When you take your pet to the veterinarian for a “simple” spay and the incision requires multiple follow-up visits as a result of its obvious superficial infection, should you pay for follow-ups?
When your vet “misses” a diagnosis and you have to go see the [expensive] internal medicine specialist only to figure out it’s something simple your regular vet should have caught in the first place…do you demand a refund?
When the bandage your vet placed on your cat’s tail causes it to slough off, should he pay for its necessary removal?
If, year after year, your vet fails to inform you of your dog’s high liver enzymes and she eventually ends up at the ER with a ruptured bile duct, should your vet pay for the expensive intensive care she requires?
When your cat’s ability to get at her sutures after her spay means a $1,000 trip to the ER after dripping intestines exited her surgery site, should your regular vet pay?
If your son’s orthodontist failed to account for an obvious, incoming permanent tooth (which you questioned him about two years ago) and your son now needs another round of braces just to accommodate said tooth after the fact, should he comp the treatment?
***
This post is something of a corollary to a popular post I penned a couple of months ago on the issue of unexpected pet death in an animal hospital setting. I’m also offering it up by way of a response to some of the comments following Wednesday’s busy post on multiple pet discounts (in which I possibly allowed my indignation in response to a client’s comments to get the better of me).
***
Complications will happen. After all, pets are not cars. The machinery of automobiles is uniform and its repair predictable. The same cannot be said for any living organism, much less a complex mammalian version.
Medical complications may be seen to fall into two categories that are not always easily distinguishable: 1-expected, routine complications and 2-those that arise out of sloppiness, lack of skill and/or poor protocols.
In a court of law (though seldom employed), sorting out the two is usually the rub. And it’s not easy to do. Any given practitioner’s track record for poor outcomes is not always available for the world to see, nor is its corollary: the excellent care this clinician might typically provide.
Having said that, complications are not always viewed in the same rational light by laypersons. They’ve suffered a loss of some sort in the aftermath of a complication. They have to pay more to the ER, they have more home care to do to solve the problem, they have to pay for antibiotics, their pet might need another anesthetic procedure, or, God forbid, the pet may even die.
Vets have to be capable of comprehending the understandable frustration, the irrational anger and/or the bereaved emotions that follow. They need to address client concerns in a responsible manner that respects these inevitable feelings—regardless of where the fault lies.
Even if the owner is clearly “at fault” for failing to provide proper follow-up care (E-collar placement, antibiotic administration, exercise restriction), veterinarians must nonetheless acknowledge their clients’ point of view and work to resolve the potentially trust-breaching gap that ensues, though they're (ethically speaking) free to choose whether to charge or not for complications that are not their fault.
To that end, many veterinarians will head off these issues with a list of possible complications, including anesthetic risks, suture line issues and other common malfunctions. Others will also build in free rechecks and let their clients know that any procedure will receive any necessary follow-ups from any complications at no charge.
Such discussions acknowledge the possibility of complications in an up front way. Some vets will even ask their clients to sign documents that specifically address the vagaries of anatomy and physiology and legally free them of blame for a list of common complications.
***
Now back to the list that led off this post:
The last example (the orthodontist) is one I’m currently dealing with. Another round of braces will cost me $3,000 dollars more and lots of time invested in orthodontic visits (time is money, too, you know)—not to mention the pain and discomfort my son will endure.
So should my son’s orthodontist find a way to acknowledge my concern? Well, he did, sort of. He discounted the extensive procedure 10% after I explained the problem and pointed out his mistake, which he did not disagree with or apologize for.
To the point may be that orthodontists don’t expect parents to know how to interpret dental radiographs. It may be that they’re not used to acknowledging complications.
Because of this, my son's orthodontist may not understand what many vets know well: Whether your clients are right or not, making concessions is part of the pact. And when your clients are right and you know it (and even if your clients aren’t aware of your mistakes) compensating clients for complications that are the direct result of your sloppiness is the ethical approach. And apologizing for your lack of attention is often even more appreciated.
When complications could have avoided with more judicious intervention and assiduous care—with careful protocols and attention to early client concerns (reference the liver enzymes example above)— compensating your clients to the tune of your mistake seems only fair.
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Some complications "just happen", with no-one doing anything wrong.
When more than a year ago my cat Zora "crashed" and was diagnosed with CRF, she needed a feeding tube placed. Unfortunately, the wound got a superficial infection, so we ended up going to the vet once or twice a week to get the wound cleaned and the bandage replaced.
I don't think he charged me for all the visits, but to not charge for all the visits was a decision he made.
For me, I was happy that she was alive and improving (we where not sure if she would survive that initial week).
The first time Zora pulled the e-tube halfway out, I payed for the office visit, the x-ray to see it's location in the body, and I think (I don't fully remember) for at least some of the efforts the vet did to put it back to it's proper place and clear it out (it got clogged).
Was this a complication? You can say so. But no one did anything wrong. So I didn't see a reason not to pay the vet (she was there for a full day until he finally got everything right).
The 2nd time Zora pulled the e-tube out she pulled it all the way out, but it was time to remove it anyway, so we just brought her in for a quick check. IIRC, the vet didn't charge for that visit. But again, it was his decision.
Xslf December 5th, 2008 11:46:09 AM
Patty, IMHO 10% isn't much of an offer! After all, won't he still basically profit off of the additional care your son now needs? Seems, at the least, that he should do it at cost. And damn sure he ought to apologize!
In a nonanimal case, we received some blinds that were the wrong color because the sample chip they gave us when we bought them was mislabeled. They offered to sell us a second set of blinds at cost and we declined. After all, they still profited and we paid twice. If they replaced the blinds at their cost, probably the markup is at least 50% and they break even and we get what we wanted to begin with and pay once. As I told them then, I won't pay you a second time.
I do think there are cases offered here that ethically, fairly require a major concession on the vet's part. I take part, for example, in a forum for dogs with Cushings (www.caninecushings.net) since it's so common for Cushings and diabetes to occur together and I have been feeling quite dejected recently about the quality of care so many of these pets are receiving. Perhaps some financial pain from providing "careless care" is the only way to engender better care in the future.
If your son's orthodontist lost money on this project, perhaps it's a mistake he would be unlikely to repeat?
Off Topic: What code do I use to break paragraphs so it doesn't all run together?
Natalie December 5th, 2008 11:55:05 AM
Ah... I found the right code!
Natalie December 5th, 2008 11:56:34 AM
Absolutely true. If there's no fault a vet shouldn't have to pay for the follow-ups. But some consideration, supportive or financial is still often the best solution. I think the difference lies in whether it's a routine procedure with a routine complication or a complex procedure with a wide array of possible complications.
Your feeding tube example is a good one. It's a location where complications are common, though the entire situation surrounding it is necessarily complex--a CRF total meltdown. Clients should be expected to pay for these.
For a simple spay or neuter, however, I'll comp all follow-ups for superficial infections and simple complications though I will charge for materials and supplies (antibiotics and suture material or anesthetics), if necessary. I want my clients to know I want them to come see me if anything goes wrong and offering free follow-ups (at least for my time) provides a big incentive, I think.
Again, vets are free to make their choice. They can charge slightly more for the original procedure, thus factoring the time any complication might require, or they can charge for follow-ups. i choose the former option because it means all my patients are granted the ability to take care of even the smallest worries after the fact.
Dr. Patty Khuly December 5th, 2008 11:57:02 AM
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Here's an example, although not my dog. Dog is diagnosed with Addison's Disease via ACTH test. The dog has completely normal electrolytes, so dog should only be given prednisone and have lytes monitored for Transition to Primary/Typical Addison’s. However dog is given percorten to control ( normal ) electrolytes for several months with no follow up blood work as vet said it was not needed. Potassium goes very low because of percorten and the dog needs ER care to save it’s life.
Vet either did not know there are 3 basic types of Addison’s disease and different ways to treat two of them or thought both types are treated the same way. Who should pay?
Elizabeth - From Nova Scotia December 5th, 2008 12:28:07 PM
While I agree that some complications "just happen", some of the scenarios you described here were not ones that "just happened". The liver enzymes and the orthodontist are the ones I am referring to here. We pay our medical professionals to disgnose and treat things we, as laypersons, cannot. We do not have the education or skillsets to do these things. The liver enzymes being elevated...this is something any wet behind the ears, 1st year out of schoo vet should note and mention to the client. Liver enzymes are not supposed to be elevated, and any vet should be able read a lab report. Especially if this is happening for years. If this wasn't mentioned to the client and the animal has complications from it, then I firmly *do* feel that the vet is at fault here: it the vet's job to interpret the lab results because this is one of things us laypeople pay them for.
As for the orthodontist, isn't that the type of thing he went to school to learn? You can't tell me that while in school he was never taught about teeth coming in and how that would affect the orthodontic work? Um, what? As far as I am concerned, again, this is what you are paying him for. *You* don't have his degree, this is something he should be knowledgable about. The permanent tooth coming in isn't an unusual occurance.
Now, I will totally agree that sometimes complications do happen, but those two scenarios were ones that could have been completely avoided if the medical professional had done their job correctly and to the best of their ability. In both of tghese cases, however, there were warnings that something was not right and the medical professionals chose to ignore the signs. This is why I feel they should be held accountable for what happened.
Heifzilla December 5th, 2008 12:38:53 PM
Re: "compensating clients for complications that are the direct result of your sloppiness is the ethical approach. And apologizing for your lack of attention is often even more appreciated."
I appreciate and agree with the above statement. You would be surprised what a world of difference it makes to clients when you simply admit what you could have done better, apologize, and offer fair recompense in response. This is the logic behind the growing disclosure and apology movement in human medicine. See SorryWorks for more info.
Taking responsibility, paying for subsequent related costs, reimbursing the cost of the original sloppy procedure(s), apologizing sincerely, and proactively taking steps to rectify the circumstances that led to the problem are the right thing to do. Also, when this is done, clients are less likely to report the vet, or file a lawsuit. Or scream to high heavens all over the internet. :) Or call the press.
Unfortunately, since the consequences to veterinarians (unlike human doctors) are nearly non-existent even if such actions are taken, it seems difficult to convince them to reject the "deny and defend" culture that pervades the field (and is still holding on to much of the medical field), and move in the direction of voluntary accountability.
As inconvenient and expensive (and yes, painful) as your son's situation is (so sorry about that . . . ) it's not really comparable to the level of severity of many of the veterinary scenarios you described. The analogy is good to spark discussion, but I'm sure you'd be less sanguine if he'd lost a limb or ended up in ER with hemmorhaging.
All that said . . . apology or not, if sloppiness during a spay ends up causing massive internal hemmorhaging, I believe clients should think long and hard about reporting the incident to the vet board, etc. The apology and accountability, financial and moral, are very important. But the issue of competence, and follow-up checks to ensure that needed retraining and/or procedural changes are made to reduce the liklihood that it will happen again, remain. Also, by reporting it, the Board (and the public, if it results in action) can determine whether or not a pattern exists.
Someone could be the nicest person in the world, but if they keep messing up spays, I'm not taking my dog there.
Thanks for the topic.
Stefani December 5th, 2008 01:16:02 PM
How about this example... what would you do: 5 year old healthy french bulldog gets adopted by a great family. 3 weeks after adoption, the dog yelps out in pain, neck stiffens, falls over, and spends the next few hours shaking, and sometimes turning to the right. The regular vet suspects a disc herniation and refers the dog to UPenn (top vet school) for a spinal MRI. Once at UPenn, the neurologist there says she thinks the dog had a seizure, it's definitely brain related,(not spinal), and orders a brain MRI and cerebral spinal fluid tap. Results of the MRI are normal, but spinal tap shows elevated white cell count. She sends the dog home on prednisone and phenobarbitol and wants a recheck in 2 weeks. She is suspecting GME (granulomatous meningeal encephalitis). All tests for bacterial infections come back negative. 2 weeks later, she sees the dog again and he looks worse than before, can't walk or stand up on his legs. She orders bloodwork which shows elevated liver values, and says it "can't be due to the prednisone." (Pre-MRI bloodwork from 2 weeks before was all normal). She now suspects cancer of the liver and orders an ultrasound. Ultrasound results are normal. She suggests euthanasia as an option because the dog is clearly sick and not getting better. She still suspects GME as a possibility. Total spent so far: $4000 Desperate for answers, the owners drive the dog to Boston (Angell Memorial ER) where they had researched and found one of the top Veterinary Neurologists that specializes in GME. Long story short, the Neurologist looks at all the test results, orders a SPINAL MRI, and diagnoses a herniated disc in the cervical region of the neck. The dog gets surgery and goes home 24 hours later. 2 weeks later, he is back to a healthy happy dog. Total spent in Boston: $5000. Should the owners get reimbursed for the $4000 spent at UPenn when the dog was originally referred there for a SPINAL MRI, and the UPenn Neurologist decided not to do it???
Tara December 5th, 2008 01:23:40 PM
This is a difficult topic because each situation and case is unique with a large variety of variables.
Every profession has risks and "to error is human" which to me means that it is a numbers game. I believe there is a certain percentage of errors that arise over time and numbers of clients.
Human doctors often miss diagnosing issues and we have several situations in my home area where one clinic missed catching cancer (dismissing it as something not too serious) and it progressed too far to be addressed. I knew three such people personally.
Did anyone sue? Did the clinic apologize or admit guilt?
No.
Locally, we have a veterinary clinic that is consistently sloppy. Large numbers of surgical infections after spays occur and other nightmares...but the advantage of a small town is that people spread the word and the place has lost a lot of business.
BTW Thanks for the great topic to get the brain matter churning!
Find me blogging at Ark Animals
Ark Lady December 5th, 2008 03:14:48 PM
I think the answer in all of the examples given, (except possibly the ones involving spays, and maybe the tail...) is to find a new vet / orthodontist.
If they're ignorant or sloppy in one case, what makes you think they won't be again? I would much rather have a full-price successfuly procedure than a free one with complications.
Unfortunately, that leaves little incentive for refunds.
If the complications are just a 'stuff happens' and not the result of negligence, I would fully expect to pay myself. Cat rips its stitches? Either an act of god or my own darn fault.
My personal story is when my mother took her cat to be declawed (we're working on her, but it's slow progress) the vet skipped one. He offered a refund or free second surgery, but it still wasn't enough to go back. What if next time he missed something more important?
puppynerd December 5th, 2008 04:17:45 PM
I don't understand the ability of people to demand guarantees for non-machined and non-mass produced products. ESPECIALLY when the "product" is a pet and health services performed on that pet. While I think that Vet prices are rather high and some billing practices are questionable, I pay my vet for the effort, not the result. So if they double bill me for something that doesn't really take their time or effort, I'll ask for it to be removed ($30 extra dollars to look in my dog's ears on top of a $30 office visit, for instance... "exam fee"... no way). But if I bring in a sick animal and they can't save them, or a routine proceedure goes wrong, I'm not going to hold everyone else but me responsible.
Christopher December 5th, 2008 06:26:52 PM
I feel change in the air! And I am welcoming every single bit of it. We watch the news of greed causing economic meltdown and we ask ourselves how did we all let this happen over the course of years!!?? Because it was pervading everywhere, and people are fed up.
Yes, your son's orthodontist should be fixing that alignment no charge, jeepers, and you shouldn't have to ask??!!
For the longest time I had "paranoia" that subscribers would think I was off my rocker with my experiences shared. Reading the many posts, I see that I'm in no way alone! BTW, Tara, I too know someone in MA. that had successful neuro-disk surgery at Angell. I also know of a good neurologist & surgeon "near" Penn. Yes, indeed, Penn owes the $4000.
Often, I get the feeling that it isn't lack of skill, poor protocol, or unexpected or routine complications that cause the most harm. It is deliberate with-holding or diminishing the seriousness of information that any 101 student would be familiar with.
Gosh, how many vets could look a pet-owner in the face after reviewing an 18 phosphorus after administering 18 hours of (2x normal rate)of fluid therapy and say "I have confidence your elderly pet will respond", how about after over 48 hours, the phosphorus declines to only 14? How about an amylase off the chart? Who would withhold the significance (and the results) of an un-corrected calcium/phosphorus ratio for an entire week?
What kind of professional would administer saturated potassium chloride to a conscious animal held in the arms of their owner?
And say you OWE $600 to meet the $3000 total and we are ruining your credit by putting you in for collection and this is ALL YOUR FAULT that you OWE us money for the cruelty and abuse we perpetrated on you and your dog.
Who is resonsible for this? Edgefield Veterinary Hospital, who took care of my pet for years and "referred me to..." OR Dover Veterinary Hospital, where she sat in a cage under the care of a "specialist"? OR... better yet, the State of New Hampshire that has allowed this cruel scam and unlicensed for narcotics clinic to accept pets for the benefit of Great Bay Community College vet tech students?
Sometimes it seems too incredible for me to believe, and I was there. Barbara A. Albright, owner of Scottish Terrier "Pocket"
Pocket's Story from NH December 5th, 2008 06:57:37 PM
Re: "[if] or a routine proceedure goes wrong, I'm not going to hold everyone else but me responsible."
Christopher, first of all, why would you hold yourself responsible for a procedure going wrong in someone else's hands?
Second, doesn't it depend on WHY the procedure went wrong?
Example: In California, a veterinarian administered an injection to a dog for "pain." It killed the dog. Why?
Stefani December 5th, 2008 07:33:09 PM
oops, embedded links killed my post, I think.
The answer to "why" is that the vet injected Sleepaway directly into the dog's abdomen.
In another case, a dog died after the vet cut a large section out of the ureter leading from her only kidney during a spay.
In another case, a vet allowed an unlicensed tech to fill a prescription, it was filled with the wrong strength, wrong dose. the owner actually asked the vet to check it before leaving, but nonetheless the unqualified person sent her home with a fatal dose. Same guy has been convicted of animal cruelty for the condition of a 'rescued' wild animal, and has come real close to assaulting employees. All these folks are in CA.
In such cases, my question goes so far BEYOND "should the client pay?" It's: Should these vets be practising AT ALL?
These cases are all on Bad Vet Daily.
Stefani December 5th, 2008 07:37:21 PM
In regards to the previous post, even though I have multiple animals I don't recall ever taking more than one in at a time and wouldn't expect my vet to give me a discount because I made the choice to have multiple animals. Now on this subject I have had a few experiences that I don't think I should have had to pay for but did. One happened many years ago when I was a teenager and the vet came out to look at my prize winning 4H goat. He said he needed to pump some medicine in her stomach and put a tube in her nostril and proceeded to pump it into her lungs. She promptly dropped dead. I, at 17 years old, was outraged and questioned the fact that I had to pay for his mistake. But I did. I never called him back. A few years ago my young Lab was hospitalized at the vet and required an I.V. which she pulled out of her leg at least three times before they put a cone on her. I had to pay for each time they put the I.V. back in. I never went back. Recently my Flat Coated Retriever stopped eating so I took him in and the young vet took Xrays, did blood work, ultra sound...the works and found nothing. She told me maybe he had a large load of worms...I knew he didn't. After a couple of days I took him back and asked the vet who owned the practice to look at him. More Xrays later they found the tumor...should I have had to pay for the second set of Xrays? I don't know but I did because there was the element of doubt and I hoped the young vet learned something. I definitly think your orthodontist should waive his fee. Man up I say. If he won't and you have to pay go somewhere else. Don't let him make more money off you.
Wendy aka goatgirl December 5th, 2008 09:51:45 PM
This is a complicated problem. However if the mistake entirely lies with the vet, or the orthodontist then yes, they should pay.
Question remains as Stefani correctly asks though....should they be practicing at all??? Vet and dentist alike....
it is called malpractice for a reason.
LorriM December 5th, 2008 09:55:35 PM
"When your vet “misses” a diagnosis and you have to go see the [expensive] internal medicine specialist only to figure out it’s something simple your regular vet should have caught in the first place…do you demand a refund?" Dr. K: Are you sure that the expensive internist won't misdiagnose just as the GP do? I paid $500 for an ultrasound which the PhD internist misinterpreted, recommended surgery for an obstruction that WAS NOT THERE (!)and my companion died 3 days after release from the referral hospital! Five veterinarians MISSED to diagnose Atypical Addison's!!! As you probably know the symptoms of intestinal obstruction and Addison's are almost identical. I never thought of demanding a refund--I was frantic to find out why my pet died. NO ONE WOULD EVEN TALK TO ME. Finally, the GPs answered my phone calls a week after my companion's passing, and the board-certified surgeon talked to me 3 weeks after my pet's death only to ask me why I needed copies of medical records! You are asking us (companion guardians)if a refund would be appropriate for sloppy work, and I am only asking for COMMUNICATION, HONESTY, AND APOLOGY. You never know how far some pet guardians are willing to go to get JUSTICE! http://alabamavetboardwatch.110MB.com
Fotini December 6th, 2008 02:02:09 AM
The orthodontia adventure sounds just plain dumb... Years ago, orthodontia was only started AFTER the patient had most of the permanent teeth (all except wisdom teeth) in place. They also used the highly visible, mouth-full-of-metal braces. I am not a dentist, but my guess is this was because the deciduous teeth would not take the pressure from the braces. With this method, there are still possible issues around age 18 or whenever the wisdom teeth start to move, if the patient has them. But, shouldn't permanent teeth, erupted or not, all be visible in a full set of x-rays?
Miss Kitty's Mom December 6th, 2008 03:47:00 AM
Fontini: Undiagnosed dogs with "Atypical Addison's" have surgery to remove suspected obstructions quite often unfortunately. We see it a lot on the yahoo addisondogs group at www.addisondogs.com/. Less frequently dogs with undiagnosed Typical Addison's do as well. Less so I think think since their sodium and potassium is usually so out of range. I understand the "Atypical" being harder to diagnose. But if my vet is honest with me I can handle whatever happens, whatever is missed, I do know she is human and can make mistakes.
Elizabeth - From Nova Scotia December 6th, 2008 07:27:24 AM
I don't know about the neuro example cited above (at Penn). Reference Sophie Sue's long list of diagnostics (including an abdominal surgery!) before her brain tumor was diagnosed. If the CT had been done before the abdominal surgery (which I declined due to cost concerns and the surgeon/internist's hunches that a pancreatic tumor was present) it would have made things much easier on her (and financially, on me!). But sometimes dogs' unclear evidence (confusing symptoms) means some hunches will be wrong. And hunches are sometimes all we have to go on when a patient can't speak.
Dr. Patty Khuly December 6th, 2008 07:45:40 AM
A misdiagnosis IS acceptable, in some cases. After all, a certain percentage of medicine is still a crapshoot. However, failure to even consider alternatives, or to offer further testing for other possibilities, or to obviously misdiagnose (such as the puppy I referred to in an earlier post that was misdiagnosed with a specialist-requiring skin disorder - and was merely suffering from plain ol' mange that even I guessed over the phone after a simple description of symptoms) is malpractice.
Since lawsuits are not common, given the state of the law in most states and provinces (companion animals being property and their maximum value being their purchase price tag) there should be some code of ethics in place, and some control board to monitor such situations (a la Penn State) where these gross injustices occur. While we can't undo what has been done, we certainly shouldn't be expected to foot the bill for services that were not only unhelpful, but sometimes harmful or even deadly.
Post surgical infections happen - and it's really not possible to say what the cause was. Treating a pet with the wrong medication or an inappropriate dose, or performing unnecessary procedures for capital gains or out of sheer ignorance/professional ineptitude should be equal to an automatic refund of all costs incurred by the client.
Dr. K, I truly applaud your stance on post op infection. Quite frankly, that's above and beyond what I expect from my clinic, and my expectations are pretty high.
As a rescuer, I do a lot of self-diagnosis and home treatment under the supervision of our vet, and because we work so closely I completely understand how difficult some diagnoses can be - however, I as a pet owner/guardian also take a very close look at every blood test, x-ray, ultrasound and medically significant observation. I research, I read, and I make sure before making any decision (whenever possible, obviously) that my vet has made the best educated guess possible. Because really, that's what medicine is, a series of educated guesses.
Hopefully, your vet is continuing their education, reading their journals, paying attention to the details surrounding new drugs/procedures/discoveries, and is taking the time to make the best educated guess possible. And if they aren't, well, YOU are your pet's medical watchdog. Don't just take their word for it... check it out!
Kim December 6th, 2008 04:29:41 PM
Dear Kim: I am not the board-certified internist or surgeon, and therefore, I couldn't interpret radiographs and ultrasound--that's why I paid the specialists so that they would interpret my pet's tests. I did take their word for it, and they blew it big time!!! The pet guardians can only be watchdogs for certain health problems, but they CAN'T intepret radiographs, ultrasounds, MRIs, etc.
Fotini http://alabamavetboardwatch.110MB.com December 6th, 2008 10:37:16 PM
When a pet goes home without an e-collar or other neck guard, and lkicks at stitches, causing guts to spill out, then yes, it's the clinic's fault. However, if they send one home and it isn't used, it's the owner's fault. But there is one issue - since the destruction of the incision to the point that intestines are falling out should take more than 10 hours (at least every time I've seen this happen it's at least three days after the animal comes home), I have to ask why the client didn't look at the pet to check how things were healing. They should have called and asked "Is this normal?" (having swollen tissues, etc.). With the liver enzymes, and the orthodontist, I agree that it was up to the doctor to catch a potential problem that is so obvious - and not even in hindsight. As for the other examples. it's harder to judge, since we don't know exactly what every step from start to finish was. In ever case, apology should be first and foremost, whether because of culpability or in sympathy/empathy - on both sides (clients need to admit responsibilty when they aren't compliant too). And it doesn't cost a thing for either side, unless they are willing to let pride go before doing the right thing.
KateH December 7th, 2008 09:21:50 AM
KateH: I agree about the cat spay stitches. Years ago an E-collar was unheard of and my cat chewed out her surface stitches...I ran her promptly down to the vets, who told me not to worry, she had 3 layers of stitches and this one didn't need to be restitched. After that, I always put a "belly wrap" around my pet's abdomen and checked daily the incision site. One of my pets got "thin wire" stitches. Don't know if those are used anymore.
Re: the Penn case, when Pearl had her MRI, I was under the impression it was going to be a complete MRI: her entire spine, neck, and possibly head, if needed, to rule out possibilty of cancer, tumor, infection/inflammation such as GME. Although the "hunch" was herniated disk(s), the other diagnoses were still considered and not dismissed.
Barbara Albright/NH
Pocket's Story from NH December 7th, 2008 01:50:12 PM
Elizabeth - from Nova Scotia" "But if my vet is honest with me I can handle whatever happens, whatever is missed, I do know she is human and can make mistakes." I wholeheartedly agree with you, but all the vets involved in my dog's case were not only not honest, but they AVOIDED any kind of contact with me after realizing that they had killed my companion through misdiagnosis and mistreatment! You are more than welcome to visit my site for more details. . .
Fotini alabamavetboardwatch.110MB.com December 9th, 2008 12:11:24 AM
Regarding the Penn case: The dog was referred to Penn for a SPINAL MRI, and the neurologist at Penn said she didn't think it was necessary, and was sure it was brain related, therefore, only recommended doing a brain MRI. Then when she couldn't find any answers she started looking for cancer and actually recommended euthanasia!!! This is total incompetence in my eyes, especially if you are a NEUROLOGIST at a TOP vet school, who has (most likely i hope) dealt with disk issues (that are common in french bulldogs). P.S. U.Penn has refused to refund their money. Do you think I or anyone I know through rescue is ever going to go there?? NO. Sorry Dr. Khuly, but that one doctor created a bad name for the whole hospital.
Tara December 11th, 2008 08:33:15 PM
Tara, At the very least gather all records from all sources, in the event you can take this to an attorney under "consumer protection".
If the referral was for a spinal MRI, that is what should have happened and the price tag you quote, certainly would have covered that, plus some.
Recovery of the funds lost appears to be thoroughly warranted! B. Albright/NH
Pocket's Story from NH December 30th, 2008 10:17:34 AM
Barbara, noone would administer KCl for euthanasia. It did not happen to Pocket. Stop lying to all these people.
cathy gajewski January 24th, 2009 11:37:15 AM
Thanks for your sharing.This is a good access to Abercrombie and Fitch.
AF September 16th, 2009 08:47:55 PM
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