Thursday, December 30, 2010

Patient Discharge Email versus "Elopement Report"

Why would Duke University Hospital (and specifically Duke Orthopedics) lie?  


I just cannot wrap my hands around it.  I trusted Duke with my dad's life.  With a push from two physicians that I respected (one an amazing orthopedic surgeon from Chicago and the other a Duke cardiologist I barely knew named Dr. Michael Blazing), I trusted Duke with my life in September 2010.
  • Bone infection surgery failed.  
  • Duke Orthopedics refused to acknowledge that the wound was still open at discharge.
  • Duke Orthopedics writes an "elopement report" that reads like a fiction story.  
  • Duke Orthopedics sends the "elopement report" w/o authorization to doctors that I hope will help me.
  • Now I still have osteomyelitis, dead tibia and no doctor to help me.

But how can the reader be certain that I am honest when I state that Duke Orthopaedics' "elopement report" is a fraud.  Here is a true and correct copy of the email communication that I had with Duke Risk Management as I left the Hospital. 


Remember


(1) Duke Orthopedic Surgeon Dr. Mark Easley told me that I should not start PICC line antibiotics post osteomyelitis surgery if the surgical wound reopens because it means that there is still an unidentified infection in the bone.  The PICC line antibiotic will complicate the Infectious Disease Specialists' ability to diagnose the bone infection.  


(2) My surgical wound was open.  I told the resident at discharge that the wound was open.  The resident refused to look at the wound.  The Duke orthopedic resident said to me "there is nothing more we [Duke Hospital] can do for you here."  From my perspective as a patient, that meant that I could go home.


(3) I asked the Duke Orthopedic resident if I could please speak to someone about the open wound.  The Duke Orthopedic Resident said "No, but you can talk to Duke Risk Management." 


(4) The nurse said I could not leave because the Duke Orthopedic Resident was on the telephone with Risk Management.  


(5) Even thought the Resident specifically stated that "there is nothing else we can do for you here," I did not want to leave without informing someone I knew in Duke Risk Management because I did not want to be disrespectful.


Re:     Cheryl Handy dc on 9-18-2010
From:  Sharon S Maddox (xxx@mc.duke.edu)
To:     Cheryl Handy  (handylaw@mac.com)
Cc:     Michael A Blazing (xxx@duke.edu)
Date:  September 20, 2010 7:48:38 AM
Ms. Handy,
I am unclear as to why you are requesting paperwork from me or why you were expecting Risk Management to meet with you. As you know, discharge plans and documentation are to be obtained from your clinical team. Please work with them for any medical information that you need.
Sharon Maddox, ARM
Risk Manager
DUMC Risk Management
684.32xx
681.86xx (Fax)
This message and any included attachments are confidential and are intended only for the addressee(s). The information contained herein may be confidential under the attorney/client privilege and/or the quality assurance and peer review privilege. Unauthorized review, forwarding, printing, copying, distributing, or using such information is strictly prohibited and may be unlawful. If you received this message in error, or if you have reason to believe you are not authorized to receive it, please promptly notify the sender by e-mail or telephone, and delete the message.
From:     Cheryl Handy (handylaw@me.com)
To:         Sharon S Maddox (xxx@mc.duke.edu)
Cc:         Michael A Blazing (xxx@duke.edu)
Date:      09/18/2010 11:17 AM
Subject:  Cheryl Handy dc on 9-18-2010
I couldn't wait for RM to come talk to me about dc and getting 2nd opinion.
Docs said ok to leave today.
I would like a dc plan so I can show other docs when I get 2nd opinion.
My mom is in driving lot. She is old and crying.
Pl fax paperwork to me
630-689-58xx
Cheryl Handy
Sent from my iPhone

Duke Orthopaedics's "elopement report" refers to 
(1) my being in the Hospital in afternoon (but the email clearly shows I left the Hospital in morning) and 
(2) Risk Management being involved (but the email clearly shows that Risk Management was not involved). 


The "elopement report" indicates that I did not want to take the IV antibiotic.  But if that was my issue, why didn't the Resident Dr. Schweitzer ask me why I did not want the IV antibiotic?
  1. I had PICC line antibiotic from the Monday September 13 until Saturday September 18 without any problem.
  2. I had IV chemotherapy without any problem.
  3. I administered push antibiotics in my dad's port-a-cath without a problem.
I did not have a problem with the PICC line or IV antibiotics.  The problem was always and only the open wound.  Duke Orthopedics refused to acknowledge that I had the open wound at discharge.


But Dr. Michael Bolognesi's PA Diane Covington examined the open wound three days after discharge and it looked bad.  Stitches were pulling and popping out.   Below is a true and correct copy of my appointment statement from Duke Medical:


Tuesday September 21, 2010
11:30AM
COVINGTON PA,DIANE B             Duke Clinic 200 Trent Drive
ORTHOPAEDICS                         Clinic 1F
919-684-4007                            Durham, North Carolina 27710

Diane Covington, PA knew the wound was open three days after the discharge. I removed the gauze bandage that revealed 3 or 4 butterfly bandages stretched tightly to precariously hold together the opened surgical wound.  I placed the bandaging prior to arriving at the Clinic.  


PA Covington just looked at the wound as if it was completely normal.  PA Covington said nothing to me at all.  Weird.  PA Covington just replaced my gauze bandage with a new bandage and left the room.  She did not have a physician look at the wound. She did not give me any further instructions.


A group of paraprofessionals entered the room and, as planned, the PICC Line was removed in completely unsanitary conditions.


Two days later (September 23, 2010) I was at UNC Orthopedics.  By the time I arrived at UNC Orthopedics, Dr. Michael Bolognesi already faxed the "elopement report" with no information at all about the open wound (that his PA Diane Covington saw two days earlier) to UNC Orthopedics.  


Why would Dr. Michael Bolognesi do that?  Why would Duke cardiologist 
Dr. Michael Blazing do that?


I was denied care by UNC Orthopedics because of the "elopement report."  UNC Orthopedics actually sent a report indicating exactly that fact.


Again, what the heck is Duke Orthopaedics' end game here?  Me dying or something else?

2 comments:

  1. In a case like yours, whereby it seems no one is listening and those who do are acting rude, and you are put in a desperate situation with your life at risk, my recommendation would be to go directly to the Head Administrator's office of the hospital, or if you are unable to go, have a friend or family member do so and request that the Head Administrator (the Big Boss) come to your room. Have your LIST of "mistakes made by the health care team" ready. You can also, in the worst of situations, call 911! They will come to the hospital, and what an embarrassment that would be...especially if media hears about it. One other point...You may want to contact a "medical mistakes" attorney.
    Sheryl Kurland/
    Orlando Patient Advocates

    ReplyDelete
  2. Sadly, I have no physician to treat the osteomyelitis since Duke Orthopedics sent the "Elopement Report" to my second opinions.

    I get to do a lot of writing and studying since I am bed ridden with the bad leg (open wound draining the tibia's bone marrow). The infection causes sores on my skin and fevers.

    Attorneys cant help me at this point - I just want to live long enough to make other people understand that bone infection is serious. Patients (especially elderly people) who get joint replacements need to be very conscious of the possibility of bone infections. As you probably know, bed sores get deadly when it becomes osteomyelitis.

    I am so concerned about the elderly or alone who go to rehab centers after joint replacements and there is no one who watches for bone infection (osteomyelitis).

    If Duke University cannot treat osteomyelitis (my dad died of osteomyelitis under Duke's care on 1/15/2010 and now me) and UNC-Chapel Hill is clueless . . . then I am frightened about the upsurge of joint replacements.

    I so appreciate your concern for me. Please continue to watch out for your patients in Florida and make sure orthopedic patients are safe.

    God bless you and yours. Happy 2011.

    ReplyDelete