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Malpractice and/or theft?

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bcubed

Member
What is the name of your state (only U.S. law)? Pennsylvania

In the course of filing a petition to expunge a civil commitment under 7302 of the mental health code (of which I've posted before and won't here), I found that the ER admitting doctor gave an opinion that clearly shows he failed to consult my medical record before shunting me off to the psych ward.

The details are: had a hypoxemia diagnosis on 12/15 (pulmonologist at same hospital), along with a Rx for oxygen. Presented self at 1/20 with symptoms of: 1. shortness of breath 2. insomnia due to 1 3. tingling and vertigo in conjunction with sleep loss. I pointed out to him that, unlike when he saw me 2 years ago, I now had a valid diagnosis of hypoxemia on file in my medical record.

He declined to admit me and noted on the record, "Patient presents himself every so often complaining of sleep difficulties. Patient has been worked up numerous times, all of which have been unremarkable." That portion of the medical record, coupled with no mention of my new hypoxemia diagnosis, makes it clear that he neglected to check facts, yet represented as if he had done a normally-thorough job. His decision was cited by psychiatric staff in their decision to seek committment.

1. Is the neglect to "check the record" here malpractice?

2. Considering that he "went through the motions," yet represented (and billed) as if he had a regularly-through job, does this also constitute "theft by misrepresentation," considering that a half-hearted version of his job has a lower economic value--similar to passing off Thunderbird as Dom Perignon?
 


lya

Senior Member
Nothing seems to have been done wrong. You do frequently seek medical treatment for shortness of breath and it doesn't matter that you were given an Rx for oxygen. 2 liters per nasal prongs, right? simply a comfort measure.

Panic attacks, emotional problems, and metal problems can manifest as shortness of breath. It does not indicate a respiratory ailment or disease.

I don't know about comparing a cheap wine to champagne...
 

bcubed

Member
I appreciate that you feel I've been treated adequately. I'm taking the (expungement) matter to court, so I'll sink or swim on the strength of my arguments.

I don't intend to seek criminal charges against the MD in question; I'm asking--in a general way--if an MD, doing a substandard job in a way that is not readily apparent, then representing (and billing) for "usual and customary" is guilty of theft. My ECON prof would say "substitution of an inferior good"; I wouldn't pay for a "Kobe beef" dinner that was horsemeat, and odometer rollback is illegal. All three are cases of serruptitiously substituting a good/service--does it follow that all three are theft?
 

lealea1005

Senior Member
"Good service" in whose opinion?

The Physician's documentation of his/her examination/treatment must match the procedure code entered to generate the fee. The evaluation and management services guidlines are very specific.

In addition, you sought medical treatment at an Emergency Room which increases the intensity and cost of the services you received.
 

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