Scared, then angry...

[ARB57]

So, here's the deal...

A couple of weeks ago, I discovered a large amount of blood in my urine (not a hint...it was blood red.) I took myself to the emergency room where they ordered blood work, a urine sample and began a saline IV. Upon finding no good reason for my symptoms, the Dr. ordered a CT scan.

Upon reviewing the scan, he told me that they had found a "mass" on my bladder (and indicated such in writing on my release papers.) He said that he didn't believe that it was a cyst, indicating instead that it may be a tumor. Odds that any cancer had spread were low, but he left open the possibilty that the "tumor" was cancerous. He told me to see a urologist immediately.

I left the hospital (at 2am) fearing that, in fact, I had cancer. Fast forward to the next day, when another Dr. from the hospital calls to tell me that they had reviewed the scan and there was, in fact, NO MASS afterall, which has since been confirmed with another expensive test.

While I was obviously thrilled to hear the change in diagnosis, I was and remain angry about the complete misdiagnosis that night. I just got the bill ($3000 after insurance adjustments.) Do I have any legal options here? I'm not excited about sueing anybody...but I really don't think I should be paying the bill...when they, unneccesarily put me through hell with their faulty diagnosis. I've never sued anyone...nor have I ever avoided paying a bill...this time, though, I'm more than a little upset.

What say you?

 

[W2R]

What a scare that must have been. Ugh.

My suggestion would be to go ahead and pay what you have to pay, and then to pursue this with your urologist until you are satisfied with his explanation of why you had so much blood in your urine. The hospital did do all of those expensive tests, but the second opinion was quite different from the opinion of the first doctor. So personally I would feel obliged to pay. If there is another facility that you think might provide better emergency services, you might prefer to go there instead next time.

Glad it apparently is not a tumor.

 

[BigNick]

While I was obviously thrilled to hear the change in diagnosis, I was and remain angry about the complete misdiagnosis that night. I just got the bill ($3000 after insurance adjustments.) Do I have any legal options here? I'm not excited about sueing anybody...but I really don't think I should be paying the bill...when they, unneccesarily put me through hell with their faulty diagnosis. I've never sued anyone...nor have I ever avoided paying a bill...this time, though, I'm more than a little upset.

Faulty diagnoses are perhaps not the norm, but they are part and parcel of the medical profession. Don't fall for the TV myth that the doctor runs a test and a nice, clear-cut, single-symptom diagnosis emerges; it's still a rather inexact science.

To sue successfully, you would have to demonstrate that they were acting incompetently. Any compensation based on your mental anguish would be based on one day's mental anguish.

You might also ask yourself, sincerely, what your attitude is when you read in the paper about "all these people who sue each other whenever anything goes slightly wrong".

And finally, you probably shouldn't do anything else at all until the blood in your urine has gone away and you have a satisfactory explanation of what was causing it. Maybe both of those have happened, but you didn't report them yet.

 

[MichaelB]

If it were someone in my family I would give them a big hug, tell them how happy I am to know they are in good health, and suggest they turn their attention to something more important. The mistake may have been made in good faith, health care is expensive, and in this situation you had been inconvenienced, not wronged.

 

[Bestwifeever]

Glad your tests showed no problems. You could call the hospital and ask nicely that the charges be reduced because you're a senior citizen and on a fixed income. But you did agree to the tests and they're not free unfortunately.

The feeling when a loved one's test results come back negative is just the most joyous feeling.

 

[donheff]

Faulty diagnoses are perhaps not the norm, but they are part and parcel of the medical profession. Don't fall for the TV myth that the doctor runs a test and a nice, clear-cut, single-symptom diagnosis emerges; it's still a rather inexact science.

To sue successfully, you would have to demonstrate that they were acting incompetently. Any compensation based on your mental anguish would be based on one day's mental anguish.

+1 I think you need more evidence of negligence or incompetence before you pursue this. Errors like this can and do occur with good faith efforts. In any event, the problem was corrected quickly unlike, say, the surgical removal of the wrong organ.

Might be worth pursuing with the hospital to find out why the great disparity in opinions. If it is just one doctor's reading vs another's maybe the first was correct. Or maybe the second review led the first to take another look and see the error. Who knows without more info?

 

[marko]

Perspective!

Consider the alternative.

I'd pay the bill and go have a nice dinner, thanking God for having dodged a bullet.

 

[braumeister]

He told me to see a urologist immediately.

That was "a couple of weeks ago."

So what has the urologist told you?

 

[LOL!]

You wrote "change of diagnosis", but didn't say what it was. For example, you don't have mass in bladder, but you didn't say if you have kidney cancer or a simple kidney stone or something else.

Anyways, you gotta pay for the emergency room visit, the tests, and the doctors. You will be better prepared the next time this happens. And it will.

 

[73ss454]

Thank your luck stars and move on.

That's why Dr.s call it "practice".

 

[bizlady]

Sometimes only the radiologist can correctly read the scans. We had a similar but opposite experience 2 years ago. DH was short of breath and saw a doctor. They took scans and said he had a lung infection and gave him some antibiotics. The following day at dinner time, we got a call from the radiologist who said his lung was collapsed and get to the emergency room.

My point being medicine is a science, and not always are all the experts available at the moment we need them.

 

[Midpack]

It's frustrating and expensive, but not unusual in our experience. There were many cases with employees over my career with employees and their family members being misdiagnosed, and we had to pay for every mistake. DW had a very serious GI surgery where the recommended course of action post surgery was completely different among three gastroenterologists. More recently she had ankle surgery, she went to a local doctor and he found little. She got a second opinion and it was completely different. We got to pay for all of that too.

Not only is it frustrating and expensive, but how on earth is a patient supposed to figure out who to listen too?

But more importantly in this thread, I'm glad to hear the OP's condition was less serious than originally diagnosed.

 

[mystang52]

I'm not a lawyer, but I'll echo the others and say that you do not have any basis to sue. A doctor giving a good-faith, albeit incorrect, diagnosis is not medical malpractice. Had they performed some medical procedure (e.g., surgery) that was unnecessary due to misdiagnosis might be basis for a cause of action.
But in your case apparently all that was done was further tests -- one can easily argue that was good medical practice vs malpractice. I can understand your original fears, but I don't believe that would be enough to claim damages.

 

[rescueme]

A doctor giving a good-faith, albeit incorrect, diagnosis is not medical malpractice. Had they performed some medical procedure (e.g., surgery) that was unnecessary due to misdiagnosis might be basis for a cause of action.

IMHO, one of the main reasons that health care in the U.S. is more expensive than it needs to be.

Everybody is looking for "what's in it for me?" and willing to sue at the drop of a hat.

Tort reform is one of the main points to bring down medical costs ...

 

[Midpack]

IMHO, one of the main reasons that health care in the U.S. is more expensive than it needs to be.

Everybody is looking for "what's in it for me?" and willing to sue at the drop of a hat.

Tort reform is one of the main points to bring down medical costs ...

Many people like to believe malpractice is a primary cause, it's just one of many and not one of the biggies. Do your own research of course but...

Yes, the malpractice system costs money. Yes, defensive medicine exists. But no, malpractice is not the real reason for the high cost of care in the United States, and no, tort reform won’t fix it.

How much does the malpractice system cost? The most recent estimate published in Health Affairs found that medical liability system costs are about $55.6 billion in 2008 dollars, or about 2.4% of all US health care spending. Most of this, or about $47 billion, is due to defensive medicine. So yes, that is theoretically care that should be reduced. But we have no idea how much of it is actually not beneficial. It’s likely that some good comes from that care. How much? Blaming the massive amount of overspending we’re seeing on this relatively small amount is not going to help.

Moreover, pushing this as the real cause of high costs is misleading because there’s little reason to believe that tort reform will do any good. A recent study showed that tort reform which led to a 10% reduction in malpractice premiums might translate into a health care spending reduction of 0.1%. That’s not going to make any difference. This is confirmed by what we’ve seen tort reform do in Texas. And, it’s confirmed by what we’ve seen tort reform do in California.

Malpractice isn’t the root cause of our cost problem, and tort reform isn’t the solution. I wish it were that easy.

 

[TromboneAl]

As Braumeister mentioned, this happened a couple of weeks ago. Be aware that according to the forum rules, you can be sued for not updating the story.

 

[marko]

IMHO, one of the main reasons that health care in the U.S. is more expensive than it needs to be.

Everybody is looking for "what's in it for me?" and willing to sue at the drop of a hat.

Tort reform is one of the main points to bring down medical costs ...

Agreed 110%!
So, why isn't it a significant part of the Health Care Reform Bill? (maybe they're afraid of getting sued?)

 

[powerplay]

I'm sorry you had this scare, but happy that there is no tumor as that is the most important part.

 

[Brat]

I have a good friend who is a general surgeon (now retired from surgery). He has all the academic awards one could imagine, practiced in leading hospitals, so I asked why he didn't choose a specialty. He said that when you plan a surgery expecting one problem and discover something different once the patient is open, you must be prepared to address that issue in the moment. Diagnosis is probability, not certainty.

The quality of tests and imaging has made miss-diagnosis less frequent but figuring out a problem can still be a process of elimination. I see the role of emergency room physicians is that of keeping the patient alive and treating immediate problems as possible, sometimes a through investigation of causation happens later.

IMHO having a 'worst case' diagnosis that was subsequently eliminated is better than having a diagnosis of minor problem when a major one was missed.

 

[RunningBum]

I don't think you have any case whatsoever. Pay the bill, and be thankful it wasn't cancer.

That $3000...was that a deductible, co-pay, or what?

 

[Accidental Retiree]

That is a lot of turmoil to go through and like everyone else I am glad it has a better outcome than expected.

My takeaway from your story is that if I end up in a similar situation, maybe I would question the "emergency" need for the test.

I went through quite a few months recently with my mom and a medical condition from which she ultimately -- and surprisingly -- died. During the last bits of those months I got a glimpse of "the man behind the curtain" and had to learn to ask questions much more diligently.

With medicine as with money, I feel no one will watch out for our interests as well as we do. We are our own first line of defense.

I have lost a lot of trust in those whom I trusted before.

 

[sheehs1]

And finally, you probably shouldn't do anything else at all until the blood in your urine has gone away and you have a satisfactory explanation of what was causing it. Maybe both of those have happened, but you didn't report them yet.

ARB57...consider getting copies of the CT scan and get another opinion, preferably from a urologist. The CT scan results belong to you. I agree with BigNick in that you need to find the reason for the "large amount of blood". That would seem more important than the bill at the moment. Once you've done that, depending on the other opinion....you can decide how you want to handle the bill.

 

[flyfishnevada]

IMHO, if the subsequent tests were only required to debunk the faulty diagnosis or only administered because of the faulty diagnosis, I'd work with you insurance company and the billing department to get those adjusted or eliminated. You do in fact owe them money, but you have recourse. You can dispute the bill and sate your reasons. Worse that can happen is you are told no.

I had a single drop of blood in the toilet one morning about 15 years ago. I searched high and low for the source. No external bleeding, no sneaky bloody nose, nothing! Just a single drop of blood in a bowl of yellow water. Urologist took tests, found nothing and shrugged his shoulders. I'm still alive. Glad it seems to be nothing, but definitely follow up with your urologist.

 

[Brat]

Your profile indicates that you are in WA. Were I you I would find the best urologist in Seattle or Portland for a consult. If you don't know where to start I would look at faculty at the U of WA or OHSU. Bring a copy of all the lab results and CT scan.

Something bled into your bladder. You want to know why.

 

[Old Microbiologist]

Medicine is an Art not a Science

I am glad for you it wasn't a tumor that would have been a horrible diagnosis and one I wouldn't wish on anyone. I think $3k for peace of mind is okay. Empirically it probably was a stone (as you haven't told us yet what the final diagnosis is) and I question why a CT scan was performed when an ultrasound would have been faster and a lot cheaper. But, that is the choice the physician made at the time and based on what he sees. A lot of the diagnosis is based on clinical signs and symptoms. But, many patients present differently making that hard to interpret. The very best physicians I have worked with rarely order tests and treat empirically. It is also partially true that the malpractice issue is causing physicians to order tests to back-up their already formed diagnosis. There are others who are not so confident and perform "shot-gun" testing hoping to find something to assist them in the diagnosis. You can see the difference based on the amounts of tests ordered by a particular doctor. Most of medicine is really palliative care and 99% of problems will heal themselves and they know that well. In the ER it is hours of repeated sniffs and sniffles followed by the panic of real emergencies. In between are the "routine" emergencies. So, in their defense it gets frustrating to see so many patients coming to the ER with nothing serious wrong with them. Worse are the GOMERS (get out of my emergency room) who are chronic emergency room patients. So, it is a very tough profession. And the meaning of the word "professional" means in one sense artistic and not academic. That is the main difference between a PhD and an MD or for that matter a JD (Doctorate of Jurisprudence). A PhD is an academic degree based on skill and original research with significant contribution to science. A professional degree is largely "monkey see - monkey do" and rote learning. Did you know there aren't even grades at many Medical Schools? It is mostly pass/fail and if you fail you repeat the year you failed. But still it is a good system and the US has some of the best medical schools in the world. It just isn't the same thing as an academic degree nor should it be. The extremely gifted actually go on to earn a PhD after their medical school and are who I look for to have as my own personal physician. Additionally, the mannerism of their professional conduct can make the largest difference in outcomes. I have seen doctors that are perceived to be the very best who really are that good but have that added ability to act well and to make a theater of each patient's treatment. It is a very interesting fact that the patient's perception of the care is a large part of recovery and successful outcome. Compassionate and personal attention goes a long way towards successful treatment. Anyway, I though a bit of insight into the world of Emergency Medicine might help understand some of the issues from the other side of things.