Feeling Like a Victim of the System (Negligence?)

[Jason2012]

Hi All,

I am wondering if I can possibly sue someone for negligence. I'm really irritated about the situation I've been in for the last four years.

I will try to keep to the core points:

- In 2008, with no relevant medical history, I experienced a transient cardiomyopathy known as takotsubo cardiomyopathy after a heavy amount of exertion (I went skateboarding, and was pushing myself and showing off despite feeling winded, after having not skateboarded for years). I was intubated for days and days and on my deathbed (with some kind of assisting pump in my leg). I was transferred to a transplant unit, my family were told that I was probably on my way out (of this life). I was 28 years old.

- Needless to say, I had a whole basket of tests, including a TEE (transesophageal echocardiogram -- this is important regarding the prognosis I have today). On this echo and numerous (probably five) standard echoes my aortic valve was listed as "normal" (tricuspid).

- I have had rather debilitating symptoms since my takotsubo event in '08. I told my doctors about a new visible pulsation in the front of my throat (from the aortic arch), and I told them about the "fish out of water" feeling my heart has during activity. I asked them to listen to my heart or possibly look at it while I was doing activity, and that was like pulling teeth (I had to beg and plea and visibly irritate my doctor to even get him to listen to my heart after doing a bit of walking around in the office). He acknowledged murmurs at that time. I mean I did not have symptoms at rest, but many of their tests were done when I was at rest (with exception of one stress echo I had, and could barely perform for years ago).

- I had a 5.2 cm left ventricle in '09 (sometime AFTER my takotsubo episode -- "normal ventricle dimensions"). In '11 my ventricle measured 5.8 cm on the next echo. The doctor despite this enlargement wrote on my echo "no significant change"?

- Anyways. I went about my life, assuming that my heart was structurally sound. The doctor I mentioned before never scheduled me for a followup. I know that I have resp. in this dept., but the impression I was given was that I was stable/that I didn't even need medication (they had me on very small amounts of enalapril and a beta blocker wrt my weight at one point, literally negligible amounts).

- Fast forward to '12. I am living with heart challenges still. Some of my symptoms have changed/gone away/evolved (prob. due to remodeling), and my wife and I decide to switch to PPO insurance. On the FIRST visit to a PPO doctor, I was diagnosed with bicuspid aortic valve. The #1 congenital heart defect, a prognosis for which it turns out I have the exact symptoms of which I described to my doctors (they ignored many of the "feelings" I described, I could tell they thought I was being paranoid, and I know they made too many assumptions around the takotsubo event I had in '08).

How is this not negligence? Should I not be able to sue someone for missing this obvious diagnosis (and win I mean, not that it will make up for the fact that my heart has been put through unnecessary stress since '08 and is now enlarged)? I've been living a challenging life for four years now due to my symptoms, I begged and pleaded for these doctors to spend some time trying to figure out what was wrong with me, but they barely had time to see me for 10 minute followups (they did NOT put due effort into my case). Now, because I was not on proper medication, because I did not get a replacement for my aortic valve which obviously leaks horribly during exertion, I have gone from having a normal left ventricle to a moderately dilated one at 6.5 cm (1.3 cm enlargement in three years).

Thanks for your thoughts. :frown2: I am thankful for these forums. Even though this is my first post, I've been watching from the sidelines (and searching thread topics) for a few weeks.

 

[scott.eitman]

This is a great example of needing to be involved in our healthcare. We need to insist on 2nd opinions. Especially when the answers we get are suspect. Do not be scared of hurting the feelings of healthcare providers...they will eventually get over it and if they don't, they are probably not the right people to be addressing your concerns. Remember, they are human and as such, have the possibility of being fallible. We cannot expect every doctor to have the same training, skills and knowledge.

In addition, this is why this site, and support sites and groups like it, are so important. We need to be able to lean on each other.

 

[pellicle]

Hi

so sorry to hear of your grief with doctors. I can't comment on the likely success of litigation but here in Australia the medical profession will close ranks to defend their own. Perhaps where you are may be different.

For my own part I grew up at a time in Australia where doctors had time and took care of their patients. The ways have changed since then and while we have a myriad of fantastic imaging and testing equipment it seems that the medical profession has been subjugated to the funding of new diagnostic gear.

None of this is of much use if the medical professionals don't have time to process the data and comprehend it.

Continuity is part of the issue I feel, for the data itself in examination is as revealing as what an ant sees when crawling along a tree. The broader terrain requires a more holistic view of both persent AND past. It is this which I feel our time challenged doctors fail to grasp.

When I went to my local doctor with my swollen sternum (see my thread on that) he ASKED ME what did I think we should do. At least he had the honesty to recognise he was out of his depth. Luckilly I was not yet (as a case manager) out of mine. Had I just taken a course of antibiotics I would probably have moved over into endocarditous.

What I am saying to you is this: become as aware as possible about your condition. Learn about it, and become your own case manager. You can't supply all the medical knowledge but you CAN take a greater interest in it and keep abreast of the bigger picture outcomes.

Learn to be able to say "oh, so a change from 5.2 to 5.8 is 'not significant', so please tell me what would be significant?"

I know that I have not been a squeeky wheel enough after this last surgery, perhaps I would not be in this situation if I had been more proactive. perhaps if I had been more agressive in chasing down my wifes headaches she would be here with me now

 

[Lynlw]

I'm sorry to hear youve gone thru so much how scarey that must have been.
This is just MY opinion and Im not a lawyer or medical person but...
It's hard to say with out more details, but from what you've written , probably not would be my guess. If I have this right, since your transient cardiomyopathy in 08, you had echos in 09, 10 and 11, and then changed docs and had another this year? which LOOKs like they were following you up. Have you had surgery or will be having it soon or is it still too early? Beside the bicuspid or not, how have your Aortic valve and Aorta measurements been? "normally" for a stenotic valve to need replaced it depends on hitting a certain size less than 1 ish no matter how many leaflets, or how bad the regurgitation is if that is why surgery is needed, so IF you didnt meet the criteria for surgery, and so have permanent damage because you didnt,, I'm not sure you would win a case
Often they are not 100% sure if a bicuspid valve is bicuspid or not until surgery and they can really look at it.

 

[Superman]

I would guess it's really difficult to sue somebody for being just a pain in the rear. I had to press my cardiology group for further testing on an ascending aortic aneurysm back in 2009. Fortunately they caved. Even if I was doing the pressing - it was still caught in time and I had surgery to correct it, which when well. More to that story is that a PA reviewed the echo and my regular cardiologist was out of the office on vacation. While my root wasn't alarmingly large, they didn't check it against the rate of change from recent echos. I had to make them do that, and the rate of change was significant (after a CT scan it was 3.2cm to 4.9cm in a years time).

Now had they replaced my mitral valve and not my aortic, then i have litigation. If they didn't allow further testing and I died, then my family has litigation.

So from what I'm reading, you had doctors with bad bedside manners who were not listening to you. But in terms of actual treatment and outcome, not much would have been different in the last four years. Maybe a little less aggrevation, but I don't know if that would be worth a whole lot.

 

[Superman]

...so IF you didnt meet the criteria for surgery, and so have permanent damage because you didnt,, I'm not sure you would win a case

Did you mean, "IF you DID meet the criteria for surgery" ?

 

[Lynlw]

Did you mean, "IF you DID meet the criteria for surgery" ?

No, but I did word it badly. What I meant was unless he met the criteria for surgery and due to the fact he did not have surgery in 11 there is permant damage, I do not believe (in my non professional opinion) he would have a case, or at least a winable case.

 

[Luana]

If you're back to working, and reasonably healthy, there probably would not be anything available to you for a monetary settlement, which I assume is your motivation. Large settlements are won when people lose their earning capacity (permanently disabled and can never work again, and generally somewhat young, as amounts are calculated on a lifetime of earnings), and this is part of what they're awarded.

As for suing someone for negligence, you can pretty much forget about isolating it to one person. During discovery, every doctor you've seen for that condition, and since, will be investigated, and attorneys usually try to bring in as many entities (doctors, nurses, hospitals, etc.) as possible. You would also need to put up quite a bit of a sum of money (I would guess around $30,000) to even determine if you have a case, and after that it's possible to find out you don't have a case.

There's also the statue of limitations to consider, being this is now over 4 years, it may be too late to do anything.

And, Scott, as for insisting on second opinions, no one is stopped from getting another opinion, just go see another doc. The last person you want to ask for a referral for another opinion is the doc you don't agree with. At least that's how things are now, not sure if it will change with the full implementation of the ACA.

 

[Jason2012]

Thanks

Thanks

Thanks very much for the replies and kind words guys.

I followed up with my former cardiologist today -- he doesn't think I have BAV despite the new cardiologist and his colleagues being 98% sure. He also told me he thinks my symptoms are "psychological", because he's given me a stress echo, and despite me telling him my symptoms only come with certain kinds of activity/somewhat randomly, the stress echo only showed moderate regurgitation. I am a scientist/have some understanding of psychology, so being told this really was just the cherry on top wrt this cardiologist, arg. Hehe. Every time I tried to ask this doctor a question, he tried to talk over me. When I asked him to listen to my heart after walking some stairs (I think I mentioned this before), he got irritated. Anyways, this doesn't seem to be a unique thing among doctors. I understand how someone could end up treating others like this (they are prob. entirely tired of people coming in with their own ideas based on things they've read online, for ex.), but it's really unprofessional, these people make hundreds of dollars for seeing us for fifteen minutes. He basically tried to guilt me a few times for taking up any of his valuable time to respond to me. Thanks for listening to my rant -- back on topic...

So I think it's pretty clear that the last cardiologist I had doesn't understand BAV. The Bicuspid Aortic Foundation website had the best and more relevant information that I could relate to (because I've had these symptoms for a long time). My new cardiologist would like me to just continue living with my symptoms until I am in worse shape, maybe ten years out or so. This is frustrating knowing that other parts of my heart could remodel/get worse in the process, but I understand the seriousness of valve replacement.

The good news from my last checkup is that my left ventricle is fine for now. It is still in the normal size range. The 6.5 cm reading was incorrect. I was told that because of how my heart sits in my chest, there is a lot of variability in the LV reading if they use this one method of measuring it, but that it's more accurate with the other way they measure it on echo (apparently there are at least two methods). I will be going in in about a month for an MRI of the rest of my aorta, which will prob. be fine, and also to get an echo while riding a bike (so that they can see what happens when I am actually doing something).

Thank you for the replies. Really appreciate it. We'll be in touch!

 

[Fundy]

Jason, I can relate to your feeling about some doctors. A walkin clinic doc sent me for an echo in April 2006 after hearing a murmur. Told me to get a family doctor and he could get the results and follow up. I couldn't find a local doctor willing to take new patients so he had me get on the waiting list for a new doc coming to town. I didn't see him until October and my main complaint was severe pain and cramping in muscles.

I mentioned the murmur and echo I had done and the new doc said if I hadn't heard anything by now, there would be nothing wrong with my heart. I seen this doc five times from then until January each time with me whining about my heart and the echo and him saying nothing wrong and giving me prescriptions for psyche meds. That fifth time I seen him I asked to see the echo results. He mentioned he still didn't have it but he would get it to clear my mind about it.

That afternoon I got a call to see him later that week. Turns out I the echo said moderate to severe aortic stenosis and having a bicuspid aortic valve. A year ago I had my valve replaced.

Now that's a severe difference from nothing wrong to something serious wrong. He just looked at the situation of an echo done about 6 months ago and made the call without looking at the report that for certain nothing was wrong or the original doc would have told me. He didn't even but a stethoscope on me, just wanted to write anti-anxiety med prescriptions.

 

[Jason2012]

Jason, I can relate to your feeling about some doctors. A walkin clinic doc sent me for an echo in April 2006 after hearing a murmur. Told me to get a family doctor and he could get the results and follow up. I couldn't find a local doctor willing to take new patients so he had me get on the waiting list for a new doc coming to town. I didn't see him until October and my main complaint was severe pain and cramping in muscles.

I mentioned the murmur and echo I had done and the new doc said if I hadn't heard anything by now, there would be nothing wrong with my heart. I seen this doc five times from then until January each time with me whining about my heart and the echo and him saying nothing wrong and giving me prescriptions for psyche meds. That fifth time I seen him I asked to see the echo results. He mentioned he still didn't have it but he would get it to clear my mind about it.

That afternoon I got a call to see him later that week. Turns out I the echo said moderate to severe aortic stenosis and having a bicuspid aortic valve. A year ago I had my valve replaced.

Now that's a severe difference from nothing wrong to something serious wrong. He just looked at the situation of an echo done about 6 months ago and made the call without looking at the report that for certain nothing was wrong or the original doc would have told me. He didn't even but a stethoscope on me, just wanted to write anti-anxiety med prescriptions.

Wow, that's nuts. I wonder what they expect to wait for in my case regarding surgery, since mine is not stenotic. Aortic root dilation and more regurgitation, I guess. Glad you're here to tell the tale, thanks for the reply. :smile2:

 

[Lynlw]

Wow, that's nuts. I wonder what they expect to wait for in my case regarding surgery, since mine is not stenotic. Aortic root dilation and more regurgitation, I guess. Glad you're here to tell the tale, thanks for the reply. :smile2:

Ask them. Also if you havent, you should request copes of all your test results you MIGHT have to pay for them, if you get them from medical records, so ask your doctors first.