failing to follow their standard protocol does not make malpractice.

 

[Oubliette331]

How can they make sure she is stable if they don’t order standard tests like toxicology and urinalysis? They can’t even make a definitive diagnosis without those results. There were a total of 13 flagged items on her blood and plasma lab results. They didn’t address or explain that neither to her or in the medical record. The discharge instructions stated “Follow up with your physician ____ in 2-5 days. If you don’t have a physician please call the following on-call doctor for follow up care:____.” There were blanks where contact info was supposed to be filled in. They didn’t explain any risks, complications, or symptoms to watch out for and seek medical attention if experiencing, especially considering her blood results and vitals were all messed up.
And if they diagnosed it as an intentional overdose, then they definitely should have done a psych evaluation with a mobile crisis worker before deciding if she was “stable.”

 

[justalayman]

But I was stating that she is not PHYSICALLY DEPENDANT on heroin and that a small amount was ingested and not by IV,

Yet she required narcan

It doesn’t require talking heroin IV to be considered an addict

The fact she doesn’t typcislly take enough to overdose doesn’t mean she isn’t an addict


So, you’re taking this very seriously.

Have you got her into a rehab?

Have you found drug counseling

Mental health counseling?

I hope you have because if you are taking this seriously, you know that is what she needs b

 

[Just Blue]

How can they make sure she is stable if they don’t order standard tests like toxicology and urinalysis? They can’t even make a definitive diagnosis without those results. There were a total of 13 flagged items on her blood and plasma lab results. They didn’t address or explain that neither to her or in the medical record. The discharge instructions stated “Follow up with your physician ____ in 2-5 days. If you don’t have a physician please call the following on-call doctor for follow up care:____.” There were blanks where contact info was supposed to be filled in. They didn’t explain any risks, complications, or symptoms to watch out for and seek medical attention if experiencing, especially considering her blood results and vitals were all messed up.
And if they diagnosed it as an intentional overdose, then they definitely should have done a psych evaluation with a mobile crisis worker before deciding if she was “stable.”

take it to a MED/MAL Attorney.

 

[justalayman]

How can they make sure she is stable if they don’t order standard tests like toxicology and urinalysis? They can’t even make a definitive diagnosis without those results. There were a total of 13 flagged items on her blood and plasma lab results. They didn’t address or explain that neither to her or in the medical record. The discharge instructions stated “Follow up with your physician ____ in 2-5 days. If you don’t have a physician please call the following on-call doctor for follow up care:____.” There were blanks where contact info was supposed to be filled in. They didn’t explain any risks, complications, or symptoms to watch out for and seek medical attention if experiencing, especially considering her blood results and vitals were all messed up.
And if they diagnosed it as an intentional overdose, then they definitely should have done a psych evaluation with a mobile crisis worker before deciding if she was “stable.”

They observed her for how many hours?

So, how do you determine if they are stable?

You observe them and check their vitals long enough to see they have settled at a normal or near normal status (become stable).

If they aren’t getting worse, they’re stable.

If the flagged results aren’t dealing with her current issue, they are disregarded for the time being. They aren’t there to make sure she has good cholesterol numbers unless high cholesterol will affect stabilizing her.

How could they tell her what doctor to call? Are you suggesting there is but one doctor that worked 24/7 they would receive the call?

And again; since you already have ALL of her records, take them and your wallet (for the review of the records by a medical pro) to a lawyer and see if she has a case.

 

[Oubliette331]

K. For one, you can’t force an adult into rehab or counseling. Nor can you enter a rehab whilst needing dialysis three times a week. Two, I would not be obtaining a lawyer as it is her situation and most lawyers don’t require upfront fees for a consult.
Next, you really don’t understand the whole bit about physical opiate addiction.Narcan reverses any opiate overdose in any person, addicted or not.
The test results were things that could indicate poor kidney function. Organ failure is a possible complication of drug overdose. Without knowing what drugs were in her system and at what levels they had no way of evaluating what type of danger she might still be in.
And yes they actually are obligated to give her the phone number of the on-call doctor for a follow up if that’s who they instruct her to see. That’s literally her only way of knowing who to contact.

 

[quincy]

K. For one, you can’t force an adult into rehab or counseling. Nor can you enter a rehab whilst needing dialysis three times a week. Two, I would not be obtaining a lawyer as it is her situation and most lawyers don’t require upfront fees for a consult.
Next, you really don’t understand the whole bit about physical opiate addiction.Narcan reverses any opiate overdose in any person, addicted or not.
The test results were things that could indicate poor kidney function. Organ failure is a possible complication of drug overdose. Without knowing what drugs were in her system and at what levels they had no way of evaluating what type of danger she might still be in.
And yes they actually are obligated to give her the phone number of the on-call doctor for a follow up if that’s who they instruct her to see. That’s literally her only way of knowing who to contact.

I am curious. Were you with her at the ER?

If not, there is no way you can know what the ER told her or, importantly, what she told the ER.

It is possible that the discharge instructions lacked necessary information. It is possible that the care and treatment your sister received at the ER was substandard. There are many possibilities.

YOU are not a doctor and nor are any of us. YOU have limits on what you can do for your adult sibling. WE have limits on what we can do for you.

The best WE can do for YOU is to advise you to tell your sister to seek legal assistance in her area for a personal review. The best YOU can do for HER is to pass this advice on and encourage her to seek medical help for a depression that is severe enough that she is dangerously self-medicating.

Good luck.

 

[LdiJ]

I don’t know why you get the impression that I don’t take this whole ordeal very seriously. My issue is that the hospital didn’t take it seriously enough.

I really do feel that your sister needs a consult with a medical malpractice attorney, perhaps with another family member present to ensure that the attorney gets the full story.

No one here has enough experience to give you anything more than their personal opinion and you need more than that.

 

[justalayman]

K. For one, you canÂ’t force an adult into rehab or counseling. Nor can you enter a rehab whilst needing dialysis three times a week. Two, I would not be obtaining a lawyer as it is her situation and most lawyers donÂ’t require upfront fees for a consult.
Next, you really donÂ’t understand the whole bit about physical opiate addiction.Narcan reverses any opiate overdose in any person, addicted or not.
The test results were things that could indicate poor kidney function. Organ failure is a possible complication of drug overdose. Without knowing what drugs were in her system and at what levels they had no way of evaluating what type of danger she might still be in.
And yes they actually are obligated to give her the phone number of the on-call doctor for a follow up if thatÂ’s who they instruct her to see. ThatÂ’s literally her only way of knowing who to contact.

How do they know who will be on call so they can provide the correct phone number. But since they didn’t instruct her to see the on call doctor (whoever that poor would that works 24/7 may be) so they didn’t have to provide a phone number, right?

If they hit her twice with narcan, she was in an overdose situation. But that has nothing to do with addiction.

Most medmsl lawyers do require you to pay the fee the medidcsl pro charges to review the file. The lawyer is not qualified to determine whether it’s malpractice so they hire somebody that is. That is almost always an up front fee.


The rest;

All I see is a bunch of excuses of why you can’t help her. All of a sudden it didn’t sound like your very serious about your sister health but quote serious of whether ther is financial gain to be made.

 

[Oubliette331]

It’s not that complicated, whoever is on call at the time takes the call to see the patient. Or they schedule your appointment upon discharge.
My sister’s treatment and recovery and whether the hospital was negligent are two entirely different topics, one of which isn’t really up for discussion here. It’s not about financial gain. It’s about my sister could have died and is still in serious trouble. It’s aboht the tendency to dismiss anyone viewed as a “junkie” and not prioritize their health as you would any other patient due to personal bias. A demographic of people with the least amount of resources as it is and not in the position to advocate for themselves or seek recourse when neglected or harmed.

 

[justalayman]

It’s not that complicated, whoever is on call at the time takes the call to see the patient. Or they schedule your appointment upon discharge.
My sister’s treatment and recovery and whether the hospital was negligent are two entirely different topics, one of which isn’t really up for discussion here. It’s not about financial gain. It’s about my sister could have died and is still in serious trouble. It’s aboht the tendency to dismiss anyone viewed as a “junkie” and not prioritize their health as you would any other patient due to personal bias. A demographic of people with the least amount of resources as it is and not in the position to advocate for themselves or seek recourse when neglected or harmed.

Well, if it’s not about the money you should just stop now since that is the only thing the medical providers would be required to go do is pay your sister.

But you cannot collect for: could have or might have.

But again, they do not have to give her phone numbers. That is not a legal obligation.


It’s obvious you have no idea what an emergency medical provider is obligated to do. since you don’t want to listen to anybody here i suggest you research the acronym: EMTALA

It is not unlawful to treat what is believed to be a junkie different than the state governor. It just isn’t. The law obligates an emergency services provider to triage and stabilize a patient after which they can arrange transport to another provider (if more treatment is needed) or simply discharge them of they no longer require immediate treatment. After that they can boot them out the door. (This generally does not apply to a state operated hospital)

But again, have your sister take her medical records to an attorney for review. Do not be surprised if they want some money to pay the person they hire to actually review those records. If the lawyer believes there is a worthwhile case they may roll that into the costs of the suit and not charge her upfront.

 

[quincy]

It’s not that complicated, whoever is on call at the time takes the call to see the patient. Or they schedule your appointment upon discharge.
My sister’s treatment and recovery and whether the hospital was negligent are two entirely different topics, one of which isn’t really up for discussion here. It’s not about financial gain. It’s about my sister could have died and is still in serious trouble. It’s aboht the tendency to dismiss anyone viewed as a “junkie” and not prioritize their health as you would any other patient due to personal bias. A demographic of people with the least amount of resources as it is and not in the position to advocate for themselves or seek recourse when neglected or harmed.

Your sister is lucky to have a caring sibling.

And I agree with you that those who use or abuse drugs can be viewed, and treated, differently by people.

That said, however, an ER is not obligated to provide continuing care to anyone. Those who arrive with signs of a heart attack and those who arrive with a drug overdose will both be evaluated and stabilized. The ER is for these types of emergencies.

An ER will not recommend admission to the hospital without a medical reason (e.g., a need for more testing and treatment is indicated). But often, once a patient is evaluated, treated and observed (a gash to a leg stitched, a stomach pumped), the patient will be released. The emergency that brought them to the ER is no longer an emergency. The patient needs to seek continued non-emergency care from their own personal physician.

I am not sure what else you are looking for from us. An argument about drug users?

Encourage your sister to see an attorney for a personal review of her ER treatment. Encourage your sister to find a doctor to treat her depression.

Good luck.

 

[Gail in Georgia]

The test results were things that could indicate poor kidney function.


A creatinine of 1.3 with the "normal" range being no higher than 1.1 is not an indication of poor kidney function. It may reflect nothing more than dehydration at the time of the blood draw.

Stop assuming that the ER failing to assess your sister needing future dialysis is an indication of malpractice.

Hopefully her need for dialysis will be short term and kidney function will improve. That is, if she discontinues her use of street drugs.

Gail