First...we kill all the surgeons

The BBQ Pit
1

This is a bit of a rant, mixed with a plea for some legal guidance.

My Great Aunt (who really IS a great aunt) has a horrible back, worse than mine. It runs in the family, you see, bad, brittle backs. And she’s had well nigh to five surgeries trying to correct it. Five years ago, she had surgery in Syracuse, New York, a procedure she’d had before to reinforce the discs or whatever.

It didn’t work. And in fact, as months passed, even with physical therapy, her back got worse and worse. Now, she’s an oldish woman for back surgery, and very overweight. So each time she decides to have surgery, its sort of a battle among doctors and her and her insurance and whatever.

So, her back got worse and worse and she finally found a specialist here in Chicago who decided to do surgery to implant a rod in her back. Fine! Great!

He got her into surgery, opened her up, and what did he find? A FOUR INCH CATHETER TUBE that had been left inside her from the previous surgery four years ago! It had attached itself to her spinal column, there were tumors growing on it that were putting pressure on her spinal cord and discs…it was infected and pus filled and gross.

Anyway, the surgeon promptly removed it, treated her for the infection, and a week later did the rod surgery…which also didn’t alleviate her pain.

And so she’s suing the tube doctor for malpractice. NOT, I repeat, NOT because her back doesn’t feel better, but because he left a mother fucking TUBE INSIDE HER BODY.

And here’s the kicker. The surgeon who removed the tube has been advised by HIS lawyer…not to provide information. The surgeon who probably saved her life by removing a tumored, infected tube will not even say in writing that he did it.

So essentially, my aunt has no record or proof that it ever happened because her doctor won’t say that it did because he’s afraid of being a part of the lawsuit because her back still doesn’t feel better.

JESUS CHRIST MY MAN! This isn’t about you! We’re trying to paint you as the fucking hero. And can’t we take anyone at their word anymore? She said she wouldn’t sue you. And now you’re going to let her lawsuit be dropped because you and your fucking lawyer are scared?

And what is the point of having a lawyer on your side if he can’t do anything for you? Can’t my aunt’s lawyer FORCE him to release the records? How can he do this to her?

I can’t fucking believe this story. She’s going to drop the lawsuit (which isn’t an outrageous $5 billion pain and suffering thing, just medical expenses and travel and all that shit) because of this pussy chicago surgeon.

You fucking jerkass coward. Tell the truth!

jar

2

Welcome to a hyper-litigious society.

3

And what would happen if your aunt did decide to sue Dr. Chicago? Could he keep all the records of the surgery a friggin secret? I damn well hope not.

4

I can’t believe the second doctor’s findings would be covered by doctor-patient confidentiality, given that the patient WANTS him to tell the judge what he found. Shouldn’t she be able to subpoena the records?

5

They have done that. He never seems to be in his office, he always promises to “get them right to her”. He says he’s misplaced them, he asks for a time extension. She’s been trying to get them for months.

grrr

6

IANAD or lawyer but it seems like she could:

  1. sue the doctor that removed the catheter for unnecessary surgery to make him prove that he did indeed necessarily remove a forgotton tube.

  2. drop that suit once the evidence is made public, and

  3. petition that evidence in a suit against Dr. Forgetful.

But regardless, the second doc is a spineless bastard.

7

[sub] Holy shit-in-a-bucket[/sub]

Was it Mr Chicago-surgeon who told your aunt that he’d removed the tube? (I assume it was). If someone asked him (in writing or not) whether he’d removed the tube, would he deny it completely (i.e. lie)?

What about other people who were present at the op (attending nurse, guy-with-the-gas (I can’t spell anaethesiologigigist) etc)?

Does the hospital have a position on this? Were there notes taken? Can they be released?

Holy-moly.

8

jarbabyj -

IANAL nor an expert, but I’ve had a sad amount of experience with malpractice suits.

Yes, quite often, physicians WILL NOT give any information whatsoever if they can possibly avoid doing so. After my mother’s surgeon fucked up her spinal cord while doing a procedure that he’d read about in a magazine :eek: (not to mention a fair number of other egregious mistakes we found in the opnotes), we had to travel to California to find a neurosurgeon who was willing to testify as an expert witness. Every local surgeon we found would agree in private that she’d been royally screwed; not one of the monkey-licking fucknuggets would speak publicly.

Get your aunt’s records from the hospital, if you’ve not done so already. Quite often they contain a copy of the opnotes. Ditto with the anesthesiologist - they are required to keep their own notes, plus they often use surgery notes for billing. Call the insurance company - if he filed charges for ANY EXTRA WORK OR UNUSUAL CIRCUMSTANCES (say, removing a tube that shouldn’t be there), they will have required a copy of the opnotes prior to payment. Don’t buy this “I don’t have a copy” crap - opnotes are not something that just get lost.

Talk to her lawyer. If she doesn’t have a good lawyer who’s willing to get things done, find a new one.

If the surgeon won’t give her copies of ALL her medical records, get a subpoena. She is legally entitled to that information and he has to provide it. If he tries to duck, get him subpoenaed for a deposition. You’re sworn for a deposition just like you are in court and can be legally liable for what you state therein. Goes back to a good lawyer - a good attorney can make him admit much more than he wants to by carefully worded questions. Depose the nurses, anesthesiologist, OR staff, recovery staff, etc. etc. etc. Talk to everyone you can think of, and consider a subpoena & deposition for anyone that logically should have known about the incident. Don’t forget gossip: hospitals are gossip-havens. You can’t use gossip in court, but it can be a good place to find out who did witness this.

Quite often, other staff (nurses, aides, etc.) are much more willing to talk. They don’t have the protection of the PHYSICIAN COMPACT OF SILENCE, so they’re much more willing to speak up, especially for something this bad. Don’t forget those subpoenas - a lot of people may want to talk, but are unwilling for fear of consequences. If they’ve been subpoenaed, they have an excuse to help keep them out of trouble - “I didn’t have a choice!”. Not to mention there is a vast difference in most folks’ minds between “I’ll keep quiet and hope no one asks” and “I’ll lie to cover for someone else”.

My sympathies for y’all’s problems. Good luck and remember: Illegitimis non carborundum!

9

Wow, redtail, for a non-expert, you kick ass. You even got some latin in there! Woo-hoo!

Best wishes to your Aunt, Jarbabyj.

10

Just thought of something else on this - find out what PROCEDURE CODING he billed for. This is a special language used between docs, insurance companies, and the gov’t to make computer billing possible. What you need are the CPT codes AND modifiers, plus the ICD9 codes. Get copies of detailed statements from everyone that billed anything, plus detailed statements from the insurance company as to what they were billed for. Get details from the hospital, too. (Hospital codes are often called DRG codes, too.) It’s amazing what you can find by going through those 30-page billings.

For instance, if the doc billed a modifier 22 on his claim to the insurance company, that would indicate “Unusual Procedural Services”. Not only will the ins.co. have required opnotes, but you can ask him (in deposition) just exactly what was unusual. A modifier 59 indicates a distinctly separate procedure, if he billed something extra for the removal. On the anesthesiologist’s bills, a modifier 23 would indicate unusual circumstances for the anesthesia. So on and et cetera.

Docs may not be willing to talk to you, but they’re amazingly often willing to bill for the services they won’t talk about. :wink:

Don’t forget to get all the records from all the same sorts of people for the previous surgery. Again, it’s amazing what another doc can get from the surgery notes, as far as what was and wasn’t done properly in a procedure.

Anyone familiar with medical billing can read the bill codes for you - they’re standard nationwide (with a few items that vary state-to-state and company-to-company).

I’ll try to check back later & see if I’ve made sense or if you need a translation. Hope this helps!

Yondan - not only have I been intimately involved in a nasty, multi-physician malpractice suit, but I’ve spent the last ten years working for physicians doing medical billing! :eek: Scares me just to think about it! (But you do know that’s not really Latin, don’t you?)

11

As already mentioned you need to put the screws to Chicago Doc. IANAL but my dad is and I know he would have been all over Chicago Doc. He would have politely asked once and at the first sign of foot dragging the doctor would have found every legal tool on the book thrown at him on the spot. I say that my dad would have done this with confidence because that was his modus operandi. You’d be amazed at how fast people snap-to when threatened with ungodly amounts of legal wrangling facing them. Hell, my dad would not only ask for the notes relating to your aunt’s surgery he’d ask for the last 7 years of notes (to see if there are patterns to verify the validity of the notes in question or some such bullshit). Depositions, request for financial records, request for school records…you name it. Not that all of that stuff would be useful but A) It might be…you never know; B) After all of that people tended to be a little more prompt in replies for information and C) He liked fucking with people who pissed him off.

It is one thing for doctors to be scared in this litigious society but it is quite another for a doctor to cover what was clearly a BIG mistake. I say let Chicago Doc get one in the ass…

12

It’s hard to believe that we put our lives in the hands of people like these. So afraid they will lose money, etc. that they won’t even do the decent thing. I sure hope that your aunt finds all the loopholes and takes the responsible doctor to the tables.

13

If your aunt is absolutely, positively, sure she won’t sue the doctor who removed the tube, why not have your aunt go beyond merely saying she won’t sue and sign a release agreeing not to sue him? An oral promise not to sue isn’t worth diddly-squat, and an attorney who accepted one and acted to his client’s detriment because of it would be a fool. But valid written releases are done, and relied on, all the time.

Of course, your aunt’s attorney would have to make the release contingent on turning over the medical records – no records, the release isn’t binding anymore.

14

Holy shmoley, redtail! You could be charging for this advice! (taking notes in the event of future malpractice trouble).

You know the thing that’s so odd about this is that you would think one doc would be interested, if not anxious, to get another, incompetent surgeon out of the profession. It’s not like they’re cops or something and have a loyalty issue. I think it actually would be incumbent upon the Chicago Doc to address the damage done by another doctor to the fullest extent possible, simply as an extension of his role as a healer.

[slight hijack] And no, I didn’t know it wasn’t latin, so feel free to fight my ignorance. [/slight hijack]

15

Maybe the guy could be granted immunity or something like that in exchange for his testimony/records/whatever else?

16

Hey Yondan, I wuz just teasin’ ya. It’s pseudo-Latin: AUE: FAQ excerpt: "Illegitimis non carborundum".
I don’t think y’all get it. IMO & IME, the reason this guy won’t testify is NOT because ‘his lawyer said’ or because he’s afraid he’ll get sued (unless he screwed up something outrageous as well - happened to my mom). That’s a convenient excuse. His lawyer sure as hell wouldn’t have told him to dodge giving her the records - or you can sue hell out of him too, for advising illegal activities.

It’s because he won’t get referrals from other doctors, if he pisses them off by breaking the CODE OF SILENCE. It’s because he’s afraid that, if he ever is sued for something, other docs will testify against him because he broke the CODE OF SILENCE. It’s a ‘you scratch my back, I’ll get yours’ system. It is EXACTLY like the problems that we often have with cops - professional ‘loyalty’ to peers overriding professional duty to the public.

Your best bet is to get a really good malpractice lawyer. Whack-a-Mole, your dad sounds just about right. A wee bit obnoxious, perhaps, but then, he’s a lawyer, eh? :wink: (For those that may be wondering - seven years because that is the Federal requirement for maintaining medical records. His dad made them cough up every damn record they had on that patient.)

I’m not fond of our suit-happy culture, but this sort of absolutely unacceptable medical care is a valid use of the courts. The above paragraph explains why it is necessary and, IMO, why it has become common. If there had ever been any sort of real peer review and punishment, I don’t think that malpractice suits would be so prevalent today.

ultress - the sad part is that most physicians are good, caring people who do want to help their patients. I can understand that they are human and make mistakes, even egregious ones. But the utter cowardice of their peers disgusts me profoundly.

17

<This is not advice given in my lawyerly mode–just friendly>

Not familiar w/ state law where suit is filed, but…

If suit is filed, Dr. who removed tube is a fact witness. Redtail’s right–subpoena records. In a standard subpoena you have a time in it for compliance. If he does not comply–then you can take him to court and if he doesn’t have a decent excuse the judge can hold him in contempt. Not that he will, but… But it’s also possible the Dr.'s lawyer will try to quash the subpoena, but tough shit–he’s a treating physician so…

Anyway–you should probably also notice and subpoena said Dr. for a deposition. Which, again, his lawyer will probably try to quash…But he’s not going to lie in a deposition.

Drs. are paranoid–they get sued all the time–especially surgeons. A release won’t cut it…he may even want to help, but needs you to “force” him into it. Great suggestion re getting info from nurses and scrub techs. Someone remembers that tube, and sometimes nurses like to “put it to” doctors. I wish her good luck!

18

Nothing to add except, “yeah, what they said.”

jarbabyj, this back thing for you guys just blows. I have a friend who gets periodicaly tortured (and pays good money for the priviledge) by doctors who insert electrical thingies into her fucking spine to try and relieve her pain. While she’s still awake, BTW, so she can tell them what spot they’ve hit. She says when she almost pees her pants and passes out, they know they’re in the right place and only THEN do they put her under.

19

My first thought is “Why should this be a problem?” Does her lawyer have experience with malpractice cases? If so, surely he’s got 101 aces up his sleeve for dealing with this guy as a hostile witness. As in, some of the things suggested here.

I’m of the opinion that mistakes do happen. Hey, one happened to me during my c-section. I wouldn’t sue over the tube itself. I’d sue over him not finding it in standard follow-up care, especially when she was complaining of new pain after surgery.

20

I am an RN but my background is in Med-Surg i.e. oncology, renal, pulmonary and now detox. It has been my experience that somedoctors will cover for each other and are reluctant to admit in writing that another doctor is incompetant or negligent even in the face of overwhelming proof. This could set them up to be a party in the other’s lawsuit. Better to quietly put the pressure on him to leave the hospital “to pursue better opportunities” than to become involved in a nasty involved malpractice suit.

I have heard Dr’s say that something was not being done correctly but then write a very carefully worded progress note that doesn’t quite put it in writing. It’s all a matter of CYA–Cover Your Ass.