A teachable moment

I have been wanting to post about this but waited till there was some progress. Back the end of Jan 2024 Barb ended up having lumbar surgery. Her pain had reached a level that even upping her doses of opioids over several months could not suppress her increased pain.

She debated on having the surgery for several months before relenting to having it done. The Surgeon what we chose, was recommended by the surgeon that had done my partial knee replacement in mid-2023.

This surgeon is an employee of a very large and very well known and respected ortho surgeon group that has been around for maybe 5+ decades, and the practice is owned by one of the three major hospital system in a city that is the largest city in the state and there is also a nearby medical school.

Barb went back for a 6 weeks follow up. The surgeon seem to start off with THE INCISION IS INFECTED!  After we expanded our pharmacy into providing home medical equipment and then we started dealing with pts who were bed or wheelchair confined and experiencing “bed sores” and/or “decubitus ulcers“. Barb got the opportunity to get certified as a tissue therapist. So she could help pts and their caregivers try to prevent those decubitus ulcers and/or help them to heal those if they already had them. She knew the outwards signs if a broken skin, bedsore, surgical incision was infected, and I learned them via osmosis being married to her.  I knew from clinical standpoint what lab tests would suggest that the pt had an infected decubitus.  A infected decubitus typically had necrotic (dead) tissue around the perimeter, had a bad odor, their blood work should show elevated white blood cell count and pts would have at least a low grade elevated temp.

Barb’s labs nor her surgical incision showed any indication that it was infected, but the surgeon was insistent that he had to debride Barb’s incision STAT.. sent her directly from his office to the hospital and had her admitted. Two days later she was in surgery again. While Barb “survived” the surgery. The overall care that Barb received was no where ideal nor close to best practices and standard of care.

https://www.cms.gov/medicare/quality/quality-improvement-organizations

The above organization QIO, followups on complaints from Medicare pts and the pt’s care in a hospital environment.  I filed a complaint with this organization around the end of April 2024 and just got a return phone call from one of their representatives, as a follow up. This representative was basically quoting from the physician reviewer report/summary. First of all the ortho surgeon NEVER provided any of Barb’s medical records from his practice. The representative said that, my complaints would be forward on to CMS (Center for Medicare/Medicaid Services) to deal with the ortho surgeon’s lack of response of providing medical records.

Most of what I heard, was the reviewer could not document most of my complaints from the medical records from the various providers, starting with the hospital itself down to several vendors who provided Barb’s home services.

When all was said and done, the representative told me that I could have a second reviewer to look over my complaints and also said that I could add any more information.  I had provided them with 7-8 pages of  typed (word processor) detailed complaints and I told the representative that I felts that my complaint was VERY DETAILED!

There was a pause in the conversation and then the representative said “that is a good description”. I asked the representative that if I asked for another reviewer to look at my complaint that if I could ask that the reviewer focus on the what appeared to be that most of the medical documentation – IMO – did not come close to what I understand as what should be a standard of care and best practice.   The representative stated that she would state that and highlight it on my request for a second reviewer to evaluate the quality of medical records that were provided.

Apparently the jury is still out!

 

 

6 Responses

  1. Steve,,I hope u get this alll straighten out,,u know,,print records,pictures etc,,,cause u know,,,from all of us,,,they can disappear w/the click of 1 button,and THEY WILL DISAPPEAR
    FOREVER,,, it not like it use to be,,ie integrity/honesty in medicine,,jmo,,,maryw

  2. It’s crazy how some of these Doctors are “top-rated” and can’t even supply proper medical records and misdiagnose an infection! God Bless you Barbara and Thank you Steve for sticking up for your wife. I hope this Doctor gets what he deserves!

  3. Your wife is a very lucky woman to have such a great advocate. We all need someone in our lives to be able to stick up and promote our well being. Now days that isn’t very common I’m afraid, and this is how the system gets away with so many abuses!

  4. Sometimes these complaints get faster action if you submit them to the state health department with jurisdiction over licensing hospitals. It depends on what state you are in. Also pictures and specific complaints such as the hospital was dirty or someone did not wash their hands may trigger an a state inspection.
    Cc

    • You are correct, however, I have had to go down this path once before with my wife and a Hospitalist. That time the QIO reviewer ripped the Hospitalist a new one and I took that reviewer’s opinion and filed a complaint with our state AG and the Hospitalist got ripped another one.. I don’t remember if it was the AG’s office or the state medical board that did the rip but the AG’s office made sure that whatever state agency did not just file the complaint in the circular file and take no action. I found out after the fact that since we are a one-hospital county and the hospital system owns most of the office practices and only specialists were able to see pts in the hospital and all the PCP had to relinquish seeing their pt when they were in the hospital and the complaint I had about this hospitalist was his SOP and the PCP in the county were not happy with him, but felt intimidated if they spoke up about his Hospital’s policies & procedures. It took a while, but HE IS GONE!

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