[pixiegypsy]

Hello,
I had shoulder arthroscopic (?) surgery 2/5. Three days later in physical rehab my shoulder was hurting really bad and also snapping, bone on bone. I had the stitches removed on 2/13, telling the doc that I was in agonizing pain and not sleeping. He had me come back on 2/21 for a steroid injection and I again told him I was in terrible pain, as if I had broken bones or maybe a bone infection. He took x-rays and found a good size piece of bone that he "missed" and it is rubbing/snapping on my collar bone. He said it was his fault. He told me to come back in three weeks to check it. I am in terrible pain, not sleeping and have about 20% use of my arm. Any movement makes me scream. How do I get him to pay for the co-pays for the next surgery, the 8 PT appointments and my scripts without insulting or threatening getting an attorney? We are closing on a house in three weeks, every extra penny is being carefully saved and pinched. I do not have the extra $500 to cover my costs for another surgery that was caused by his mistake.
What type of words/terminology can you suggest to help me convince him that he should cover those costs?
He really is a good surgeon and I would like to avoid a lawsuit, and most of all avoid any damage that may be happening while I wait.

[debsherlrn]

Hi - Ouch! Sounds like the repair needed due to the doctor's error during 1st surgery is what is called "within the regularly accepted post-operative time frame. Meaning - the physician is responsible to make it right - surgically - but not necessarily financially. Depending on the state in which you live, your health insurance rules/regs etc etc. I am a certified legal nurse consultant / RN by trade and training.
1. Contact the doctor and make an immediate appointment to discuss the redo that is needed and what to expect financially.
2. The doctor admitted error and may well be not planning on another charge, but that does nothing for the surgical site, and other providers. He/she cannot make the others waive their fees too.
3.You more than likely signed a consent form / was told of the risks vs benefits of this elective procedure - right?
4. At this moment in time - you have a really bad shoulder issue, but not a legal action that has legs to stand on - yet.
5. If it were my arm, I would do everything possible, as soon as possible, to prevent permanent damage to your hand, arm and shoulder.
6. If your doctor is good & wise - talking this all out now will work. Straight out ask if there will be a second set of fees and expenses - ask that the answer be explained until you can understand.
PS -What was wrong in the 1st place AND were you a surgical risk for some reason that may have enabled/amplified the error's potential?

[pixiegypsy]

Hello, thank you for your answer. I had a "standard nerve impingement" and arthritis in my shoulder. It had been causing periodic problems for 20 years. It flared up this past fall and with PT the problem got worse. He shaved the clavicle and acromion, removed bone spurs and removed a piece of bone from the clavicle where the impingement was putting pressure on the tendon and ligaments. From what I understand, he told me he missed a piece of bone/spur/arthritis on the Acromion. You could see on the x-rays a piece of bone/spur/? That was at the tip of the shoulder, and I am not sure if it is a floating piece or not. I do know that it is causing different nerve pain and problems that I did not have before the surgery. I now have a ripping type pain that shoots down the front of my arm into my biceps. I cannot reach forward or up and the bones are still snapping.
I do not know how to approach this issue with him. My concern is that he may disregard any issues about my financial problems and say he is not responsible for this second surgery. If so, do I embarrass him by saying I am not financially prepared for a second surgery especially when he is at fault? And most of all I am concerned about any damage that may be occurring now.
How do I bring this up, how can I convince him this surgery is necessary and I need him to make the $150 co-pay to the hospital and (at least) pay the co-pays for 6 PT sessions? Is there specific terminology I can use to help move this over to my side without sounding like I am threatening him? $300 and this can be done. We just signed to purchase a house the weekend after surgery. The down payment, our appraisal fee, termite inspection fee, and the bank inspection fees have drained our savings. I had budgeted this whole surgery into our bills, and it has cost me well over $500 so far because of extra prescriptions that the insurance would not cover. Since you are in the medical field you may have some idea of specific terminology I can use to "beg" him to do the right thing.
I have spoken to a legal assistant, she agrees that I should go into speak with him about how I am going to financially handle the second surgery and if he would help with the co-pays and that I would sign a release if he wanted. If not, she said to call them back and they would find me a doctor. Is this whole thing worth wasting my time and maybe more injuries if I wait. I guess it all depends upon his attitude and his answer. So, if you have any helpful magic words, I would be very grateful if you shared them with me.

[debsherlrn]

Dear Pixiegypsy,
Actually, there are no magic words beyond empathetic truthful inquiry.

Have you considered getting a 2nd opinion about just how successful a 2nd repair would actually be? It's always possible for things to get worse instead of better.

You truly have nothing to lose by sitting down and kindly talking with your surgeon. Show him these writing. Some doctors frequently do not perceive the anxiety that they are able to provoke in us. What is the worst that could happen by having the peaceful talk with the surgeon - I mean really, really.

I would personally leave any legal activity out of the picture until you have absolutely no other options and even then - since you most likely signed a surgical consent form, you have possibly incurred an "acceptable known risk" of this type of surgery. Therefore, there is no legal case. That is not to say there is no problem. You see - the medical profession and the legal profession are totally, totally different in the definitions of medical problems and acceptable solutions or as the medical world puts it "outcomes".

Finally - I hope that you can come to the place where you will feel comfortable verbalizing your obvious needs to this physician. I'd ask that you simply give him/her a chance to finish helping you. Please try to remember that your personal family financial issues related to signing for a new home ( congratulations !) have really no bearing on the doctors' work or the surgical outcome. As hard as it may be, try to put your physical health in front for the current moment. DAS

[pixiegypsy]

Hi Deb,
Well the appointment did not go as well as I would have liked. His behavior and attitude was all about covering his own butt. My health and well-being was not a part of his priorites. The new x-rays showed arthritus in the area's that he had "already" worked on. His statement was that he would have to scrape more from the clavical, remove the bone fragment, more arthritus spots, and address the nerve impingement again. I thought that was what was suppose to be done in the first place. The piece of bone that he left was very apparent on the x-ray. He had his nurse give me an open-end doctor release form to sign, which I did but I added "right shoulder only" on the page. So it seems to me that his interest is for himself and having the right paperwork to give to his attorney.
I saw my PC doc today and she is setting up a second opinion with another surgeon next week. She will speak directly to this Doctor and let them understand this is a second opinion. This area is very well known to be a bunch of "good ol' boys" that cover each others butt. There is no accountability for anything.
I have no idea what will happen next. Even if I got an attorney I would then remain in pain and try to find a doctor in my small health coverage area that would want to take me, especially if it is part of a lawsuit. I can only hope for the best, unless I sick my husband on him, my defender with his lack of diplomacy in times of stress, lol. No that would not be good!
I will not be online for a few weeks as we are moving and cutting expenses until we find our budget affords an internet provider.
Thanks so much for your feedback, I will let you know how this turns out.
Pixiegypsy

[debsherlrn]

Pixiegypsy, Good to hear from you !
Best wishes on your new home! Your input leads me to believe at least you are not feeling worse with your shoulder pain/s. The 2nd Opinion is a really GOOD thing to do, let's hope for the best. I will await your return to the net. DAS