Cervical Discectomy

Hypocrite-ic Oaf … Medical Professionals — The protected class of Nevada. or “Come to Nevada, where your best medical bet, is your pet’s local vet.”

For the past year, my wife has been the victim of sub-standard medical care in the state of Nevada.

Of course, the ensuing malevolence was deemed acceptable by the powers-that-be. However, after much investigation, it was found that the greater the medical debacle, the greater the support from the various state agencies to hide any extreme errors. This obtuse approach maintains solace in the community and ensures that the system’s defects are concealed. The result is that the cattle are put out to pasture to die without recourse for injury to life or quality of life. Of course, what is sub-standard? Is it below regulatory standards, or below acceptable standards, such as ambiguous, inferior, unacceptable, life threatening, quality of life threatening, and publicly endangering? For this context, let’s accept the latter, as it is obvious that the governing bodies have lowered the bar on quality healthcare standards over the years.

The core situation involved two anterior cervical discectomy with fusion (ACDF) surgeries in 2002. The first, in February 2002, was to repair C5-C6-C7 disc damage. The second, in October 2002, was to remove and replace the supporting plate and screws — which broke, causing failure of the fusion, thus re-breaking her neck. After the second surgery, the entire situation turned into a ludicrous spectacle instead of a situation with a path of resolution. Obviously, this is only a cursory overview of this fiasco — there’s much more to this!

It is interesting to note that I did query my wife’s surgeon on the issue of material fatigue when the screws broke. He told us that everything “will be fine,” after the fusion and the screws broke, if he leaves the situation alone. However, when I mentioned that she was having trouble breathing, swallowing, and was spitting up blood with a sore throat in addition to the fact of having a skull pivoting on two small, broken screws sounds like a recipe for disaster, then indeed, he scheduled a second surgery.

For the second surgery, the surgeon’s staff placed my wife in the wrong hospital, not covered by insurance, even after I warned them vehemently that we were not covered in the particular hospital. As we waited in the hospital, just before her scheduled surgery, we were given a choice as to whether we wanted to pay 30% upfront, reschedule the surgery and our jobs at the risk of jeopardizing our positions, or raise Hades to gain some immediate resolution and attention as everyone was scampering for a dupe. I chose to raise Hades, as had we been placed in the right hospital, as I had requested by name, we would have only had to pay a small co-pay! Note, that there were other hospitals covered under my insurance that did support the procedure. This entire situation reminded me of the bait and switch tactic of used car salespeople. However, from this experience, and what I’ve learned through dialogue with others, this is a common issue, which leads to the fact that medical administra tive staff should undergo some type of instruction in the handling of insurance for their patients. Such hit and run insurance handling and verification is objectionable as the fiascoes caused by unskilled medical staff create a significant amount of stress for the already stressed patients and their families.

Second, my wife requested that the broken hardware be retained after the second surgery for investigation by the hardware’s manufacturer to determine the cause of the breakage. Yet, according to the hardware company, the doctor and the hospital discarded the hardware. Now, the hardware company cannot properly report the issue to the FDA, thus adding further risk to the public. Additionally, this issue has been ignored on several instances and resolution through proper channels is non-existent. Interestingly, several attorneys and my wife’s new doctor stated, “broken hardware is always kept for future reference and investigation.” Her current doctor has no idea why her former surgeon breached protocol and discarded the hardware. Apparently, obstruction of this sort is common practice in the medical community to conceal errors — without any recourse. But, after experiencing additional tangents in this fiasco, this act makes me wonder what was it that the broken hardware reveal ed?

Yet another ludicrous part of this situation is that, after months of trying to find out why my wife’s neck was not healing properly and why she was unable to turn her head, she had to fire her surgeon and locate a qualified medical professional. Her former surgeon presumed that she had Carpal Tunnel; however, she had just experienced spinal surgery! But, her new doctor noted that the reason for her situation was that she had large amounts of scare tissue and her C7-T1 disc is collapsing — which was ignored on the last MRI by her former surgeon, yet was specifically noted by the MRI specialist. This is all noted by her new doctor as a result of the second surgery — for which we are now looking forward to a third surgery and additional expenses. Rhetorically, why was all of this not revealed and my wife not placed on a plan to assist in recovery and pain management instead of prolonging the situation?

My wife’s new doctor put her on a resolution path for the pain through nerve blocking. It actually took firing a surgeon and finding a new doctor to seek resolution and answers. The problem here was that her former surgeon knew that he could provide sub-standard care without risk because he is part of the protected class of Nevada’s citizens — the doctor. In all honesty, I was inane to think that, ethically, doctors would refer their patients on when they cannot effectively continue care toward a vision of resolution. Performing unnecessary procedures in hopes of finding an alternative issue to cover an error is completely unacceptable and a desecration of the patient’s time and money. Indeed, occasionally, resolution cannot be attained, but there are solutions for pain management and for placing the patient into a better situation.

One of the other disturbing items in this situation was the utter lack of respect shown by the medical community and the fact that I literally had to fight to obtain information and provide assistance for my own wife. The unbelievable manner that doctors treat concerned family members is most appalling and is reminiscent of the horrendous manner in which cattle are treated before the slaughter.

As my cowhide is a bit tougher than this, my immediate concern is for those who don’t have friends or family members to support them. What of the older, widowed, or abandoned patients who literally have no one for support and assistance? We could not even imagine how my wife could have eaten and taken care of herself after these spinal surgeries — even after we were told that she would not require any assistance. Not to minimize the intellect of the older generations; however, they knew things a certain way in their time. Now, being thrust into this uncertain present without any support or understanding for the situation leaves them to be nothing more than frightened dupes for today’s medical hacks.

My wife reported this entire fiasco to the Nevada Board of Medical Examiners, the FDA, and she spoke with several attorneys. Interestingly, the attorneys noted that the BME will not reprimand the doctor and no attorney will sue a Nevada doctor because of the medical crisis in the state. It was stated that, while there were at least five legitimate cases within her situation, litigation would not proceed since there are so few surgeons in the state. Attorneys now only take on the small, ambulance-chaser cases, but when it comes to something overwhelming and legitimate, they will avoid the situation for concern over their reputation.

Additionally, it was noted that the attorneys would have a more difficult time because the hardware was discarded.

But, what of the welfare of the patient, and future patients? Once again, this raises the claim that small infractions are made public as they will generally go unnoticed in the public eye; however, larger infractions are disguised as such issues could unnerve the community. In our case, my wife had a second botched surgery and is now looking at a third, without any recourse, because some ham-fisted surgeon has been hidden behind the political wall of shame. I must ask — what is the rationale for the BME and the legal system, again?

This raises concern that this malpractice crisis and tort reform has created a breeding ground for additional deceit and a mechanism to raise the status of the inept in the medical community. However, as with all things, was this a planned catastrophe or a mistake? It’s difficult to accept that such a politically beneficial situation would be a mistake, as it seems that this malpractice crisis is a matter of political directives as opposed to public choice.

Additionally, I found that informed consent is a good idea, in theory. As a statement on a piece of paper you sign in the waiting room, the consent merely represents that, whether the doctor informs you or not, it is accepted that he has informed you — this, regardless of whether he informed you or when it is documented in your medical charts. It was interesting to note that the pages of questions that we brought to each appointment deeply troubled this surgeon — as though we were questioning his ability — which should have been taken as an immediate sign of impending problems. I realized years ago that when you’re faced with a life, or quality-of-life, threatening surgery, it is wise to push forward with research and questions without regard for the doctor’s feelings. However, it all reduces to the fact that, as was demonstrated in this case, a doctor doesn’t have to tell you anything that you don’t ask and, even still, they’re not obligated to answer your questions. As w as found, simply by responding with, “I dunno,” instead of putting forth the effort to find a reasonable answer, any doctor can state that he answered all of your questions.

An item that I present here is mandatory patient education prior to surgeries. It is the responsibility of the surgeon and the medical vendors to provide reasonable information to the patient so that they can make educated decisions, whether it is an elective or necessary surgery. It is necessary to provide booklets, product documentation, and videos that educate the patient on what will be performed as well as the potential results. Perhaps this could be called, “The Medical Lemon Law — Know What You’re Buying.” Such legislation is a difficult task as it interferes with political swag; however, merely the presentation of such bills will begin to raise an awareness for the public.

Another item I challenge is that of training. It is the responsibility of the medical vendors to provide adequate training to surgeons and their staff to ensure that they are qualified to perform surgeries and intelligently inform the patients of the products. Even automobile mechanics must undergo training before they are allowed to provide support for a vehicular component. Some type of qualification training should be mandatory for surgeons and, if they don’t qualify, then they are not allowed to use the vendor’s hardware in a patient. Indeed, from a business standpoint, this is not a reasonable decision and by applying the formula (i.e., profit:payout) to this situation does show that paying damages for every error does still provide a reasonable positive cash flow in accounting. However, the people factor should be a necessary variable in the equation. Personally, I would much rather live without the damage resulting from botched surgeries than to have a pocket full of hus h money. Not to mention the fact that such issues are rarely publicized so that the public doesn’t become stigmatized — another business decision. However, smaller issues are indeed made public as they go unnoticed by the public eye — this so that it can be said, “we do inform the public.” Back to the cattle theory — hoping that the cows just do what they do without taking notice.

There are still many unanswered questions in this situation, yet I can see that finding someone to step up and provide the answers will be a daunting task. It is remarkable to observe the politicians and the medical community avoiding accountability in what started as a simple situation, with one simple question, turn into an interminable debacle for no reason other than to hide the convoluted errors and mayhem of one doctor and his staff. However, it is quite humorous to consider how one simple question caused an entire professional community to devise such a web of yarns. I now realize that indeed, this was truly a sore spot.

While driving to California, Arizona, and Utah to find reasonable healthcare is a simple and valid option, it is a distressing situation that, as this state is growing, it is evident that it is not ready for growth. Forcing the population to abscond to neighboring states for reasonable medical care is counter-productive. Focus on bringing quality to the medical community, not to mention the school system, and then focus on growth. If the state allows negligent doctors the right to practice under the guise of quality, and protects their negligent actions, why would people want to remain here for any extended period of time at the risk of life and limb?

After speaking with a group of independent medical malpractice investigators, they said that they have “witnessed first hand” the utterly ridiculous medical demonstrations noted in this situation. Additionally, I have spoken with media contacts to find that they hear of this type of situation, and worse, occurring hundreds of times each year without any recourse or resolution provided by the medical community or the governing bodies. Since the situation I mention here is more common than not, why is it still occurring? Obviously, expecting some sort of resolution after the disdain of culpability demonstrated by the Nevada medical community would be imprudent. We have to wait until enough cattle die for such situations to become important issues — otherwise known as a surprise to the politicians.

In our case, we commend our insurance company for their patience and efforts in assisting my wife. Yet, this brings up another situation regarding the costs and abuse of healthcare insurance — perhaps politicians should examine the medical community’s practices. To reduce risk, doctors perform redundant and unnecessary diagnostic tests and offer only middle-of-the-road medical advice and procedures, even when they know that other treatments would be more beneficial. Not only does this escalate expenses and pad the doctor’s wallet, but it also wastes a tremendous amount of time in hopes that the cattle will die and the risk dissipates. However, doctors are not performing procedures and tests to resolve medical issues, but instead dance around issues to cover or avert errors and reduce risk. Accordingly, as long as the doctors do something, regardless of the outcome, then they have done their job, according to the powers-that-be.

It’s a trade off. Sub-standard care is politically acceptable to limit risk, which in turn raises risk because of sub-standard care. To avoid the resulting risk, the political system relieves the medical community of accountability. This downward spiral only demonstrates that the politicians are aware of the situation, but are not seeking any resolution. Now, the brunt of the risk is absorbed by the patient in that they’re paying for ineffectual care, especially once the doctor errs and is unwilling to accept responsibility. When you buy a car, the dealer is willing to provide support and repairs, even when they err. As naïve as this may sound, I would assume that human life is more precious than an automobile, which makes me wonder why the standards of quality are higher for car maintenance than they are for human care.

We have consumer advocates, the FTC, and various consumer protection agencies that will sue a company out of existence because some child wedged a toy in his nose or some person spilled coffee in their lap. But, when it comes to the sanctity of human life and rights within the medical community, there is literally no one available. Of course, this point could be argued; however, those organizations that are supposed to protect us against medical injustice were the exact groups that stated that they could do nothing because of the medical malpractice crisis in the state — yet another vicious circle. You’re on your own at the hands of the protected class. Again, here I ask, what is the purpose of the BME and the legal system?

The one thing that I am sure of is the survival of this new protected class in Nevada. Even if Nevada were to become a ghost state, and the only people left were doctors, they could still make a reasonable income by maligning each other. That is, until they eventually exterminate each other through inept practice. However, as is the case in today’s environment, it’s not the best man that will be left standing — it will be the one that acquired his medical degree for $50 at some online school in the Dominican Republic.

As we await surgery 3 to repair the results of slipshod surgeries 1 and 2, I have to wonder as to why I must continually pay for the irresponsibility, negligence, and incompetence of this protected class and their followers? But, I chuckle when I realize that through taxation, I’ve been doing that for years. However, what about accountability? Why can’t I get away with slipshod ethics and procedures like the protected class and their followers? But, then I realize that those I am paying require scapegoats, pigeons, guinea pigs, and the cattle. Yes, back to the farm. The comical point about cattle is, while they are not very bright, their survival instincts will force them to migrate in packs in search of safer and better feeding grounds.

Well, I am off to California next week in search of a doctor and to speak with an attorney for my wife. If that doesn’t work, since my expectations have been lowered considerably by the Nevada medical community, I’ll look into some drugged-out witch doctor from Mexico. Although shoving a live chicken up my back-side in a bizarre medicine-man voodoo ritual doesn’t sound appealing, I am sure it would be more pleasant than dealing with the butchery and debauchery of the Nevada medical community.

I find it most interesting how the political engine protects the medical community so well. In this case, it is not so much that anyone wanted to sue anybody — it is a matter of accountability and resolution. However, having to pay for someone else’s negligent actions as well as the ramifications of those actions do change one’s view and desires.

I do agree that, indeed, doctors are good targets for lawsuits and do require some level of reasonable protection through the legal system — just like the rest of us. However, this inept display by legal, government, and regulatory agencies not only protects the doctors by removing all accountability, but it also endangers the public. I see this as utterly ludicrous as when you are dealing with the most precious thing on this planet, human life, and you are not held accountable, it turns into a matter of life and death on a conveyor belt.

I have contacted Nevada Senators, Congressmen, Governor Guinn, and the Attorney General with a pointed letter on this situation and the details of the medical issues and politics behind the situation. Of course, no response; however, as expected, it was an excellent exercise in squandering time in a productive manner.

Again, to show my naïveté, but I hope that, this time, some Nevada politician with a little intelligence does the right thing and examines the appalling practices of and around the Nevada medical community. Whatever you do — at least try to be smart about it. You have a serious problem and your previous shows have not been impressive. Most disturbing.

Edward T.
SHARE