Do I pursue the fact that my GI doc did not wait for the anaesthetic to take effect during my upper endoscopy & colonoscopy?
September 4, 2010 9:36 AM   Subscribe

I just underwent upper endoscopy and colonoscopy. The GI administered the anaesthetic in a haphazard, guesswork fashion and eventually just gave up and proceeded even though the anaesthetic was clearly having no effect yet. My reflexive reactions to the EGD were pretty violent although I don't think I ended up with any injuries. The drugs kicked in 3/4 of the way through the colonoscopy. How much of a big deal should I make out of this?

I understand that anaesthesia is not a *requirement* to perform these procedures. My issues are that:

[a] they *intended* for me to be 'twilighted' presumably for a good reason,
[b] they administered the drugs that I and my insurance company paid for, and
[c] they honestly seemed to have no idea what they were doing, and dosed me three or four different times before just giving up and shoving that fucking thing down my throat.

Before the dosing they had been griping about how few colonoscopies they seemed to be getting done that day.

I'm extremely fit and relatively young (39), so I sucked it up and made it through. But what about the hazy little old lady that was prepping in the area across from me? This would likely have been intensely traumatic for her and many others. Not to mention we don't pay for the lights to finally go out as we're trying to get dressed and go home.

I'm going to write the clinic and doctor a nasty letter. But my question is whether this is enough of a problem that I should raise a bigger stink. Write the letter to all the doctors that are part owners of this clinic? Go to the State Medical Board? Get a lawyer?
posted by anonymous to Health & Fitness (14 answers total)
What you do depends on your goal.

If you want restitution of some sort, contact a lawyer first. If you want the practice to be aware of the problem, contact them first. If your goal is to initiate some sort of sanction through a licensing board, contact the board first.
posted by HuronBob at 9:39 AM on September 4, 2010 [1 favorite]

Well, my first question for you is how far DO you want to take it? Is it worth it for you to go find a lawyer? I am not sure what I'd do in your situation, as I've never been in a situation like yours.

Did you speak up and let them know that the anesthetic wasn't working, and that you weren't comfortable? If I'm in pain, when I shouldn't be, I would definitely say something.

I am not excusing their behavior at all, in fact it sounds like their patient care was pretty poor. but we live in a pretty litigious society and are always looking for some sort of retribution for anything. I think you should follow your gut on this and do what you think will bring you the most peace here. If that means getting a lawyer, then, by all means, get a lawyer.
posted by TheBones at 9:44 AM on September 4, 2010

I am only sharing this anecdotally, you should of course consult your own legal counsel. Last year I had severe complications from a fairly minor surgical procedure, that required multiple emergency surgeries and a total of three weeks in the hospital. Doctor error probably played some part in the matter. When my family talked to an attorney about the matter, we were told that unless I sustained some sort of permanent damage (I thankfully didn't) that it was very unlikely legal action would result in any sort of damages. Since my insurance paid for nearly all of my medical costs (over $500,000) , and my job was awesome about the whole thing, I decided to just leave the matter alone. I think the whole thing scared the shit out my surgeon, and that was enough for me.
posted by kimdog at 9:50 AM on September 4, 2010

Don't write the clinic and the doctor a nasty letter. That's not going to undo what was done, and it's not going to get you any sympathy from the clinic or the doctor. They're just going to think you're a nutjob with his caps lock stuck (I say this as someone who often receives nasty letters from customers).

You should write a sane, calm letter to the clinic and the doctor (I would send a copy to the State Medical Board) explaining your feelings, how what you received was not what you expected and how this has forever changed your view of [clinic's] method of care. Don't threaten to never go back to the clinic or to tell all your friends how much they suck.

Then write an angry letter and don't send it to them if it'll make you feel better.
posted by geekchic at 10:08 AM on September 4, 2010 [1 favorite]

I think you should make some kind of noise about this. This could run the gamut from simply letting key people know (so that there isn't any gray area of doubt) that this wasn't "okay", to legal action/restitution.

Begin with writing a letter to figure in your own mind exactly why this was unacceptable. Edit the hell out of it until it's perfect and then talk to a layer. This letter will either be sent to several people or become the basis of your complaint.
posted by marimeko at 10:14 AM on September 4, 2010

Since my insurance paid for nearly all of my medical costs (over $500,000) , and my job was awesome about the whole thing, I decided to just leave the matter alone. I think the whole thing scared the shit out my surgeon, and that was enough for me.

For someone whose policy likely has lifetime limits of 1 or 2 million, using up half or a quarter of that is probably not going to be a good deal. Good karma, yes. Financially sound, not so much.

What I would do is talk to your own physician: "you know, the clowns who did my $scopys messed up in the following ways. What do you think I should do to make sure I didn't suffer any medical injuries, and to make sure someone else doesn't have to go through this like me?"
posted by gjc at 10:20 AM on September 4, 2010

It sounds like you're not so much interested in some kind of monetary restitution as you are in taking steps to keep these people from traumatizing other patients. Sloppy anesthesia, even for a "minor" procedure, sounds like a pretty big problem to me, and it may be that whoever is in charge at the clinic is unaware of the way that this doctor is practicing.

Write your nasty letter and don't send it. Let it sit for a few days and then come back and write an awesomely coherent letter detailing the facts of what happened. In the meantime, check with your State Medical Board to find out what your options are--you can probably file a complaint and if you decide to do so, mention that in the letter. See what happens from there; you may find that a lawyer is helpful.

When there are no consequences for situations like this, the situation will continue. You're right to speak up if it's bothering you.
posted by corey flood at 10:21 AM on September 4, 2010 [1 favorite]

For someone whose policy likely has lifetime limits of 1 or 2 million,

Lifetime limits were basically banned in the insurance reform legislation.
posted by anastasiav at 10:24 AM on September 4, 2010

This exact thing happened to me during an upper endoscopy. I was supposed to be under "twilight" too. They kept upping the dosage to no effect and finally just shoved the thing down my throat. I instinctively grabbed at the tube and kept trying to pull it out. It was a miserable experience. While I was in recovery the doctor asked my husband if I was a heavy drinker or drug-user. That was his suggestion as to why the twilight didn't take. I've had twilight a few times since then, and it's worked perfectly.

I don't think a letter will be taken too seriously. They can suggest other reasons why the drugs didn't work that have nothing to do with their own incompetence. Or is your complaint less about them not properly administering the anesthesia and more about them going ahead with the procedure in spite of the fact that you were not properly sedated? Believe me, you have my sympathy.
posted by Evangeline at 10:27 AM on September 4, 2010

For someone whose policy likely has lifetime limits of 1 or 2 million, using up half or a quarter of that is probably not going to be a good deal. Good karma, yes. Financially sound, not so much.

Yeah, my policy has no limits, and that was before the healthcare reform. But I also had to weigh the time and energy that would be involved in a lawsuit. My surgeon wasn't exactly a chucklehead, he's one of the top in his field. And he did go the extra mile to give me the best care during the complications. So it's not like he left me high and dry. I simply think that he though of the procedure as so utterly routine, that he ignored the signs that something was NOT GOING AS PLANNED. I mean this is a guy who is regularly in the news for doing pro bono surgery on children with massive birth defects.

I guess my point to the OP was that "pain and suffering" isn't enough always enough to pursue legal action, especially when there are other means calling attention to the matter.
posted by kimdog at 11:45 AM on September 4, 2010

I would be inclined to complain (calmly, so they can't write you off as a nut and pretend it didn't happen) to whoever was managing the facility that doing the procedure without the anesthesia working was unacceptable. After that I would complain to my GP so that (a) she'd think twice before referring other people there, and (b) hopefully she'd call the facility that did the procedure and read them the riot act.
posted by Blue Jello Elf at 1:18 PM on September 4, 2010

It depends on how much you want to make the physician sorry. If you write the letter, he will know about the problem and hopefully try to avoid this happening in the future if he is a decent human being. If he's a jerk, he'll just write it off. If you write one to the State Medical Board, if it is anything like our State Medical Board, you'll cause him a world of pain because he'll be summoned for questioning by the board, his license will be on the line, and he'll have to mention it every time he applies for privileges at hospitals or new state medical licenses. It will result in a lot of paperwork and trouble. I have no idea what exactly occurred in your case, but I will say that it can be difficult sometimes when giving the sedation medications and getting up to high doses, to decide what to do. Because if you give enough of the meds and knock the person out, you will have to put a tube down the person's throat to help them breathe, and oftentimes the meds do take time to kick in, so you don't want to get ahead of yourself and cause the person to go completely unconscious. Since GI doctors don't manage airways, they'd have to call in anesthesia to help them emergently, and that's not a good thing. All that being said I can't really explain his perspective, because when I do sedation/'twilighting', it's always an urgent/emergent situation, so we have good reason if we go ahead despite the sedation not being precisely where we wish it would be.
posted by treehorn+bunny at 7:28 PM on September 4, 2010

I am so sorry that this happened to you - And I can't tell you what you should do, but I can share my Mom's experience in this arena:

That hazy little old lady prepping across from you might as well have been my Mom - She was supposed to be under general for a colonoscopy but never made it totally under, and also was made to feel a great deal of pain. She said that she begged the doctor to stop many times and to go easier, but she said the doctor not only ignored her but that he also increased his pace. As you can imagine, this was horribly violating. She is a 63 year old nurse and has plenty of surgical experience and has been an emotional wreck ever since. After weeks of not being able to sleep she consulted with a therapist who diagnosed her with PTSD.

When she confided with her primary doc, she found out that a nurse's mother in the same practice just had the same experience. Upon talking to the clinical director of the surgical center, they told her 'off the record' that this doc has had multiple complaints against him but that because he is such a money-maker no one will ever pin him down. The director also told her that the doctor made it a practice to schedule one procedure every 20 minutes. And the numerous informal complaints about this guy never go anywhere because people don't follow through. In other words, the director was giving her details to at least start a case if she chose to.

My mom hasn't decided how she will proceed. She doesn't want a monetary judgement, but she doesn't want this to happen to anyone else. My parents have some other huge stressors in their life right now so a lawsuit is another helping of big-ass stress that she is stil trying to decide if she can handle at this point. I will support her in any way possible but I am totally in favor of getting an attorney involved. I am not a lawyer but I told her that she and the others might have a case if a pattern of negligence can be proven. She has not communicated with the offending doc - I told her that she needs to hold off until she decides on a path of action because a letter won't do anything but alert him to the fact that he and his team is about to be investigated.

Issues like this are very complicated. Again, I am so sorry that this happened to you. I think I would start by asking questions of people - Your doctor, a therapist, your lawyer. Only you can decide what your next step is. Best of luck to you.
posted by inquisitrix at 10:14 PM on September 4, 2010 [1 favorite]

If this doctor is considered "in-network" for your health insurance, you may want to look into filing a grievance with the insurance company and/or provider network company. They usually have measures in place to investigate complaints about the providers they contract with and ensure they are sending their members to competent physicians.
posted by platinum at 12:56 AM on September 5, 2010

« Older Quit My Hedonistic Ways?   |   Google's Logo Kills IE8 Newer »
This thread is closed to new comments.