Failure to Diagnose or General Neglect?

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Sally P.

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Florida
Finding the right type of legal help is hard, especially when you have no idea if you're grasping at straws or if one might have a case. What I am sure of, is that I have a condition that is rare in the younger population. I suffered from unbearable, left-sided abdominal pain from the summer of 2012 up until the fall of 2018.

I was initially diagnosed with having diverticula (pockets that form within the intestines) in the Spring of 2015 when I was urged by an internist to go to an ER to have a cat scan done (she explained that because I was young, I was 27 years old, and generally healthy that it would be hard to get an out patient cat scan approved by my insurance). My pain episodes were not as intense back then, but none the less, the pain had begun causing me to call out of work and had me religiously taking Tylenol as no doctor was ever able to help me truly find the cause of the pain so I continued to mask it for years.

After that ER visit which was noted as my first diverticular episode, I was referred to a Gastroenterologist. I went for my first visit and the wait was much longer than the actual face-to-face with this doctor. I described the intense pain and the symptoms I had felt for years, and he offered basic advice on diet and exercising. He said the only way to truly know what was happening was to get a colonoscopy done. Before jumping the gun, I decided to change my diet and see if maybe certain foods were triggering my discomfort. I also went for a second a opinion to another Gastroenterologist. They had me modify my diet based on something called the FODMAP diet. For a while, the diet helped me immensely, but the pain soon returned and it came back with a vengeance. I lived with chronic pain and discomfort related to my bowels everyday. That doctor said if I did not show real improvement, he also recommended a colonoscopy. Keep in mind, that second doctor works in a University system and I would have had to pay considerably more money to get the procedure done there.

I returned to the first Gastro doctor to proceed with the colonoscopy as that was something I could afford. He performed the colonoscopy in July of 2017. He explained I did in fact have diverticula in my intestines and said the pain I was feeling probably came from what he diagnosed as Irritable Bowl Syndrome (IBS). He made no mention of the damage the diverticula could potentially cause in someone of my age and did not make any connection to my chronic pain with the diverticula.

Diverticulosis is common and occurs in 10% of people over age 40 and in 50% of people over age 60. What I did not know at the time, is that only 10% of the population of persons under 40 years of age can develop diverticula and can lead to serious complications - as was my case. I developed acute diverticulitis.

My first episode of a ruptured diverticula due to diverticulitis (when the pockets get infested and rupture into the abdomen) was in March 2018 - this was noted by the doctor to which I went to for a second opinion as my 2nd divertuclar event (I will refer to him as Dr. B). I was hospitalized for 3 days and was placed on a no food or liquid diet and then switched to clear liquids. I followed-up with Dr. B, and he said if I were to have a third diverticular event, he would refer me to an Intestinal Surgeon.

My third diverticular event proved to be the worst. I was admitted to the hospital on July 25th, 2018 and they found one of the divertula had formed into a abscess that was slowly latching onto my bladder. They placed a drain connecting to the abscess, but it would not diminish in size. I was placed on antibiotics and a liquid diet for many days. I was released from the hospital on August 14th, 2018 with a picc line and the drain still connected to my body. The doctors were trying to avoid invasive surgery in someone my age (I was 29 at the time). I was "laid off" from my job on August 28th, 2018. My previous employer extended my insurance coverage by one month...

After I finished the intravenous antibiotic course, I developed complications and was re-admitted to the hospital on September 3rd, 2019. My infectious disease doctor, assigned hospital gastroenterologist and assigned intestinal surgeon agreed the passive therapies were not working and as such, I had a large colon resection surgery in which they removed the problematic piece of intestine on September 5th, 2018 and I was discharged with a picc line on September 11th, 2018.

Not only did I lose my job, but the trauma of the experience weighed very heavily on me and caused me to incur countless medical bills. My surgeon was shocked to hear that no one referred me to a specialist for surgery even back in 2015. He said I have the intestines of an 80-year old woman and said he could not guarantee I would not suffer a similar experience later in life.

I do not have a legal background or know anything about how to proceed - this is why i'm here. Even if I do have a case, I wouldn't know who to contact in South Florida (specifically Miami, FL). I don't think it takes a legal savant to understand that the first Gastroenterologist I saw completely failed me as a doctor. If he would have referred me to a specialist, maybe some of the pain, suffering and loss of income I endured could have been lessened or at least planned for in some way. The doctor was utterly unhelpful, never gave me meaningful advice or more than even 15 mins. of his time and completely neglected to tie in my long history of pain and discomfort and the dangerous consequences my disease could have in someone of my age.

I don't want any other patient to go through what I did - if I can help ease someone's pain or anguish I feel my job would be done. This doctor cannot go unpunished - it's just not fair to the general population to allow someone so neglectful to continue making money off the backs of innocent patients. Thank you to anyone who takes the time to read my story and offer advice - I will be forever grateful to you.
 
Thank you to anyone who takes the time to read my story and offer advice - I will be forever grateful to you.

You can discuss your issues with any number of medical malpractice attorneys in your county.

The initial consultation is often provided free of charge or further obligation.

A prospective client will normally receive 30-45 minutes to ask questions and discuss their concerns.

The last thing anyone should do is discuss medical issues or concerns with internet strangers.

Good luck.
 
Before you can go anywhere with this, you need more than one surgeon saying, after the fact, that the first doctor should have done something different treating a condition that is rare in your age group. You need a malpractice expert who will go into court and testify that the standard of care was breached. For that you will need a malpractice attorney. This is very definitely NOT a DIY project.
 
Yeah, I stopped reading about half way through.

This is really something to be discussed with a medical malpractice attorney.
 
While I agree that you need to speak to an attorney, I find it surprising that you feel that the first
gastroenterologist somehow failed you. He recommended a diagnostic procedure and you declined.
 
While I agree that you need to speak to an attorney, I find it surprising that you feel that the first
gastroenterologist somehow failed you. He recommended a diagnostic procedure and you declined.


People often demur suggestions or recommendations to attend to their medical needs, choosing to blame others is seen by many as the path of least resistance in achieving the BIG payday.
 
I don't want any other patient to go through what I did - if I can help ease someone's pain or anguish I feel my job would be done. This doctor cannot go unpunished - it's just not fair to the general population to allow someone so neglectful to continue making money off the backs of innocent patients. Thank you to anyone who takes the time to read my story and offer advice - I will be forever grateful to you.

The digestive system taken together is a major part of our bodies, doing the boring but essential work of taking the food and water we consume to absorb the nutrients we need and to convert it to the energy we need. We take it for granted and largely forget about it until something goes wrong. And there are an incredible number of things that can go wrong, including a number of uncommon and even truly rare conditions. What's more, the symptoms you get with many GI disorders can be common to a number of different conditions, making it a challenge for doctors to pin down the exact cause of the problems you face.

When it comes to intestinal disorders specifically, often the best way to diagnose them is with a colonoscopy exam. The doctor really needs to actually see the gut to figure out what is going on. You resisted doing that for awhile, for reasons of cost and, though you didn't say it, probably also because you'd heard that the test is quite unpleasant. (The reality, though, of course is that while the prep isn't exactly fun, the exam itself is not that bad.) I understand that. I have two GI conditions that are even less common that yours. Mine were even harder to diagnose because my initial symptoms didn't give a clue that it was actually GI related at all. But my doctor had suggested reasonably early on that I go to a GI doc and have a colonoscopy done to check out if there might be problem there. I, too, initially resisted doing that. That cost me. When I finally did have it done later and we saw what the real problem was, it had already become so severe that surgery ultimately was unavoidable. I too lost a good portion of my colon and small intestine. Sometimes with the very best care you still end up with a bad outcome. That's just part of medicine.

With that in mind, the question is whether that first GI doc actually committed malpractice, as you seem to think. The answer, based on what you said, is that there isn't obvious malpractice there. The first doctors you saw in 2015 apparently suspected diverticulitis and recommended a colonoscopy to be sure. You did not take the recommendation and did not do the colonoscopy. Like with me, that was in hindsight a mistake. As a result, the doctor did not see the actual state of your colon and could not see how severe it was. It also gave time for the condition to get worse before we found out what the problem was. A doctor cannot recommend surgery on the colon without first determining the exact state of the colon, and the colonoscopy is necessary for that. In short, even if your intestines were in 2015 "the intestines of an 80-year old woman" he would not have known that because you didn't have the colonoscopy done.

The doctors did recommend dietary changes, though, which is reasonable to do if they might help since intestinal resection surgery should always be the last resort to try; if something like diet or medication might treat it, it is better to try that first. And, indeed, you say that helped, at least for a time. So I'm not seeing obvious malpractice in 2015 since you didn't follow the recommendation for the colonoscopy and that was very likely needed to figure out how bad things really were. But maybe some additional information you didn't mention would make a difference.

So now we get to 2017. You have the colonoscopy done finally. And the diagnosis is finally confirmed as diverticulitis and the doctor could see finally the extent of it all. The question then becomes was it bad enough then that surgery was obviously needed at that point? I've not seen the medical records to have any idea of that. But it might not have been that bad yet.

You get to 2018 and its apparent that things are now worse. You have the ER admissions and treatment. The doctors still try to avoid surgery — again surgery is generally a last resort, particularly in someone your age. I was only a couple years older than you when I had my surgery. Like with you, after my colonoscopy, we tried one last effort to avoid surgery by using a course of antibiotics and bowel rest for a period of months. That failed to help. So in the end, I also needed bowel resection surgery. It was not fun. And it has affected my GI tract ever since, with short bowl syndrome and other problems. It's not likely to be fun for you either.

So was there malpractice in 2017 when again you were not referred to surgery right away? No way to tell. It is indeed common, as I experienced, for doctors to try to avoid surgery with other treatments first, if they can. After all, removing chunks of your intestine invites a whole host of other problems. By the way, take the surgeon's comments with a little grain of salt; surgeons tend to be more eager to operate and think surgery is the best solution to things since surgery is what they do and how they make money. So his perspective, while significant to consider, also has to be viewed in that light.

I mention all this because malpractice means that the care the doctor provided fell below the generally accepted standard of care for doctors with similar knowledge and skill (i.e. GI docs) given what they knew of your condition. And it may well be that trying the nonsurgical remedies first was the right way to go. I don't blame my doctors for trying that first — I really didn't want the surgery if I could avoid it. But ultimately it had to be done anyway. Sometimes that's just how it goes.

So in the end, if you want to know if you might have a good malpractice case, you will have to see a medical malpractice attorney in your state. The attorney can have your medical records reviewed by an expert to see if there is a strong enough case to make a medical malpractice case worthwhile. The information you provided here is not just detailed enough to make that determination.

You need to do that promptly. Florida has a two year statute of limitations for malpractice claims, starting when the malpractice occurred or when you should have discovered the malpractice occurred through due diligence, and in no event more than 4 years after the malpractice occurred. That means that if the time for any 2015 malpractice claim hasn't yet expired it will soon if you don't act, and it also means that potentially claims for malpractice in 2017 may be expired, too, and if not you may not have much time to pursue that either. And you'll have to take into account that part of the issue was your own delay in getting the colonoscopy done.

You can't litigate to prevent others from going through what you did. All you can do is get compensation for any harm caused by malpractice, if there was any.

I sympathize with the pain and other problems you've have, and the difficulty of the various treatments you've had along the way. I have had similar experiences. It sucks. But while you have had lots of problems, that does not necessarily mean that any doctor was at fault here or that had things been done a bit differently you'd have had a different outcome. Sometimes life just hands you a bad hand of cards to play. I do hope that you have a good recovery and a stable condition going forward.
 
Wow TM. You out wrote the OP by 175 words. :D

I have some sympathy for the OP's situation, having been in a somewhat similar situation myself. So I wanted to provide an explanation of things that would allow her to fully understand the complexity of the legal problem she is asking about and to understand a bit of the medical profession's approach to these kinds of intestinal problems.
 
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