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Medical Malpractice knowledge? - Page 2  

post #31 of 41
Originally Posted by NE Racer View Post

'As reported by USNews, malpractice costs account for 2.4 percent of US healthcare costs.  It looks like 80% of the 2.4% is in "defensive medicine".  That's a far cry from half.'


That may be true about actual payouts, but that doesn't factor in the cost of malpractice insurance.  Imagine if 2.4% of the gross of your business went to lawsuit payouts, and then imagine the insurance and other costs that come with it.  Some of the costs that need to be added are the actual time MD's and other spend filling out paperwork.  I know an orthopedic specialist who spends 1-2 days per week dealing with insurance paperwork. It may not be half, but it's a high percentage we all chip in for.

It's kinda like a neighborhood where the residents say they don't suffer many burglaries, but they have iron bars on all the ground-level windows, alarm systems, and walk to and from their front doors in a hurry.  They actually pay thousands of dollars each because of burglary in the form of preventive measures, and if you price their lack of peace of mind it's worse.


Whole regions of the U.S. are losing certain specialists because of malpractice.  While the actual payouts are not a big slice of the pie, the collateral damage is enormous.


In terms of blame, it is a bit rich that the o.p. says he doesn't plan on suing, but titled this thread "medical malpractice knowledge."  That's a huge glaring red flag. 


To put it in skiing terms, there are lots of people whose acl rehab wasn't as good as it could have been because of defensive medicine, because of assholes who want to play the blame game.  We now know that in most cases, the faster you get someone up and moving after acl surgery, the better, but acceptance of this was a lot slower than it could have been.  That's a lot of real people who could have better outcomes but basically had lawyers standing in the way.


In terms of blame, how about someone not reading up on their injury beforehand, not discussing with their doc and PT what the rehab protocol BEFORE going in, and then afterwards asking for medical malpractice advice from a bunch of people on the internet who have no knowledge at all of his specific shoulder, doc or actual course of treatment?


Way uncool.


post #32 of 41


Originally Posted by SkiMangoJazz View Post

I don't see a lawsuit as much of a possibility, I do however see possible blame here. How am I to know what is an acceptable amount of effort to exert to rebuild the muscles around a tear after a long period of immobilization? They are highly paid and trained experts.

I agree that the likelihood of winning is low - perhaps the Risk Management people will at least see that they should help me in some way.

However - it isn't my fault that I was encouraged by a person whose job and training are to heal injuries - to make aggressive movements that may have caused the tear.

If another surgery is necessary who should have to pay for it? Me? My Health Insurance Company? The HMO who employs the people who likely created the need for the second surgery? You can bet they have money put aside for these purposes.

Who should have to pay for the MRI that was done to see if an error was made? At this point my Insurance company did. Is that right? Is this not part of the reason Health Insurance is so expensive, because providers overcharge for their services?

What about all the co-payments I'm making?

You talk about personal responsibility? How about the personal responsibility of the people who (if they did) screwed up here? I did exactly what they told me to do.

Believe me I'm sure it's better in Canada as you have single payer healthcare. In the US it's a whole different ballgame.

If a lawsuit isn't a possibility why dwell on blame? Will blaming someone help heal you? Instead focus on doing what you need to do to heal your injury. You can't undo what's done and you are wasting energy.


If you don't feel in tune to your body enough to make judgment calls yourself on what is too much you might want to start to learn how to "read" your body and trust your instinct. Maybe take some Yoga after you are better?


I definitely feel for you as I have had plenty of injuries myself in the past (Finally healed - I think - from a back injury 2 years ago!).



I did exactly what they told me to do.


"Don't take your body to the doctor as if he were a repair shop.“ ~ Quentin Regestein


post #33 of 41
Thread Starter 



BYE BYE (oh and thanks for all the intelligent people who discussed this with me on this thread. The all caps is for the two *&@! who attacked me. I hope you guys have someone screw your lives up some day by poor care. Actually I don't, I'm not a *&@! like you are.)
post #34 of 41

SMJ, I think most member have great empathy for your injury and my reading of this thread is critical of the title and defensive of malpractice claims in general.  Personal attacks for bringing up the idea for discussion should not have happened, and an earlier post report would have helped.  I think I would have left it at this:


Originally Posted by SkiMangoJazz View Post

Thanks everyone for your help. I am not planning on suing anyone. Should the Risk Management department want to offer to eliminate my co-pays that would be nice - lol.

I am starting PT again and hope to regain acceptable use of my left arm - although limited. We'll see. Perhaps someday I will have shoulder replacement, but going through that is going to involve a pretty bad life without it. I'm 59 and want to get as many more years of skiing as I can. If I can ski this way I would hate to lose another 1-2 years in rehab from a major operation.


Sorry for your injury and wish you a fast, effective recovery.  This is a tough injury and I have had a friend who had multiple cuff surgeries.  Wish I could say the outcome was 100%, but you know the odds. 


Let me know if I can help by closing or re-titling the thread.

Edited by Cirquerider - 8/30/11 at 1:16pm
post #35 of 41

It may help to go over what someone can and can't expect from surgery.  They can expect surgery, including all the discomfort, risks of things like infection and other complications and risk that it won't work out, and should be able to get a sense from the surgeon how likely it is that the actual surgery will make things better.  They can't expect "success" from surgery, or from PT, beyond a certain bandwidth of outcomes that seem to apply to groups of patients and that they hope will apply to them.


They can't expect no "mistakes," which can also be hard to separate from just plain bad luck.  Extremely skilled, professional ski and snowboard instructors make mistakes all the time, without being negligent, and doctors and PTs can give a great level of care and still sometimes be mistaken. 


A negative outcome does not equal malpractice, and a negative outcome does not even mean there was a mistake. 


Also, most people who ski and ride a lot are going to have injuries that may require surgery at some point.  Probably most people in this thread have had several.  It's part of life.  Part of partnering with your doc and PT going in is in fact talking to both about what your rehab protocol should be, and also confirming that right after the surgery.  The web can be a useful tool for actually learning about things like rehab protocols.  Trying to assign blame to others because something didn't work out is easily done on the web, but not necessarily as useful, and often self-serving.

post #36 of 41

75% failure rate normal for RC surgery??? Why is everyone accepting that is the case?


My DH is recovering from RC surgery and is having (thank heaven) a very different experience. The success rates he was quoted were not anything like that. There are many types of tears and RC injuries, so all is not the same, but a quick internet search could not reveal anyone citing a success rate for RC surgery as  low as 25%. Unless of course you smoke....


From the AAOS (American Academy of Orthopaedic Surgery) website: "Good or excellent results (for RC surgery) were seen in 84 percent of nonsmokers, but in only 35 percent of smokers" ... and... "the nature of the tendon is beyond the surgeon’s control, he or she can elect nonsurgical treatment in patients who are suspected of having poor tissue.”  


At the least, you should get the gastric juices this is understandably bringing up for you dealt with before you add ulcers to injury. It might make you feel better to write your surgeon and PT letters so it's a one-way conversation and not a debate. Tell the surgeon just how outraged you are that s/he did not tell you about the poor success rate with this type of surgery. You might have elected not to have it if you'd known. Also, s/he could have decided not to continue the surgery once it was discovered the condition of your tissue was so poor. As others have said, quick jerky movements to effect a range of motion you couldn't get by slow lifting just doesn't sound right for any PT to approve. (Are you really sure they OK'd that, or is it that you chose to use those sudden burst moves to try to comply with the goal they'd set out?)


Condolences to you SMJ. Maybe Yoga is the ticket for you until you are ready for SRS. At least it's your shoulder and not your hips!

post #37 of 41
Originally Posted by Mom View Post Unless of course you smoke....

I would like that one explained to me in a cause and effect fashion.

post #38 of 41
Thread Starter 
The 75% failure rate was determined during the surgery when the surgeon saw the condition of my tissue and the extent of the tear. He did not however tell me that after the surgery.

The exercise in question was full range front raises, unassisted in a supine (lying position) and with an assist (the other arm, a wand and/or a pulley) standing. I did all of these in the presence of the PT exactly as I was doing them at home and she encouraged me to.

The surgeon called me today and we had a good long talk. He is unhappy with the outcome as well and wants to help me find the best possible outcome.

"Malpractice" does not mean "lawsuit." It means "improper, illegal, or negligent professional activity or treatment, esp. by a medical practitioner, lawyer, or public official." In this case improper is the closest.

The errors that were made were the surgeon not telling me and the PT after the surgery just how bad it was and just how careful we needed to be in my rehab. She should not have allowed me to do those full range of motion front raises. Poor communication. They both wanted to help me and as I said I don't want to hurt them.

I was misled and received improper care. Whether that was the cause of the re-tear is hard to say. Probably was, but it might have re-torn anyway. We'll never know. Should continued PT not give me reasonable use of my arm then a tendon replacement procedure would be the next option, where my lat tendon is used to replace the RC tendon. Maybe next Spring. Hopefully not necessary.

btw I don't smoke.
post #39 of 41

Improper and possibly imperfect are two very different things.  There is still nothing in what you have recounted that suggests impropriety, much less illegality or other reckless or negligent behavior.  And, again, since you continue to try to assign blame, you also could have communicated better post-op yourself.

post #40 of 41
Thread Starter 
Fine CT. I am to blame because I didn't communicate. Sure thing. And what exactly didn't I communicate?

Improper - yes. Improper to have my only medical contact, the PT, giving me exercises that the surgeon adamantly said I should NOT be doing.

Either she prescribed the wrong treatment, or he neglected to tell her what to prescribe.

You think if a doctor prescribed a drug to you that injured you that that would not have been improper? Oh that's right, you would be to blame for taking it and not communicating better.

Why so many of you fail to understand why I want to figure out what went wrong here, who is to blame is beyond me. It is human nature to want to understand what happened after something bad happened.

I'm done defending myself from the criticism of fools. Thanks for playing.
post #41 of 41
Thread Starter 
Sure Tom, please close the thread, it has definitely run it's course.
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