So my dermatologist made a major boo boo

[kittynh]

I really like medicine. But I have to sometimes remind myself that doctors are only HUMAN. Still, I'm really pissed about this mistake my dermotologist made.

I go in every 6 months for a full body screen since I've had some bad pre cancer moles.

My doctor and I today were talking about this small bump on my neck. It's most likely a basal cell but it's nice and tiny and should have been no problem. He also joked about the biggish bug bite I had nearby. He wanted it off before tam and TODAY because it's in a very obvious place and he didn't want to leave much of a scar.

He leaves, and his nurse comes in the prep the area. She preps while I lay down eyes closed so as NOT to see the needles.

In comes the doctor and slices away and takes it off to be biopsied.

Tonight I take off the bandage to see...

the doctor cut off the bug bite.

The small basal cell is still THERE. I know it's there as I've been following it for a few months (it grew which is why I knew to get him to look at it carefully). GREAT. I have a scar now where I had the bug bite. I have to get another scar soonish when he cuts off the REAL problem, and I'm going to be paying for the testing of a bug bite as well as this one. I'm really MAD as this scar is in a very obvious place, the front of the neck, and is much bigger than the one I would have had if he'd just cut off the tiny basal cell one. I can see how the nurse prepped the wrong bump, as the but bite was certainly more obvious. The doctor wasn't in the room to point out which bump to prep. I was too scared of the needles to pay attention, I just sort of zoned out best I could

But I'm so mad, I'm crying...

OK OK I'm not Mona Lisa, but this is a scar and it hurts. And now I need another scar. And I'm going to have to pay for part of his mistake. I am trying to focus on how he hasn't done this before that I know of and we all make mistakes. But it's also my neck and I'm really sad.

I also am mad he didn't make sure the nurse KNEW which bump to prep and didn't notice her mistake.

I'm going to call in the morning, but he doesn't have office hours tomorrow so who knows when he'll be able to fit me in. Meanwhile where he took off the bump is all bruised and ugly looking. Yeah I'm mad.

gggrrrrr...doctors aren't perfect, but boy is it a bother when they make a mistake.

[Marduk]

I had a doctor once who I went to on the occaison of having five stitches in my hand removed.
I first started to get nervous when he took off his glasses, then even more nervous when he put on some other ones which looked like they were made from dustbin lids filled with coke bottle bottoms, then he bought out his surgical scalpel which to my eyes looked to be a surgically sharp knife about a foot long
I have to admit I couldn't look as he came around the desk bumping into it on the way and proceeded to snip the stitches pulling them out with a pair of tweezers. With a flourish he announced that he was finished

I looked at my hand

He'd missed one completely and left it in there.
thesedays I remove my own stitches

still it could be worse
Nirmala David, Attorney-at-Law sent letters of demand to Dr. W.N. Parakrama Weerasoriya and Dr. Champha Wickremasinghe with copies to the Attorney General, informing these persons that the lawyers have instructions to file a case for civil damages regarding the alleged wrongful amputation of a healthy leg on March 1, 2005 at the Negombo hospital. Dr. W.N. Parakrama Weerasoriya has been asked to pay Rs. Ten Million on or before July 10, 2005 with interest accumulated from the date of the said act of medical negligence. Dr. Champha Wickremasinghe has been asked to pay Rs. Five Million on the same date and on the same terms.
http://newsletters.ahrchk.net/js/mainfile.php/0430/992/

[Skeptic Ginger]

I really like medicine. But I have to sometimes remind myself that doctors are only HUMAN. Still, I'm really pissed about this mistake my dermotologist made.
....

My doctor and I today were talking about this small bump on my neck. It's most likely a basal cell ...He'll also likely be embarrassed when the biopsy pathology report comes back.

Mistakes happen but at the same time, this one doesn't make sense. Shouldn't he have noticed what he was removing, not just the fact one area was prepped?

And why does such a simple procedure even need a ns prep? Usually removing a single mole sized growth is a one person procedure.

I would be very upset.

OTOH, it does you no good to be stressed. Ask the guy to explain and if he says he was just wrong, I'd be content. If he comes up with a flimsy rationalization, I'd be less happy and maybe even would say so.

[godless dave]

I don't see why you should have to pay for the procedure or the biopsy. He made a mistake.

[kittynh]

I don't know what will happen.

For a biopsy, he likes the nurse to give me 4 injections. 2 keep you from bleeding a lot and the others numb it an sort of "raise" it up.

he cuts out pretty deep... and he was taking off extra since he was pretty sure it is a basal cell one. I think once it was "raised up" it just looked different.

I am making my husband call....I can't handle talking to him or his staff.

[Marduk]

three magic words "General Medical Council"

or if you're in the states
"American Medical Association"

;)

[Cavemonster]

I'm curious, I know there are a lot of doctors in the forum, is kittynh (or kitty's insurance) obligated to pay for a procedure that was the doctor's mistake?

If a restaurant brings me the wrong food, then when corrected, the right one, I don't have to pay for both meals. But the ugly way healthcare costs seem to be structured in the US makes me suspect that it may not be the case with doctors.

Without getting all litigious about it, can a patient refuse to be billed for a medical service gone wrong?

[paximperium]

three magic words "General Medical Council"

or if you're in the states
"American Medical Association"

;)
The AMA has no power over physicians in the US. It is a National advocacy group. The only ones to complain to is the State licensing board.

[paximperium]

Without getting all litigious about it, can a patient refuse to be billed for a medical service gone wrong?
Yes. Call the insurance company. They don't want to pay for something that was either not done or incorrectly done either.

However "medical service gone wrong" is a very fuzzy term. It is not "gone wrong" if something occurs that is considered a well known side-effect or complication of a procedure. This event is just major bungling.

[NoZed Avenger]

Let's wait and see what the doctor and his staff do before thinking about reports.

I don't know how easy or hard this mistake was to make, but 5 will get you 10 that the doctor will not charge anyone for the procedure.

I hope it doesn't cause you any further problems, K.

[Marduk]

The AMA has no power over physicians in the US. It is a National advocacy group. The only ones to complain to is the State licensing board.

thanks for that PaxI, the GMC in England is a central governing body, is there really no american equivalent ?

no wonder I've heard some horror stories
:(

[Starthinker]

He's in on the alien conspiracy and recognized the implant that the remote drone planted.

[paximperium]

thanks for that PaxI, the GMC in England is a central governing body, is there really no american equivalent ?

no wonder I've heard some horror stories
:(
State specific. Each state licenses physicians and each state has very different requirements. A State like Illinois, Massachusetts or California which have a large number of University Hospitals and physicians tend to have very high standards, while small states with a severe shortage of physicians will have very loose standards.

Board certification for each specialty(Dermatology, Internal Medicine, Surgery etc.) is via private national boards coordinated via the American Board of Medical Specialties.

While voluntary, no hospital will hire someone who is not board certified, however there some states have no system to check on a physician's training or certification.

[Dogdoctor]

Awwww poooooooa baaaaaaaby there there :hug2 at least he didn't amputate your foot or something. It sounds like the nurse screwed up if she did the numbing and prepping. The doctor too but bumps change in appearance when they have fluid injected under them. I guess it might be possible the doctor was more worried about the other bump but why didn't they do both lumps? Well you can show your scar to everyone and tell them all about it at TAM.

[Soapy Sam]

This is negligence.
At the very least you are owed an apology.
Under no circumstances should you pay him for removing something there was no need to remove and that yiu did not ask to be removed. Doesn't matter if he's a doctor or a tree surgeon.

[seayakin]

I had something similar happen but they removed the wrong mole so they might have done me a favor in the end. Either way, the doctor apologized but I never followed up to see if they charged the insurance company. (My insurance is quite good so I didn't pay out of pocket.)

[Miss_Kitt]

kittynh --

There, there! I understand you being mad and sad, and you have every right to be! The doctor's office / path lab, etc. should not charge you (or your insurer) a dime for their mistaken removal and any biopsy that is done to it, nor for the office call. And, if you (or your husband) calmly but firmly point out their mistake to them, they should agree to that.

Medical staff are human beings, and they do make mistakes--which is why we are advised to write "not this leg" or "not this arm" on the opposite limb before having major work done on the other--but they should offer to cover the cost of their mistake.

I'm sure your doctor will be embarassed and probably angry at himself and the nurse, but you should have a 'free pass' -- and he should fit in your correct procedure right away!

Slow, deep breaths and we'll laugh about it at TAM, okay?

Miss_Kitt

[Aurelian]

Gah! Paying for the removal of a mosquito bite would be adding insult to injury. Call the doctor - and mention this is high priority. Mention that it is an expense and The Doc should take care of removing the charges. Mention that the removal site is unsightly and painful and think on what you would like - a plastic surgeon consult? A consult after the site has healed? That would be something the doctor would pay for. You might want the plastic surgeon consult after the mis-behaving mole is removed, depending on the personal geography of the sites.

Other options would begin with what state you live in - is there a medical malpractice board? Physician Quality Assurance? A lot of what I'd do would depend on the doc - was this a horribly bad day? Are you worried that he might screw up on someone else? Is he appropriately apologetic and willing to make it better? Do you have a good rapport with him/her, or are you ready to chuck the relationship and find another doc? Are you fenced in with your insurance?

Serving up some food for thought, and I really, really hope you feel better soon,

A.

[Skeptic Ginger]

....

Medical staff are human beings, and they do make mistakes--...Yes, and had the mistake only been the nurse prepping the wrong site, I would agree with your sentiments. But this doctor just examined the patient, saw both lesions, and should know what a basal cell like growth looks like. That goes beyond unavoidable-we're-all-human error and spills into careless.

I can't imagine any doctor billing for this unless it gets overlooked and sent to a third party payer inadvertently.

[Rolfe]

I don't know how American doctors deal with this, but in any vet practice I have worked in, we'de have waived the fee on the first procedure and then done the second for free, grovelling to floor level as we went.

Rolfe.

[Kittyclaws]

In my admittedly minimal experience, when doctor goofs, it doesn't show up on the bill either to you or your insurance. I'm thinking of a specific occurrence when I was having my hand stitched and the doc gave himself a jab with the suture needle after it had been in me. Blood draws and labs for hep/HIV testing weren't billed and I got the (happily negative) results gratis.

[Buckaroo]

My first doctor (a PCP) said my small spot "wasn't suspicious" since I was "too young." Months later, the slightly larger BCC which had developed had to be removed by a second doctor, a dermatologist. The pathology report came back with some cells on the margin, but he insisted that we "wait to see what happens" rather that going back to get the rest. A year or so later my third doctor, while performing a Mohs procedure to remove the now pissed-off BCC, noted that the cancer had quickly invaded the scar left by the first surgery, with the result being that much of the right side of my nose had to be removed, with significant reconstructive surgery, turning me into a hideous mutant freak.

OK, so I'm only one who really notices, but DAMN. If that idiot who dismissed me in the beginning had just done his job, I wouldn't have this nasty z-shaped scar on my schnoz, and I would still be attractive to women (that's my story, and I'm sticking to it :D)

[Harpyja]

I don't know how American doctors deal with this, but in any vet practice I have worked in, we'de have waived the fee on the first procedure and then done the second for free, grovelling to floor level as we went.

Rolfe.

Makes me wish that we have boarded at one of your practices, Rolfe. I left a poodle at a vet clinic once while away on a trip (they boarded) and one of the people there decided to groom her a bit without asking us first. My poodle had to get stitches in her ear as a result of a slipped scissor.

@kitty: Best wishes and I hope everything goes well.
@Buckaroo: Turn the scar into a story about how you personally defended an old woman from being attacked by a mugger. Works every time.

[MattusMaximus]

*Hugs for Kitty*

[Soapy Sam]

Buckaroo- I think the critical datum about possibly cancerous skin blemishes is "change".
As change , by definition, requires at least two observations, it seems the obvious way for any dermatologist to act in case of doubt would be to photograph the object and ask the patient to come back after a fixed time to compare. He can't be expected to see change in one examination.
Perhaps we should all take a few photos of ourselves for future comparison?

[Buckaroo]

Buckaroo- I think the critical datum about possibly cancerous skin blemishes is "change".
As change , by definition, requires at least two observations, it seems the obvious way for any dermatologist to act in case of doubt would be to photograph the object and ask the patient to come back after a fixed time to compare. He can't be expected to see change in one examination.
Perhaps we should all take a few photos of ourselves for future comparison?

True for melanoma or squamous, but not so much I think for BCC, since they are very slow growing. There are other signs, though -- particularly a sore that won't heal, or scales, or breaks open easily. At any rate, when I told the first doctor about ALL of these symptoms, he was completely dismissive, and didn't suggest a biopsy. That's the problem -- he dismissed my input, relying only on what saw at that moment.

He did a similar thing for a problem that was later revealed to be a minor, though important to know about, heart condition. I found a new doctor after that.

[Roma]

You shouldn't have to pay for that of course,
and I think you should get some free stuff too , just to make up for the mistake.

When I called the Gerber baby food company and complained they sent me $25 worth of coupons.
When I complained to the video store about the homemade XXX porn movie I found in the family movie case I brought home they gave me 10 free rentals.
(okay my boyfriend really wasn't upset about that mistake).

Just saying, why not ask for the next 5 body scans free ?

(this haggling is part of the Winnipeg culture)

[Criticalist]

At the hospital where I work, there was recently a much touted new "protocol" that was implemented to make sure operations were never performed on the wrong limb or wrong side of the body. A strict check list was to be followed, and the instructions stated that EVERY operation had to have the site clearly marked to make sure no mistakes were made.

Its safe to say the patients coming in for prostate surgery were both surprised and alarmed by the apparent necessity to draw large arrows on their penises.

[Rolfe]

Makes me wish that we have boarded at one of your practices, Rolfe. I left a poodle at a vet clinic once while away on a trip (they boarded) and one of the people there decided to groom her a bit without asking us first. My poodle had to get stitches in her ear as a result of a slipped scissor.


And they charged you for that? :jaw-dropp

Oh dear. I'd have refused to pay.

Hah, who am I to talk. I recently went to pick up a picture from the framing shop, and they'd only done half of what I asked - so they had to open the frame again and replace the glass with non-reflective, even though the request for that type of glass was clearly marked on the original request form (it was actually the primary reason for altering the frame, the size adjustment was secondary).

He blithely added another £5 to the bill for the revision work. I was too embarrassed to object. I suppose I thought that I'd rather pay the extra fiver than make a fuss.

Rolfe.