Three weeks ago, my wife had an outpatient surgical procedure. It all seemed to go fine, but on Saturday (two days ago) she was feeling badly and, long story short, she was admitted to the hospital with a massive infection that had begun at the surgical site and spread throughout her body. She’s been on IV antibiotics since Saturday night, and swelling of various body parts continues. She may be there until Wednesday. Needless to say, this has been very unpleasant and stressful on top of a life that has ready been extraordinarily stressful for months.
A doctor at the hospital asked if the surgeon had prescribed antibiotics after the procedure, and seemed surprised that they hadn’t done so as a matter of course.
I intend to inform the surgeon about what has happened because I think they should know. At the moment that’s all I intend to do; I’m not going to bring up lawyers, lawsuits, malpractice or anything. I want to see what their reaction will be.
But if this hospital visit is going to cost us anything, we don’t think we should have to pay it. To say nothing of her discomfort, inconvenience, and stress for the four days or so this may last.
What, if anything, can we expect the surgeon to do if we don’t bring lawyers into the issue? At what point do we get lawyers involved?
I’d recommend telling the surgeon, and then asking him for what you want instead of waiting for him to offer, or say “okay, thx for letting me know” and then staring at you.
If malpractice is a possibility here, wouldn’t you want to speak to a lawyer beforehand? What if the surgeon tries to deny what happened once you put him on the defensive?
A lawyer will always bring up malpractice, but post-surgical infections are always a risk.
As to why a post-surgical antibiotic wasn’t prescribed - I don’t know. If the operation involved an infection there probably should have been antibiotics before and after (unless it’s emergency surgery, in which case you’d still see them after). If the surgery didn’t involve an infection I’m not sure - I thought doctors in general were trying to get away from prescribing antibiotics unless needed.
I’m sorry your wife had a bad outcome, I wish her a speedy recovery and no more medical adventures.
But for Og’s sake - TALK TO THE SURGEON. Let him know what happened.
I’m posting here because I don’t really know what we can or should ask for. I’d rather not bring in lawyers if it’s not necessary, or threaten them if that would lead to additional hostility, stonewalling, etc. If a surgeon or medical plan in this situation would naturally say, “we’ll make sure you aren’t charged for this” (while probably disclaiming any responsibility), that might be the best possible outcome.
I’ve never been in this situation and just don’t know what the possibilities are. Can we present the hospital bill to the surgeon?
I doubt they will promise not to bill you. I may be wrong, but my understanding is that it’s routine in the US for patients to pay for extra costs that are due to bad outcomes. I’ve even read articles about how if that liability were moved to the hospital or medical practice, they would have more incentive to wash hands, etc., and generally improve outcomes.
Was the outpatient surgery at the same hospital where she is being treated now? Because my understanding is that “hospitals no longer receive additional payment for cases in which one of the selected conditions was not present on admission.” In other words, Medicare doesn’t pay for care related to a hospital-acquired infection. I don’t know what the rules are if the infection presents after discharge, or how an outpatient procedure applies. And of course I don’t know what insurance your wife had and whether these rules apply in that case.
I would have as much communication as possible in writing, via email. For any spoken conversation with medical or hospital administrative staff, I would follow it up with an email recap of the conversation, “it was good talking to you today, as you said…”
She is not at the hospital that did the original operation. The first telehealth nurse we spoke to about this on Saturday recommended we go back to the first one, and now I see why. The one she’s at is 10 minutes from home, which is why we went there, the other is about 30 minutes.
If you bring the issue, or a bill, to the surgeon, it’s a safe bet that he/she will go to his/her/the hospital’s attorneys … unflinchingly.
If it were me, I might try to get a medical malpractice attorney on the phone for a free/quick consult. Explain what you know, where you are, what you want, and what you don’t want, and see if you can get advice.
This is a mine field. The surgeon will get a map and a guide (or team of guides). You may want to get one, too, even if you are absolutely committed to not pursuing litigation.
It’s a question of knowing what to do, what not to do, and preserving your rights should things change.
A lawyer isn’t just for going to court - they’re are also for negotiating. If you hire a lawyer to guide you through negotiating with the hospitals involved so as to either eliminate or reduce your liability for treatment that might in the long run be a cost-effective solution. But I’ll also throw in that taking advice from people on the internet is often worth only what you pay for it.
The following is purely anecdotal, I don’t live in your state, YMMV.
First, sending all my best healing wishes to your wife - how terrible
Two years ago I went into hospital for outpatient procedure. Afterwards my husband spoke to surgeon, and asked if I would be receiving antibiotics since I’m diabetic and don’t heal easily. He was told no, the practice didn’t believe in unnecessary medications, and that there was an antibiotic used during the procedure.
Within a few days I developed a terrible infection, and was admitted to the hospital for a week for antibiotic IV infusions.
Surgeon’s office was notified of what happened, he never even bothered to come to see me at hospital.
Went back to the dr’s practice 2-3 a week for wound debridement for over 3 months (and they charged me co-pay for each visit!) Much pain/suffering.
I contacted many lawyers, no one would take my case.
It seems I signed away my rights before the operation, since post surgery infection is always a risk. I was told I
needed to have permanent injury, or loss of pay, etc. I had retired at 55 to have this operation, so no pay loss.
Again, this was just my experience.
Please make sure you get every scrap of paperwork from the hospital - you are entitled to all her medical records, tests, etc. Is your wife still working? Make sure you have written statements saying she cannot work at this time, thus losing a paycheck.
I would be surprised if the hospital did not already contact the surgeon, but yes, of course you should call the dr’s office to let them know your wife has been admitted.
Will your insurance pay for this hospitalization? Can you speak to a patient advocate at the hospital? Find out if this hospitalization might be rolled over and covered by the approval of the outpatient procedure.
Don’t mention anything to dr’s billing office yet until you find out what your financial responsibility will be.
Best of luck to both of you.
Talking to a lawyer and understanding your rights and options isn’t the same thing as pursuing litigation immediately. But this has the chance of blowing up more and more (hopefully not, of course) and the first thing on the surgeon’s mind is probably “oh shit, this could end my career if I fucked up” not “oh, we’ll try to do right by you.”
Knowing what your legal options are before speaking to the surgeon lets you choose how to proceed. The option to not litigate remains open, but if the surgeon seems noncooperatuve, you would at least have been prepared for that possibility in your mind and know what other avenues are. This is probably routine for them but for not for you, and getting professional advice just helps even the footing.
Depends; sometimes they give IV antibiotics during/immediately after, and don’t actually prescribe a course of antibiotics for you to come home with. I’ve had three knee surgeries- one in 1989, 1990 and 2014, and never come out with a prescription to be filled and taken later. They did however, give it to me in the IV that day and the next day.
OTOH, when I had a vasectomy, I did come home with a prescription for post-op antibiotics.
So I’m with the people who say to talk with the surgeon- they should know what their procedure was- it’s entirely possible that they did give antibiotics, and this is a type of bacteria that isn’t particularly affected by what they gave, or possibly acquired afterward somehow.
Heck, my spouse used to be given antibiotics on a regular basis after procedures, but managed to come down with a couple fungal infections over the years, which require different treatment than infections caused by bacteria or viruses.
Infection is always a risk with surgery, no matter how minor. A bad outcome does not always mean someone made a mistake. That said, you need to know your rights, your options, and make a plan to deal with all this.
You can add me to the list of outpatients that did not get antibiotics prescribed. Had an emergency appendectomy 2 weeks ago and they just ran the IV antibiotics. Just painkillers prescribed.
No antibiotics for me either when I had inpatient back surgery in 2018 - 2 surgeries on consecutive days, 5 days in hospital. Not IV that I’m aware of, definitely not prescription for home.
Good luck. Keeping my fingers crossed for your wife.
Two years ago I had a procedure done where they put a scope into my stomach, they blew some air into it to expand it. The air caused a perforation in my stomach and I became septic. Two weeks in the hospital. I was upset that I got stuck with a $4,000 bill as my part the insurance did not cover. I thought about suing but did not want to see the Dr. get that on his record.
This is a likely outcome. All surgical procedures are prefaced by a consent form listing possible effects of surgery, including death, and your signature may act as a waiver of liability for any of these things occurring.
Another issue is that it was an outpatient procedure and your care of the surgical wound could be a contributing factor for a post-operative infection. A good defense attorney would try to lay blame on you and your wife for being negligent or letting an infection get so far out of hand.
One thing you may want to do is look into whether prophylactic antibiotics are usually ordered for your wife’s procedure. This could show to a court negligence on the part of the surgeon. This may be difficult information to get from another doctor since they usually protect their own. Surgical nurses and hospital administrators are more likely to give you the straight dope .
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