Litigation

[Comeback Kid(ney)]

I am curious who in the community has taken the bold step and sued their former clinic for negligence. I am starting a major lawsuit against my ex-nurse and medical director for plotting to throw all my numbers out of whack. Up until 6 months ago, all my numbers were great and then mysteriously they started going haywire around the time of their merger with another clinic and subsequently being acquired by a bigger conglomerate. All of a sudden the personal care was gone and the pure profit motive became paramount. So, has anyone been successful in challenging the system?

[jbeany]

It's a hard road.  I haven't done, but I've attended a legal seminar that had good info about.  Have you seen the post?  You have to be able to find another doctor in exactly the same field who is willing to testify that what they did to you is less than standard care.

http://ihatedialysis.com/forum/index.php?topic=22942.0

[YLGuy]

I don't know if he has any experience in litigation but we have a member here named plugger. He has on his profile, "A Proud member of DialysisEthics since 2000."  Maybe he has some advice for you.  It could not hurt to shoot him a PM.

[Comeback Kid(ney)]

Unfortunately, it would be hard to find a doctor who would buck the system and isn't that the real shame of the matter. What are we just pawns to the medical world? I know the answer!

[kristina]

Very briefly:

In 1992 I suffered a stroke , caused by uncontrolled high blood-pressure,
before which time I regularly visited a NHS-GP/doctor explaining all my medical problems
which I now know to have been typical pre-stroke-symptoms.

My career was ruined at the age of only 38 by the stroke.

A local Health-Authority-Hearing white-washed my attempt at making my case heard
(my representative was not even allowed to speak
and my suffering a stroke was never mentioned at the Hearing).

I knew the doctor deliberately ignored my pre-stroke symptoms
because he had another agenda, and so I found a solicitor
to handle my case of medical negligence against this doctor.

The solicitor/lawyer used-up the funds and did nothing at all,
so I found another solicitor/lawyer and the same pattern of initial enthusiasm,
making money, and failing me, happened again.

What I found out was that the doctors have in England
one of the best legal support-systems
and because of the doctors and lawyers profession
they hold hands and back each other up.

The local Health Authority is ruled by the government Health-Department
and so it is very strong, very political,
and also walks hand in hand with the doctors and lawyers.

I had no chance whatsoever
both with the Complaints Procedure in the NHS-Health-Service
and persuing legal action.

I feel very strongly that my complaint and actions
have affected the way the doctors and Health Service have treated me after that.

It has become impossible for me to find a doctor who I can trust.

For example, I thought I could trust the specialist who was looking after my kidneys
but they failed to tell me that my kidneys were deteriorating and did nothing medically to help me.

This was many years after the stroke.

My pre-Dialysis kidneys function is only 10-12% and I have no doctor, no specialist to go to
and with the very little money I have, I am forced to pay every blood-test out of my own pocket...

So you can see I tried to put my trust in doctors, but they have all let me down,
and I have no idea how to go from here.

Good luck from Kristina


[Correction: I just noticed I made a typo-error, my stroke occurred in 1991 and not 1992 as I wrote above]

[kporter85db]

I am curious who in the community has taken the bold step and sued their former clinic for negligence. I am starting a major lawsuit against my ex-nurse and medical director for plotting to throw all my numbers out of whack. Up until 6 months ago, all my numbers were great and then mysteriously they started going haywire around the time of their merger with another clinic and subsequently being acquired by a bigger conglomerate. All of a sudden the personal care was gone and the pure profit motive became paramount. So, has anyone been successful in challenging the system?

The first thing you need to determine is were you damaged in a significant way. Unless you have the cash to pay the lawyers fees and expenses, they will only be interested in your case if they can get a big settlement to cover their fees.

That's where I would start.

[Comeback Kid(ney)]

Kristina,

     I couldn't have said it any better. My level of trust in the medical world is zero. In the kidney world, it is below zero. I know exactly how you are feeling. If you need a patient advocate, I would be more than happy to put you in touch with mine. I actually suggesated tomy advocate today that as patients we should enact a rally against the government and the poor quality of care that we get. It would take a big event like that for possibly the powers to be to take notice. Unfortunately, I don't think that after an initial surge that it would have many legs.

[Ang]

i wish you luck with your endeavours

[kristina]

Thank you, Comeback Kid(ney).

I have been wondering whether there is a way
of finding a better level of health-care by approaching
offices in the European Union ?

I have given up any hope of arranging
proper health-care in England,
because my many various experiences have shown me
that there is another agenda at work in the Health Service (NHS)
which is supported by a very strong, and very loyal  legal system,
which does not put the patient as the central priority.

Patients seem to be pawns in a complex game,
and the only hope a patient has, is to be on the winning side,
but a patient has no way of knowing which side the game thrown them to.

[dialysisadvocate]

It is very difficult to go after the dialysis providers. They have attorneys on retainers and can fight as long as anyone. They know, from their existence, that very rarely are there consequences for their actions, or lack thereof, that result in harm, including death of a patient. Again, I refer you to the dialysis facility surveys at www.qualitysafepatientcare.com  Although these are for California, I am sure this represents a similarity within the United States when it comes to preventable errors resulting in negative outcomes.

I agree that it is hard to find another nephrologist, or other specialist, who will go up against the one you are filing against. Although, there are physicians out there that do such. It is also difficult to find attorneys who do not want up front fees or who will even fight for a patient.  Then,,,,,,,,,,,,,,,,,,,

As I have reviewed medical records, it is evident, clearly, that staff do what I call 'defensive documentaion'. Meaning --- they document subjectively and not objectively. This does not present a real picture of what happened to the patient, or what the patient experienced. Therefore, when medical records are reviewed, it is often difficult as the reality and truth of the situation lies underground.  Staff further use adjectives to describe situations which, in fact, often show a different picture than that which really happened. This is why it is often even difficult for the state, when investigating a complaint, to prove deficiencies.

The providers, also, yet another aspect, have never really been held accountable. They know that all that is needed is a written document telling the state and CMS that they will not do something that was found deficient in their inspection. A slap on the wrist. CMS, the oversight agency, has for years, not fought for patients. I state this because they have not gone to legislators,etc and said 'hey, there are problems in these facilties, patients are not getting the safe care they need and we need sanctions and consequences for these providers'.... Even dating back to 1999, the OIG (Office of  Inspector General) mentioned in one of their reports that sanctions were needed. I am not sure that any providers, kidney organization, or patient advocacy groups (tied to the healthcare industry in some way)  have pushed for holding providers accountable.

Indeed now CMS is initiating the QIP, however, as I have informed HHS (federal level) this will NOT address the daily care that patients receive in their units.

What it will take is for more and more patients to ban together and speak out as a group in order to truly improve care. However, not only having experienced such myself, as well as my deceased father, the issue of staff retaliation  sits at the top of the list of why patients/families fear to speak out. Many do not believe that this exists today in this age. This is because the fear level of so high and once a patient even gets an 'eye-roll' from a staff when they question a practice, this sends a loud and clear message from the staff 'do not ever ask that again'. 

Providers need to revisit their training/education programs.....With dialysis employment being a fairly secure job, anyone is hired and trained, even those who could care less about patients. And, until providers ensure there is effective unit level supervision with those in management knowing correct procedures, I am not sure things will change on a daily basis. This is why you must educate yourself as much as you can and become empowered. But, on the other hand, you can become empowered and if there are staff that remain resistant, it can still be a problem.

If any of you are interested in posting your stories on our website, let me know as we are starting a section for patients --
You can email me at RMiklesRN@aol.com

above are opinions of  Roberta Mikles BA RN Dialysis Patient Safety Advocate
www.qualitysafepatientcare.com

[kristina]

Hello, dialysisadvocate,

In response to patient-groups my experience is this:

In the past I have been a member of several different well-known patient-groups,
each connected to a disease which I suffer from (e.g. Lupus/SLE/MCTD and ESRF).
I was led to believe that by being a member we could effect change.
Two particular groups were very large national organisations
and they had on their books some very well known people (i.e. Patrons and representatives).

To cut a long story short, when I first joined these organisations they all looked very prosperous and gave me hope. 
I soon realized that these organisations were fronts for money making activity,
either on purpose from the outset or later becoming so by being infiltrated by the wrong people.
They could also be a political voice.

Gradually they evolved in a more distressing way,
where the true suffering of patients was suppressed, and a veneer was laid over the top,
and this veneer showed a different picture of patients with disabilities:
patients could climb mountains, swim across the English Channel to France,
participate in the Marathon, in short, these patients appear more healthy than the general public.
Images portraying this picture appeared, and still appear, on the front-page of magazines
produced by these patient-organisations, giving a wrong picture of the diseases and the associated disabilities.
This misleads the public and does a great disservice to the majority of patients.

Like many organisations, when they first appear to threaten the establishment,
they are quickly infiltrated by people whose aim is to steer the organisation away from its original purpose
and the original objectives become distorted - NOT in favour of those patients who are truly suffering
and need urgent help.

These organisations very much like to exploit the sick and vulnerable.

I have been approached by more than one of these organisations
with the idea of using my medical case to promote their interest in raising money.
(I am in ESRF and suffer from Lupus/SLE/MCTD without any medical care).

But, interestingly, they never ever considered the stress and consequences I would suffer due to
my involvement with their idea, and they never gave me any constructive assistance or help.

The money raised by such articles, and the money raised generally, would not be for the benefit of patients directly.
The money raised provides excellent salaries for many people (employment),
and also pays for a whole raft of expenses, and what is left is given to doctors under the title of “research”,
to forward the doctors’ careers.

The patients are hardly ever considered and if it appears as though they are, it is not genuine.
I found out that these organisations became a fund-raising-mechanism for doctors
who were engineering their own successful careers at the expense of desperate patients.

It is sometimes very hard to understand this point of imbalance between doctors and patients.
Let me explain by my own example:

Because of the very poor health-care I was receiving my blood pressure gradually got totally out of control.
My doctor did nothing. As a consequence I suffered two cerebral haemorrhages and I almost died.
Two operations were needed to clip the burst aneurysms, and the operations were a great success.
The surgeon was, undoubtedly, extremely clever and I am grateful for his expertise. 

But, within two weeks of the operations,
having been given no chance to convalesce, I was discharged from hospital.
I was instructed to clean and dress my own fresh head-wounds every day at home, and no medical services were provided.
I was too weak to shop and cook and I lived mainly on powdered supplement with milk.

Before I left the hospital, photographs were taken of my wounds and my case was used
by the consultant Neurosurgeon for an article in a journal.
In short, the consultant used me to forward his career,
and the surgeon forwarded his career by doing the successful operations.
 
But, I was left on my own afterwards without any support healthcare,
left to fend for myself whilst being in a desperately weak and vulnerable state.
I had no health care before the operations and I had no health care after the operations.

Here we have this peculiar situation where the success is not based upon a humanitarian thought and act,
but the success is based upon the single-minded-selfishness of doctors building their careers.

I am all for doctors building their career and becoming experts in their field,
but, there surely must be respect and professional integrity
towards the patients they are dealing with whilst they are advancing their own career.

I have to say here, that I am in favour of doctors conducting research, but,
there has to be a balance between the doctors’ efforts and the medical  needs of the patients.
In my experience the pendulum has swung much too far in favour of the doctors,
with the patients left in great danger of becoming guinea-pigs.
 
I return to the patient-organisations.
Whilst studying how these, so-called, patient-organisations work,
I have not come across any help or assistance directed towards the real needs of patients.

This brings us back to the power of the medical profession, businesses, the government,
and of course, the legal system which supports them all. They make a powerful team.
How can individual patients form a group powerful enough to make the pendulum swing back
more towards them?

I have not found an answer to this patient-dilemma, and I still hope I can  soon
receive  medical care to assist me in managing my ESRF (kidney-function 10-12%),
because I do not want to end-up on the hospital-operating-table once again.

Is it possible that a patient-organisation could ever be independent and powerful enough
to effect constructive changes for the patient ?

[Rerun]

If I didn't believe my numbers I would go to a lab get a blood draw and then go to dialysis and let them do their thing  and compair the results.  At least you'd have some proof.  But, all they would say is "oh, we'll take your labs again, there must have been a mistake".

I've had problems before and written letters and documented and documented but nothing happened.  Finally one guy quit and one guy went to work for his father in law.  Thank God!

Kristina??  Aren't you in The UK?  I'm only saying that we may be talking about 2 different medical systems.

[kristina]

Yes, I am in the UK, Rerun, but I mentioned my experiences,
because there may be something which other patients feel is similar in different parts of the world,
and we also come across large organisations connected with our health-care
and therefore there may be similarities wherever we live.

It is just a matter of learning from each others’ experiences.
That's what is great about a forum-site like IHD.

There will always be patients who will receive wonderful health-care,
and those on the other end of the scale who will sadly receive very bad health-care,
with a myriad of variations in between.

The point is no one can predict where they will be on that scale,
so is is good to share experiences.