Medical Dis-Service

[treeboss]

What is the name of your state? Maryland. However, this incident took place with my mother (age 73) living in Connecticut.

My mother fell and broke her wrist on a Thursday night (2 wks ago). She went to the nearest walk-in clinic and was told they had no technician on duty so was sent to emergency room. By Friday, she had finally gotten an ex-ray and confirmation of the break. My mother has a heart condition, takes medication for cholesterol, among other medications for reflux, etc. Because Friday is "surgery day" at this hospital (Middlesex Memorial in Middletown, CT) she was told "no one is available to set your wrist", she was given Darvocet, and sent home to wait for her...MONDAY APPOINTMENT!!! It was a "clean break", she was told, they put her in a splint and sent her home with more Darvocet. By Sunday, the tightness in her chest and shallow breathing frightened her enough to stop taking the pain medication, despite the enormous pain. On Monday, she went to get the wrist set at a Dr's office, by appointment. Even the nurse who finally set the wrist could not believe they made her wait that long! When told of the tightness in her chest and shortness of breath, she was referred to her cardiologist. After waiting until Wednesday for a call back, she called again only to learn her normal cardiologist was on vacation for two weeks.
The "replacement she saw said there was an irregular heartbeat and is now monitoring her for the next two weeks to see if the effects of the Darvocet, a drug she clearly should NOT have been given (according to this cardiologist) wear off. No EKG was taken until the cardiologist saw her.
My mother has Medicaire AND a very expensive supplement so there is not a question of insurance...NOW, she is in extreme pain, even though the wrist has been set since Monday this week.

Does any of this sound as absurd to all of you as it does to me?!!
I say this is unheard of! What steps should we take now? Although I am in Maryland and she in Connecticut, I would like more investigation into this and the people responsible!

Anyone?

 

[ellencee]

Does any of this sound as absurd to all of you as it does to me?!!

Absurd, yes; negligent, no way.

Back when most people were satisfied with health care, your mother would have been admitted to the hospital and nurses in white uniforms would have cared for her and watched over until Monday when the doctor set the fracture in her wrist. Today's healthcare dictates that Mom go home and take care of herself until Monday.

The absurdity here is that all was well with healthcare until a few people sued and won big or won over triviality and then everyone started suing and healthcare cost went out the waazoo and millionaires wanted to keep making millions so healthcare provisions dropped to the lowest standard legally justifiable. Now, you and everyone else want to sue over what has become the f'ing standard of care.

Yeah, I think it is the very definition of absurd.

 

[JackSchroder]

Why does her wrist still hurt after being "set". An office nurse set the fracture? You don't mention X-rays after setting the bones. Something is wrong. Your mother should see an orthopedist now. The pain after a fracture is reduced is unacceptable. Perhaps the fracture is not reduced. Your mother needs an X-ray to see if the wrist bones are still displaced.

 

[ellencee]

Pain after a set fracture is not unusual. I'll use personal experience as reference:

I suffered a complete, clean fracture of a bone in my foot, the one on the very outside of the foot. It was not casted for a week, just splinted. It continued to hurt after it was casted and it continued to hurt severely for several weeks. Nothing was done improperly.

Each of my children has had a broken bone and each continued to suffer pain after the fracture(s) were set.

I worked for years with patients with fractures, on orthopedics and in ICU, many of the patients continued to have pain for weeks after their fractures were set.

Bones hurt after being broken and although setting the fracture aligns the bones and provides support, it does not alleviate the pain completely.

This woman has a wrist fracture! It is bound to hurt. Add to that that she is elderly and can not tolerate pain medications of sufficient strength to relieve pain, and you end up with an elderly woman in pain from fracturing her wrist. That's normal; that's life; it's not negligence.

 

[pele]

Let me just add to Ellencee's comments. I had a stress fracture in my ankle which did not show up on x-rays until callus built up three weeks later. That little sucker really hurt. Had to wear an Aircast splint for about 3-4 weeks.

Many times people are not casted but are splinted in the ER and sent to an orthopedic surgeon, and with certain cases, it is prudent not to cast a fracture until the swelling has gone done. We get quite a few patients who have been splinted in the ER and referred to us for further treatment. Your mother should have been referred to an orthopedic surgeon that Thursday or the next day where your mother could have had x-rays done. Thursday to Monday is a long time.

 

[treeboss]

Thanks, All

I appreciate all of your responses. I can't believe however, that just because "that's the way things are", this should be an acceptible way to treat anyone...especially an elderly patient.

She was not splinted and sent home to wait for swelling to go down, she was told there was no one available to do the cast and had to make an appointment outside of the emergency facility.

On top of the fact, not enough medical history was garnered to decide if she was able to receive the medication she was given. As we all know, elderly people, in most cases, will take something because the doctor told them to, regardless if it makes them feel worse.

No, there was no x-ray after the cast was placed. The orthopedist now thinks the wrist may have begun to set before the cast was placed and she will have to go back and have it re-broken because it is now set improperly. There is no reason, according to these "professionals" she should be in the kind of pain she is in.

Complacency is what allowed the medical system to get so out of hand, just like frivolous lawsuits have caused the demise of healthcare. My mother is no incurring alot of additional costs due to the heart problems caused by the incorrect medication. This is not "the norm" in healthcare where I live...in Maryland.

What you are all sayinig is, it's our own fault, as a society, things are so poor in healthcare so, just grin and bear it! Well, I have not been involved in any frivolous lawsuits and don't intend this to be one, either. I do however, feel there is some accountability due and, if this has gone wrong for my mother...wrist and heart...someone should be making this right for her. Anything less would be equivalent to telling your child bad behavior is the norm, these days, so...go right on ahead and continue...you're just like the rest of them! We weren't brought up that way and, just because these folks have degrees and certificates hanging on their walls doesn't make them any less accountable or us any less deserving of their care! After all, with her being on Medicare, I'm sure you all don't mind paying all the additional costs involved with the series of events that could have been avoided, right?

 

[cris24]

If there is no one available, what are they supposed to do? Here in Nevada, hospitals are closing down because the staff is quitting- there aren't enough doctors to deliver babies. Unfortunately, that is the state of health care today.

 

[JackSchroder]

Treeboss: I appreciate your final note. I had expected exactly what you said had happened. Pain that is bad enough for someone to cry out for help is not expected after the proper treatment of fracture. The others who said "pain is expected" must remember that pain is a subjective thing, and everyone expects discomfort at a fracture site for several days. But not pain. Now your mother will have surgery, an open surgery to set that wrist. I have no idea which bone is fractured (or how many) but she is in for a bad time. You should see a lawyer. Your lawyer will no doubt send your mother to a hand surgeon. Don't worry about "malpractice costs" or the money these birds pay their insurance carriers. If they were better at policing their own and more careful about how they talk to patients and treat patients their insurance costs would drop.

 

[ellencee]

The care rendered to your mother, more likely than not, does not fall below the minimum standard of care. I don't write the standards of care; I'd like to, though.

Darvocet was not contraindicated unless your mother was taking Tegretol and I saw nothing in the history that you provided that would make me think she was on Tegretol.

She is elderly and she has a heart condition. Any medication, Darvocet, Tylenol, any medication is going to remain in her body without being detoxified as it would be in a younger person or a person without a heart condition. What she experienced was signs of toxic levels of Darvocet and she did what she should have done, with one exception. She stopped the medication, but she did not return to the ER and she did not call the physician and tell him of the problems she was having. She stopped the medication and the situation began to improve. I don't see the first indication of negligence in this situation. She had to have something for pain.

Yes, good health care providers are closing up shop and leaving the profession over trivial lawsuits and lawsuits in general. Healthcare is now provided on a need to defend basis and not on a need to provide healthcare. The second most important factor is to generate revenue for the city, the county, the state, the federal government, the insurance carriers, and then the higher paid professionals. Somewhere in all of that is "the patient" demanding to control and run every aspect according to each person's individual standards and expectations and every family members' standards and expectations.

By the way, there is no such thing as a not-for-profit hospital. All of these specialty centers are nothing but a way to spend the profits so the hospital qualifies for federal funds. If the hospital admits a profit, they lose federal funds for next year, even if next year they might (and I laugh) have a deficit.

We have pain clinics and wound clinics and women's clinics and men's health clinics and all they are is a way to spend money and avoid lawsuits. Patients get sent to a pain clinic so the primary doctor won't get sued because a fracture causes pain. Patients get sent to a wound clinic so if their wound won't heal, the primary doctor won't get sued.

Please contact a medmal attorney and sue someone. Your mother should not have fractured her wrist, had to wait like every other fracture patient in the area that night, or receive Darvocet for pain relief. Damn those people, I hope you take everything they have.

 

[treeboss]

Thanks Jack

I appreciate your objectiveness. Yes, I do believe my mother is in for a bad time and I don't believe, no matter what the state of healthcare is today, it should be acceptable. This is the large bone in the wrist, on the outside. Thankfully her left (she is right handed) but nonetheless, as old as she is and with all the other health problems, this is very difficult for her. For me, as well, being states apart.

I also agree that if more of us chose not to roll over with stuff like this and doctors were simply held accountable, you're right, their malpractice insurance WOULD go down.

As for the post before yours where the person indicated there was nothing else the hospital could have done regarding availability...the excuse for this was the doctors were all in surgery, right there in the same hospital!...to top it off, it was a nurse who set her in the end and all the "orthopedist" did was look at the original exray taken in ER to agree that it was a clean break! You can't mean to tell me, had she waited in ER, one of them would not have been able to do the same thing at the time she first presented. It's a technician who reads the exrays FOR the doctors anyway, isn't it?

I will pursue this and I do not think it is frivolous! Thank you!

 

[treeboss]

ellencee

Let me guess...you're either a doctor or a defense attorney for doctors?

If you ARE a doctor, I hope I never have to encounter your profound bedside manner. If it is such a burden for these people to BE doctors, they SHOULD drop out of the healthcare profession!

I own a tree business and if I treated my customers like that...sorry, the tree is in your living room but you'll have to let the rain pour in until Monday because I'm busy...we'd get little return business.

My mother, by the way, did call the ER after the medication gave her problems on the weekend and she was told to call her cardiologist...on Monday! The dose she was given was way too high for her, come to find out...but, then again, we all have to be self-policing because we never know when we will encounter someone such as yourself who is so bitter and angry there is no compassion left to give the people who trust in you for their care.

If you're not a doctor...thank goodness!

 

[ShyCat]

Get real. Your exemplary tree business has a finite number of employees and a finite amount of equipment working within a finite number of hours. Even if you were all willing to give up on sleep, there are still only 24 hours in a day. You cannot be in two places at the same time. You can only remove X number of trees in a day. A storm smashes trees throughout the town and you now have 3X number of customers expecting an immediate response. You ARE too busy, that's just a fact, whether it means you don't get their return business or not. So yes, customer, get a tarp and cover your roof until Monday. (Your homeowners insurance company will tell you the same thing: you have a duty to mitigate the damages until repairs can be made.)

Yes, there were surgeons there. Guess what, they were already busy. They cannot be in two places at once either. They also need to eat and sleep sometime, even if they don't care to ever see their families. Your emotional response to your mother's pain is commendable and understandable, but it does not diminish the reality of finite resources. Deal with what is, not what you wish it to be.

 

[pele]

Does your mother have a family doctor? You could have checked with him regarding any new medication, also, your pharmacist would have been of help too. This is not to say what happened is your fault, just some suggestions to keep in mind. Xray techs do not read films, or should not, the only person who should read an xray is a radiologist or a physician. The initial films may have looked in good position, but after four days, perhaps it would have been prudent to take another film before casting to see if the bones remained in the same postion. Also, the internet is a great place to research any meds you get, i.e., Web MD, or Rxlist.com I do it all the time. Good luck to you and your mother.