The physician made a mistake; can I get my money back?

[SharonH, RN]

This was a question posed on a general discussion board that I participate on. The posters' adult son had an emergency appendectomy and in the process the surgeon nicked his bladder requiring a few extra days in the hospital. The poster was wondering how she could go about not getting charged for those extra days and the additional services and medicines provided since after all, it was the surgeon's error. I'm of the opinion that something like that would be one of the risks covered in the informed consent. I mean, there are no guarantees right? Especially not a money-back guarantee. BUT now I'm wondering, maybe I'm a little harsh. I've never worked in OR, could some of you OR nurses guide my thinking a little? When I worked on a surgical floor I recall that rarely we would get patients with a nick or something but maybe I'm way off. Was the surgeon a hack? I'm the last person to try to protect a physician's pocketbook but if we are offering 100% satisfied or your money back guarantees, then the healthcare system is in trouble, no?

[rn undisclosed name]

I think it's unfair for the patient to have to pay the cost. If they don't have insurance (or inadequate insurance) it's a hardship just to pay the bill let alone $$$ in addition to the actual procedure.

If you take your car in for repair and they accidentally fix something else - who pays?

If you're having work done on your house and they make a hole in the wrong wall - who pays?

There have been cases where the correct procedure was performed on the opposite side of the body - who pays for that? I know you're supposed to do a timeout BUT it has happened.

There's so many what ifs in so many different areas (not necessarily medical). I realize there are ICs that patients sign but sometimes I think someone other than the patient should also accept some responsibility. And no I don't think suing is the answer.

Kelly

[CHATSDALE]

laura, did you consider a complaint with the state bar assn if enough complints come in the lawyer is reviewed by peers

[Pat_Pat RN]

My wife had to have an ERCP done after her lap chole to remove the stone. She had to be transferred from the hospital that did the chole to a different one to do the ERCP. Once we were at the second facility, and she was in the endo room, they discovered the scope didn't work. She ended up staying in 2 extra days waiting on "parts" for the scope. Should we have had to pay for those days? I told the hospital administrator that I would pay for any meds or services she required during those days; but I wasn't going to pay for just her being there, since it had nothing to do with her illness.

Pat

[TrudyRN]

Why does everyone seem to be so sue happy? Like I said above, this is one of the risks of this kind of surgery and should've been addressed in the consent signed prior to surgery. I have taken care of many surgical patients and lots have had nicks and no doctor has been able to be sued. Because of the close anatomical location, nicking a bladder is a risk of removing an appendix. I'm sure he didn't do it on purpose or out of negligence.

Would you feel this way if you or your loved one were the patient?

Surgeons receive years and years of training so they can learn about variants of anatomy. Should this make them perfect and infallible? No but it seems like these (presumed) accidents should be rare. I wonder about this particular surgeon's record. Also, was it late at night? Was he drunk or on drugs? These things do happen.

Also, I wonder how it is that this patient was so hard to work on? Was there some other problem?

I was extremely upset that my child's pediatrician and an ER pediatrician (a week after 3 visits to the pediatrician) both misdiagnosed my son's appendicitis. After I insisted on imaging, so we could try to get to the bottom of my son's pain, the appendicitis was discovered. We were rushed to the ER (now it was a big surgical emergency) and admitted eventually. We were told his appy would occur at 2000. The hour came and went. Trying to be polite and not "bother" anyone, I sat and waited, praying, stewing, worrying. At 2200, I said to the nurse that I was wondering if this could be treated medically. (I have read varying opinions about proper care of appendicitis.) She replied that we should be going to surgery within an hour.

At 2300, I told the nurse I was thinking about taking my son to another hospital because I feared his appendix would rupture. The surgeon magically appeared and my child was whisked to OR where, lo and behold, it was found that his appendix had perforated. The $#@*+='s had the nerve to tell me later that "We don't know why" some rupture and some don't.

I was so angry that I replied, "Really? I bet I could tell you why. It might be because 2 doctors misdiagnosed him on 4 separate visits over the last 2 months, his mother had to push for further diagnostics (the ultrasound that found the problem), and then we were kept waiting for the surgery too long when you probably could have called in another OR team if you all were too busy." There was absolute silence from the surgeon and his troupe of about 8 interns, residents, and students.

I was truly thinking of suing them at that point. However, in view of the fact that we were charity patients and in view of the fact that my son did, thank God, survive and fully recover, (after multiple antibiotics, drains, another surgical procedure in which he was experimented upon, I believe, by the interventional radiologist, and home IV nurse visits, and a PICC line insertion), I let it go. Also, I felt that we had almost always received very good care at this hospital in the past and feared that we might be turned away if we needed future care (probably a groundless fear). I sometimes wish I hadn't let it go, though.

The surgical team, if too busy, should have called in another team. There were more surgeons available. I didn't want to upset anyone or seem pushy but, by God, there are times when it is necessary to speak up. I was so worried and so scared that I let them push us aside and around and my child suffered as a result.

You, OP, will have to figure out what to do. Research the surgeon's track record, see if your child improves and heals, then let your conscience be your guide. Good luck.

[TrudyRN]

It's life, bad things happen. I get so sick of sueing. I see all of those comercials on TV, "if you've taken this medication, or you know some one who did or died or had complications, or got cold in the winter, or hot in the summer, or blinked their eyes too much during the day or sneezed ....give me a call.....I don't make money unless you do. " People get old , die baby's are somethimes unhealthy despite good care. Why is it when an lawer makes a mistake, there is little or no chance for reprocussion. We had a will made out, simple thing correct ? Because of miss use of wording , it could have been a disaster. Yet, all that was said was , Oh , we're sorry. If that would have been a Dr. all he** would have broke loose. It was bad enough that if we would have passed our children would have went to children services. So we payed to have it rewritten. They wouldn't cover the cost of another lawer rewritting it, we certainly wern't going back to them. We summed it up as , just things that happen in life and some times it really sucks or the potential to suck. That example is minor, but I've heard of worse things. There are many times that I think we should look at several areas of American society, first we need to look at the integrity of lawers as well as the integrity of the media. They are so good at reporting how bad everyone else is, they have people condemed before a trial yet, they seem to be very protective of their own.

You can sue lawyers for malpractice.

I do know what you mean about those commercials. I think it might get to the point that docs stop prescribing anything but rest. I'd be scared to prescribe if I were a doc.

Yes, when prosecutors intentionally withhold exculpatory evidence, when police or lawyers or prosecutors or judges intentionally lie and mislead, the heavens should open up and God's wrath should consume the lot of this sorry race called mankind. I do believe He sees all of this and keeps records and that He will, someday, reward or punish us according to how well we treated each other here. An interesting read on prosecutorial, police, and judicial misconduct is about The Innocence Project.

[caliotter3]

I read TrudyRNs post and added it to my own experiences and those of others that I have become aware of. Those of us who are in the healthcare field are given an added burden, b/c most of the time we know enough or too much, in both directions, to just stand by and be "talked over" by people that have the ready answers (excuses). Nobody, even healthcare workers should be given anything but the truth about what happens. When you get right down to it, sometimes it just boils down to what the Higher Power wants. He knows how many days all of us have on this Earth and it is the job of healthcare workers to try their best, not to try to outdo the Higher Power. If pts and or their familiies do not understand or accept this, then that is the price we pay for becoming healthcare workers. A calling (sometimes), not just a job (sometimes) and sometimes hell on Earth.

[Myxel67]

The patient who got his bladder nicked wasn't a child. OP refers to adult son.

[nurse4theplanet, RN]

I don't usually side with physicians, however...

There is a reason why they call it the PRACTICE of medicine...NOTHING is guaranteed! Surgeons require very keen skills. And let us not forget that while all our organs are in the same vicinity, our bodies are very different from one another. In small patients, you would have to imagine that their organs would be in very close proximity to one another vs. in a larger/older pt. Small mistakes are going to happen and that is a known risk with surgery. That is the whole concept of informed consent.

What if (God Forbid) the pt had died because of uncontrolled bleeding or another assumed risk? It does not immediately mean that the family can sue and recoup any money spent.

I don't believe that a lawsuit is valid unless it is clear that the physician was negligent or clearly guilty of malpractice. It seems this was just an unfortunate hazard to having any kind of surgery. I don't believe this family should get anything for free.

[Patti 2nd gen RN]

The misdiagnosis, and the unacceptable wait for surgery DO count--(esp. with no communication on updates, and no emergency alternatives offered)-was that followed up on?? Mistakes happen to everyone at every level of care, and may or may not have an impact on the patient--we need to be careful of the precedents we set, and our expectations of each other.

[SharonH, RN]

The patient who got his bladder nicked wasn't a child. OP refers to adult son.

Thanks for making that distinction. I should also add that it wasn't MY son.