What do you think

[purple1953reading]

Recentlly, a friend and former patient came to me in tears, as she said she had returned to a Unversity Hospital (we live in rural area 90 miles away) and that the physcian who had done preliminary scope to look and see what major surgery would be required, had cancelled her appt, and told the whole depart. not to see her. She got her medical records, and the physcian had written that he would not see her because she had used foul language, and kept insisting and swearing. THIS IS NOT TRUE OF THIS PATIENT> She is very educated, in complete control. Turns out ( I asked when she got her surgery the friend that went with her) that in the PACU, they kept giving her Versed, instead of pain meds, and the usual effects of Versed made her unihibited, and she was screaming in pain obscenities in recovery, and the dr. went out to the waiting room, and told her friend that she better settle down, and stop swearing at people. The friend (LL) told him that was NOTHING like her, and she must be beside herself in pain. After we looked at her medical records with her, we realized that the Versed was probably to blame. BUT THE Physcian charted that she swore at him, and on and on, and that he called Risk Management, and they told him to outline what had happened. The chart reads like she is a maniac and would immediately invalidate her as a responsible patient to ANY DR. she might need to see , thereby prejudicing physcians she has not even had the opportunity to see. I went with her to see the Medical Records manager who told her all she could do was file a form that said she did not do it, and he had charted something that was untrue. (At the time I did not know about the VERSED).

In addition, I told her that on my insurance that we had a list of providers (PPO) and that he could NOT do it without filing with the insurance company and proving that she had ignored his orders, and that he had met with her at least 3 times and tried to resolve the issues between the two of them. OR THAT she had not paid her bill, but only if it was posted in the office that those who did not keep their accounts current would be discharged as patients after so long. She is also on a PPO and is checking into this.

Prior to this all happening, she had seen the dr in his office and asked when he was going to schedule her surgery. HE said "I don't have time. " He then said he would refer her to a group outside the hospital and she told him they were not on her insurance ( I was with her on this visit) and then he said Yes they were, that had changed. She said NO, that is the reason I came here in the first place,and he insisted and opened the door , telling her to come out there and ordered his nurse to call. The nurse asked what kind of ins. and she told her ( I don't remember what kind) and then said NO she is right they don't take it. He practically shoved us back in the room, and said that SHE needed the surgery, BUT he did not have time. I asked him, IF she had Medicaid instead of ins. I wonder if you would have time,(as this was a Univ. Hosp) and he said "SHE would STILL have to wait" Anyway, his solution, to give her his email, and then she was to send him a list of providers and he would set up an appt for her with one of them in another town. She did this ( this was on a Friday) and she sent it on Sun. BUT got a letter dismissing her from his practice on Monday(which he obviously sent out on Friday) and then NEVER answered the Email and stopped her from being able to email her.

This is when she contacted medical records. WHAT IS WRONG WITH THIS GUY? I think the surgery was way beyond his skills, and he is one that has a website that says he can help anyone. Goes on to say something like sometimes you have surgery in your hometown hospital, and things aren't right, through no fault, but he has better eqiupment, and skills. and can help ANYONE> Also is somebody who constantly is in the news, and publishes. He even published an article on how Univ. Hosp cannot continue to attract new qualified physcians, and will lose the best surgeons, professors,and will have nobody worth their salt to train future generations, UNLESS the University lets them start owning some of their clinics, ets, like private drs. as the Univ. Salaries are too low. HIS IS ARROGANT> that is for sure.

I think he should be stopped. WHere does he get off using a medication side effect as a reason to judge a patient, and put them down? I have worked in outpt. surgery, where we gave Versed for everything from repairing lacerations, to GI procedures. AND MANY PEOPLE SWORE AT us under the effects of the hypnotics, including another RN I knew well and would never dream of saying those words when totally in control, and not under the effects of meds. I can't believe this.

Has anybody any suggestions on how to handle this. I have recommended she contact the insurance company, send in the correction notification to medical records, etc. BUT don't know how she can prove this, as all she has is the letter he sent, dismissing her, as he did not respond to the email. I was there when he promised to help. HE LIED TO HER

I have never encountered this before, and am sorry it took me so long to post it, It is hard when it is secondhand, but I have seen the records.

Any suggestions greatly appreciated. I think the jerk should be punished. In addition, what happened to charting only the objective. This is very subjective charting. Charting is supposed to record facts relevant to patient care ONLY>

[jmgrn65, RN]

contact the state medical board, something sounds fishy! I would also contact the hospital's corparate intgrity officer.

[happybunny1970]

I agree... she has to this herself, though. She needs to document everything she can remember, and get a copy of her chart, and get witness statements from anyone present (have them notarized!). Still may be that nothing comes of it, but can't hurt to try -- file with insurance company, the hospital, and with his state Board.

[Hoozdo, ADN]

I have also seen some rare incidents of Versed causing pts to go beserk, hallucinating, and needing restraints to control them. Perhaps she just does not tolerate Versed well. The reactions I have seen happen in the elderly.

[caliotter3]

I agree that she should take the time to complain to the medical board, her insurance company, and the hospital. She also should make every effort to insure that she is not administered versed in the future.

Good luck to your friend in obtaining qualified medical care.

[TazziRN, RN]

I doubt she will be able to get statements from the PACU staff who witnessed this, but she should definitely report it to the state medical association as well as whoever manages physicians' licenses.

[walk6miles]

LAWYER TIME LAWYER TIME DON'T WAIT -- RUN, RUN, RUN TO THE NEAREST LAW FIRM..... PAY THE MONEY AND HAVE THEM WRITE THE JERK A LETTER...

what an arrogant idiot....

her lawyer should also write the hospital and the state agencies as well.... this is a case reeking of deceit!

by the way, Phenergan (for nausea/vomitting) is another "go crazy drug"... my introvert sister jumped out of bed (second day post op cabg) tore her clothing off and chased (no kidding) her family doctor out of the room by cursing him and charging at him naked... it's funny now but it wasn't then.. we use Phenergan in ICU settings but you really have to assess your patient because it can "snow" them or it can make them nuts for 3 days (neuro consult, eeg, etc.) then mysteriously they become "normal".

Best luck!

[rita359]

Also can take complaint to physician on staff who is director of his specialty.

[santhony44, MSN, RN, NP]

It just seems really odd that something done or said under the influence of drugs (prescribed and administered in the hospital) would be held against her.

It's really not that uncommon for people to "go nuts" in reaction to various medications and I've never, ever seen it be a problem in the person's ongoing care. The reaction usually is something like "Well, we know not to give you that again!" and everyone goes on about their business.

I really think there is some other reason this doc does not want to take care of her and he's covering it by blaming it on her. This simply cannot be the first patient he's ever seen have this kind of adverse drug reaction nor will it be the last.

I agree with jmgrn65, something is fishy.

[crissrn27, RN]

My son, at the age of 4, went totally crazy after versed. Screaming, crying, beating up the staff, trying to leave the hospital, kicked the CRNA when he came to assess, etc. Everyone knew it was the med and just laughed it off. I can't imagine that a reaction to a med would be grounds for dismissal from a practice, and all the other things that have been done to this poor lady. But I have seen it done. People (docs) just stop thinking some times, I have seen OBs dismiss their pts for things done in labor, etc. Just plain wrong, and if the pt had come to me to write a statement that they were under extreme stress and pain I probably would have done it.