I am so angry about something I found out about my surgery.

[caty]

I went to the emergency room at midnight (six weeks ago) with appendicitis and had surgery at 8am. By then my appendix had burst and this caused a more painful and a longer recovery time. I always wondered why it took eight hours for them to get me into surgery. I had blood work done and a catscan, but they new the results by 4am.
Then my husband told me that the emergency room doctor told him at 5am that the surgeon's regular time to come in was 7am. They could call him then and have him come in early, but they decided to wait and have him come in at his regular time. This meant that I had to lay there another 3 hours is so much pain that morphine couldn't even touch it. And if they had called him in early, he might have been able to operate before my appendix burst. Every time I think of their decision I want to cry and then I want to scream.:grr:

[RPM]

1. call a lawyer

seriously.

[jeff30997]

2. Yep,sue the bastards.

http://www.amazon.com/exec/obidos/tg/sim-explorer/explore-items/-/0809228742/0/101/1/none/purchase/ref%3Dpd%5Fsxp%5Fr0/104-7625884-5377510

[LisaL]

12. To sue the Dr, there need to be consequences.

Like complications from the surgery, etc.
The lawyers won't do anything unless there are consequences.

[RPM]

15. emotional distress?

maybe?

[Mayberry Machiavelli]

3. In fairness to the ER, unless you know for sure, it may have been the

surgeon's decision to operate at 8 instead of 4:30-5 AM.

Usually if they have these results, and it is clearly a surgical problem, the ER physician will call the surgeon on call. Then the disposition is determined between them, whether to admit, discharge, go to operating room etc.

I don't know your hospital or your surgeon. It might well be that since it was already 4 that they decided it wouldn't be a big deal to wait a couple hours to call the surgeon and arrange the surgery, but in my opinion it's at least as likely that they DID call the surgeon with these results, who then booked the surgery for 8AM.

If the ER didn't even call the surgeon until, say, 6 or 7, then they assume liability for problems like ruptured appendix etc. that may not have already occurred when you got to the hospital. It's very unlikely for ER's to assume ANY liability like this unless absolutely necessary.

Once they have notified the surgeon on call, they have essentially released themselves from this liability, if the surgeon delays seeing the patient or doing surgery, the liability is theirs.

Of course if the patient's condition seriously declines and they are in need of immediate attention, and the "on call" surgeon will not respond promptly, then the E.R. may still have responsibility to seek a transfer or to call other "not on call" surgeons to see if someone could help.

Did you stay in the ER and go straight to the OR from there? Or were you admitted to a hospital room and then brought back for surgery?

[wryter2000]

4. There's always the question of an operating room

Even if there was a surgeon available, he/she couldn't have done squat if there wasn't an OR available.

I work in the medical legal office at a large hospital, and it's actually rather difficult to win a malpractice case. You have to show that the care you got was "beneath the standard of care" and that you suffered as a consequence. You did suffer because of the prolonged pain, but you have a better case with the fact that you probably lost income because of the longer recovery.

You might want to try contacting the hospital ombudsperson or customer service department. You might be able to get an informal settlement. At the very least, you can get your point across to the ED doctor about his/her attitude.

You can approach a lawyer. A reputable one will get your medical records and assess whether you have a good case or not. If a good lawyer tells you you don't have a good case, you might as well forget it. Do NOT get any old ambulance chaser. You're likely to go through a lot of grief and expense and end up with nothing.

[Mayberry Machiavelli]

6. Yes, but you have to prove more than one thing.

1. Standard of care not met. And this can a very subjective issue.
2. There was an injury. (3 hours of extra pain for sure, non perforated appendix became perforated very difficult to prove, but this would be the crux of a case for damages for longer hospitalization and recovery)
3. The injury was CAUSED by the standard of care not being met.


All of these conditions have to be met for a successful case of malpractice.

[wryter2000]

14. Right

Thanks for the correction. :yourock:

[caty]

8. I don't really want to sue.

I just have to wonder if this is the norm. It makes me angry to think that if they had called the surgeon at 5am instead of waiting for him to come in at 7am, I might not have suffered as much.

[blondeatlast]

13. Does the hospital have a patient care ombudsman or similar?

I think you should make them aware of the pain you suffered (they should have been able to up the dose, for one thing).

Note my response below. Your pain should have been alleviated, but this may have been a better outcome for you with the delay.

Sadly, I'm a health jail vet, and I'm all too familiar with how the system works from a patient perspective.

[wryter2000]

16. In that case

You want the ombudsman or customer/patient service department. Failing that, contact the chief of the Emergency Department with your complaint. Please note, it's a department, not a room.

[RPM]

17. same shit happened to a friend of mine this spring

he languished 12 hours before they got around to him.

and they wonder why their malpractice premiums are high - they run stupid risks like this all the time.

[Mayberry Machiavelli]

19. Do you know for sure that it's the ER who made this decision and not the

surgeon though? Did you ask this specific question to the ER and to the surgeon?

I mean, if the surgeon already knew about your case, even if the ER didn't "demand" that they come in immediately and do surgery, the responsibility is his or hers.

If the ER never called until later, then the responsibility is theirs.

[Deja Q]

25. They get paid shitloads to work off hours. It's part of their job.

Consider that.

[caty]

7. I was admitted to a room.

[Mayberry Machiavelli]

11. Again, it's a "not for sure", but this argues for the surgeon already

knew your situation. Once you are transferred, it's to the care of the surgeon and out of the E.R.'s domain.

When a patient is admitted to a ward, it's under the auspices of the admitting doctor who in this case would almost certainly be the surgeon and not the ER doc.

The records should make this abundantly clear. It will show things like when the studies were done, when the surgeon was called, and if he verbally phoned in any admission orders those will be part of the record as well. Just because you may not have seen the surgeon until right before surgery doesn't mean they didn't admit you, they may have taken report on your case over the phone, and in the presence of unambiguous test studies for appendicitis, admitted you in preparation for surgery.

If you were to even contemplate suing someone I would be very clear on these points before you began. Also, I would of course have lawyer recommend whether you have a good case. In other words, if it's common or "standard of care" to do what was done even if you felt it was wrong, you may have little case (it may mean that the standard of care is whacked but that's another story). Or it may be difficult to establish that your appendix wasn't already perforated before coming into the hospital (especially if you had more than one day of pain before coming in). etc. etc. In otherwords if you can only establish that 3 hours extra pain was the injury, there may not be enough damages to justify the trouble of going through a suit except to satisfy righteous indignation.

[LisaL]

18. The lawyer won't even touch it unless there is damage.

Like, if you the person became disabled from the surgery.
Of course it doesn't hurt to talk to a lawyer, but I don't see them even taking a case like this, were there is no long term damage to a patient.

[Mayberry Machiavelli]

21. No, if you had, say an extra month of missed work and 10K extra hospital

bills for a perforation complication than if you just went home the next day like usual then you could recover those kind of damages.

It doesn't have to be that you were blinded or paraplegic or killed.

[LisaL]

23. When we had what we thought was a case, the lawyer told us

that basically he would have taken it if there were serious complications. Otherwise, he told us there was no case.
I suppose it could depend on a lawyer.

[LisaL]

20. Emotional distress isn't going to cut it, IMO.

THere need to be serious consequences for this to be a case.
Of course consultation with a lawyer is free. But I don't see this going anywhere.

[Lord_StarFyre]

5. Well, on the the bright side

...Thankfully you're still here to tell us what those incompetent swine did to you...

Just recover, get your strength back, then go and sue the bastards into oblivion...

[undeterred]

9. Besides the pain, an appendix bursting can lead to complications

I'm really surprised that they took a risk with you like that. The operation doesn't take long, and they should have had someone on call during the night to handle an emergency case.

Its inexcusable.

[LisaL]

22. And if it did lead to complications, then she would have a case.

[blondeatlast]

10. Similar experience here--but I know they weren't negligent.

I had a 90% blocked artery 3 weeks ago. Admitted to intensive care Saturday, they delayed the catheterization until Monday when my doctor and the regular cardiac surgery team was there; however, if it had gotten worse, they would have done the catheterization immediately.

They may very well have actually had your best interest in mind, in that the staff with the most experience in SURGERY is always the day shift.

[caty]

24. I have never had any intentions of

consulting a lawyer. It's just that since it happened, I kept wondering why it took 8 hours to get me into surgery. I had always thought that when you had appendicitis, they got you into surgery as soon as possible to avoid it bursting. Then, when my husband told me what the ER doctor had told him at 5am---I just got p*ss*d off and I still haven't gotten over it. :argh: :banghead:

[Mayberry Machiavelli]

26. The point I'm trying to make is that your anger is directed at the E.R.

Doc. It might belong there, but it's also likely that it's the surgeon who decided to admit you for a couple few hours before surgery. Just because someone in the E.D. made some remark to your husband about the surgeon's usual time of coming in doesn't mean that they hadn't actually called the surgeon. The fact that you were admitted to the floor argues more towards that the surgeon was the one who admitted you there in anticipation of doing surgery a few hours later.

It may well be that you feel more of a "relationship" with the surgeon because you may have spent more time talking with them, following up with them after surgery, and it's normal under such a circumstance to deflect your anger towards others where you may perceive less of a relationship.

All I'm saying is, regardless of whether you sue anyone, if you're going to be mad, try and make sure you're made at the right person.

I work in exactly this type of area, and this is a common scenario. The E.R. does not schedule cases for the surgeon usually, unless the patient is bleeding to death or something. When it is clear they have a case they need to consult the surgeon, they usually will notify them right away. It may be that there are some crusty old surgeons that the E.R. folks are loath to wake up in the middle of the night if it's not an immediate life or death emergency, but they are merely exposing themselves to liability if they don't call. And believe me, it's unusual for an E.R. to take any unnecessary liability on themselves like that, just to avoid annoying a grumpy tired surgeon.

A surgeon may already be in surgery when they are called about a case, so again, unless you were in extremis where they had to get someone else immediately, they might have to wait a bit to get your case done. It would be unusual for the hospital/E.R. to not call the surgeon because "8AM is his usual time to come in" because they have no idea if that surgeon already has elective surgeries scheduled for that time, in which case they would probably want to do your surgery earlier to get it out of the way and not delay their other scheduled cases.

So there's a lot of possibilities there, and I wouldn't conclude anything unless the E.R. Doc told you specifically that they were delaying calling the surgeon because it was just a few hours 'till the morning. It doesn't usually work that way, from what I've seen.

[bigwillq]

27. I would try and sue

Can't a ruptured appendix kill a person?:shrug:

[LisaL]

28. Yes, it can kill a person. But since it didn't, it's a moot point.

[bigwillq]

29. Yeah but the doctors and hospital staff

put her life in jeopardy, right?