Tuesday, January 6, 2009

Is the Customer Always Right?

(A disclaimer: this post is actually about my recent miscarriage, so read with caution. There are some specific details later in the post.)

How strictly do you adhere to your expectation of good service?

When you take a garment to the dry cleaners? When you order a meal at a restaurant? When you have your car serviced? When you order something from an online retailer?

Do you expect that you get what you requested, in the time frame promised by the provider? Do you expect quality work? Do you expect to be charged a fair price for services rendered?

And, here, dear reader, is the question I'm really getting at: what do you do if you don't get the service you expect?

If your garment comes back still soiled, I suppose you could have them clean it again. If your meal is delivered incorrectly, you send it back to the kitchen, or maybe suffer in silence, but request a complimentary dessert. If your car is not serviced to your satisfaction, you ask that they continue to work until the problem is resolved.

But what do you do if poor service received is unchangeable? Irrevocable? What if something that you expected to have done properly and in order wasn't, and yet, you are still expected to remit payment in full, whether or not you were satisfied with your service? Do you refuse to pay?

Here is our quandary...and I guess, let me preface by saying that, yes, we have sought legal advice, and yes, we are taking some actions to address this situation. I'm posing the question more out of my wrestling with this on a moral level....

So here goes.

When I was taken to the hospital in October during the miscarriage of our twins, I received beyond-inferior care. Negligent and almost life-threatening care. Care that made me wish that, as horrific as the experience would have been, I'd just as soon have gone through it at home.

When I was wheeled into the emergency room, I was asked to fill out standard paperwork and "just wait" until it was my turn to be seen, regardless of the fact that I was hemorrhaging so greatly. I was losing so much blood that other waiting patients, stunned to see my life's blood spilling over the wheelchair seat and down the halls, began to panic and insist the nurses take notice. Had it not been for the fury of my father, who merely ignored the nurses' scolding and wheeled me past triage, screaming for help, I'm not sure how severe the outcome would have been. (And for the record, once we found a competent orderly to assist us, he assured my dad that he had done the right thing.)

Once I was situated in a trauma room, my care was competent. I was changed, medicated, monitored, and assessed, as best as they could, until my ob/gyn could be reached. As contractions began to intensify, the ob/gyn on call delivered Baby A. From this, she informed me she thought the pregnancy was between 8 and 9 weeks. I watched her contain Baby A, and she informed me that all tissue would be sent to the pathology lab for testing. I was sad, but relieved for this news.

About an hour later, I was informed that I would need an ultrasound to determine if I had delivered all the fetal tissue, or if I would require surgery. As my orderly wheeled me up to radiology, he informed me that he would be waiting in the hallway with Jim, and that the procedure would be quick and that the technician had been "fully appraised" of the situation, so as to make it as easy on me as possible.

In a word, no. No, it wasn't, and she hadn't been, at all. Questions that at first I tolerated as routine (i.e. "what brought you to the ER tonight?" and even "are you experiencing any bleeding?") quickly turned to "are you experiencing any pain?" and "have you passed any tissue?" I sat up on the table as best as I could, and as calmly as I could muster, said to her, "Miss, I know you are just trying to do your job, and it's late, and from the look on your face, you obviously don't want to be here, but I just delivered a nine-week fetus, so in answer to your questions, yes, yes, and yes. Now, I was informed that you were aware of this situation, and that does not appear to be the case. Am I correct?" She just looked at me blankly and then down at the chart and said, "I was just ordered to to a TV [transvaginal] ultrasound. I don't know about anything else."

I insisted that she confirm those orders before she put that wand anywhere near me, and I laid back down on that table and sobbed.

Once she returned, she did, in fact, perform the ultrasound, at which point we found Baby B. Somewhat redeemed herself by honoring my request to look, just once more, to make sure that there was no heartbeat.

I was returned to the ER, only to find my very, very angry ob/gyn yelling at the ER nurses. He eventually told me that there had been a "mix up" with my labs, and that they were refusing him an operating room to do my D&C, because, according to the blood work, I wasn't pregnant. Never mind Baby A delivered and sent to testing. Never mind Baby B still in my womb. The blood test said "not pregnant," so.... The nurses were all just standing there with blank looks on their faces.

So, they redrew the blood, and two hours later, I was laying on a gurney outside the OR. But even up until the last minute, there seemed to be confusion and chaos. Both my ob/gyn and the anesthesiologist looked upset and pensive. Thankfully, the procedure itself was quick and easy and by the next morning, I was back in the antepartum ward with a fantastic nurse. Actually -- and here is the one bright spot in this story -- the nurse I had after surgery is the same nurse that discharged us after Seth was born. And she remembered me! What a blessing Kathleen was in such a dark hour.

My recovery was relatively easy; my greatest pain afterwards was more from the intubation than anything else. I expected that once I had my follow-up appointment with my ob/gyn later that week, that we would continue to heal and move forward from this.

I knew something was wrong as soon as my doctor walked into the room at my follow up appointment. I doubted that he had pathology reports back on the babies yet, as it had only been a week, but I thought maybe he'd found something wrong with me. I resolved right there, I would do whatever he was about to tell me.

Fortunately, the path lab had not found anything wrong with me. Unfortunately, the path lab hadn't found anything. That's because they didn't test anything. That's because they lost the fetal tissue. Not only that, my doctor told me, but after he did some further investigating as a result of the "not pregnant" lab results, he'd found that my blood work had been mixed up, and that had he had to do a transfusion (which, at one point, was very likely), the results may have been fatal. He informed me that my case had been sent before a sentinel board (I'm still not entirely sure what that means), and that even the president of the health care system was aware of the severity of the case and the what-might-have-beens.

So, there, in a nutshell, is the experience we had with our last loss. No babies, and no answers as to what may have caused my body to let go of them. As I now prepare to find a new ob/gyn in TN, I wonder how far-reaching the effects of the negligent care will reach.

And I also am looking at the bills. We have received the bills from the hospital for my 24 hours of "care." It's not too bad, as far as the dollar amount; under $500, from the $18,000+. But it is the principle of it. According to them, I was "never pregnant" and without the fetal tissue there is no proof that there was a baby, so how can I be expected to pay for a miscarriage?

Anyway, we are working to resolve the billing issue. Basically, we are requesting that they waive the balance in lieu of us pursuing legal action.

But what would you do? How far can one take an expectation of good service, and are we in the right to refuse to pay?

I'd be interested to hear your thoughts, dear reader. And if you've made it through this whole post, I applaud you. I know it was long. Thank you for listening, as always.

17 comments:

Shannon said...

You received horrible service - if you can even call it "service." I'd fight for it. I would refuse to pay or atleast pay a smaller amount. It's crazy that they were careless and reckless enough to screw up that many times.

TresNinos said...

You've known my POV on this from the start. Get 'em. *hugs* Let me know if there is anything I can do from up here.

Buzzings of a Queen Bee! said...

First of all, I am so sorry for your losses. I can't imagine having to go through that in the best of circumstances, let alone the worst. I would seek legal action if I were you, too. No question about it.

My husband and I had a miscarriage before we had our daughter, and the lab had a similar "mix up" and didn't perform the testing on the fetus in time. So we were left without answers too. In retrospect, we should have done more to fight the system, but in our grief we did not. I applaud whatever you decide to do. Thanks for sharing such a difficult part of your life with us.
Carrie

Jeanette "Frogster" said...

I would say definitely go with the legal action. I think the hospitals and trained medical professionals put far too little emphasis on unborn babies - after all, in their minds, it is "just a fetus." But we know that it is LIFE! and demands the respect and care that they would give any other patient.
I am so sorry that you had to go through this. I have had some bad doctor experiences but nothing like this. I am relieved that you survived it and hope that you find a quality OB-GYN and women's health services there in TN.
Hugs to you, Jeanette

Christy said...

Monica,

Let me begin by saying that I am so sorry for your losses and so sorry, saddened, and upset by the care (or lack of) that you received during a time like this.

It's definitely a difficult decision to make as to how to move forward with all of this. My only advice without it sounding simple, or over-used would be to really pray about what God wants you to do in this situation... as I'm sure you have done.

I hope that you find a very caring, sympathetic, understanding and a doctor who is in your corner. They are out there! Thank you for sharing your story because I'm sure it wasn't easy.

Kendra said...

Oh Monica...I made it through the whole post, in tears.
I am jus so upset for you. I know you are "ok", and you have most likely made it through the worst of all this, but my heart still breaks for you. I remember after our miscarriage (which I used medication and did at home...good choice for me at that time, but I am not sure I would choose it again...PRAYING TO GOD I never have to make that choice...) just feeling like my body had turned on me, and then to feel so violated after is just insult to absolute injury. I simply can not fathom what all that must have been like for you. I really can't. To feel such loss and confusion and heartache in your own soul...and then to have such confusion and chaos around you, by the very people who are supposed to be taking CARE of you...so WRONG!!!
Monica, I will pray about wisdom for this. I personally think that any form of settling for your bill is not enough, I really do. The people at the hospital were humans, and humans make mistakes...but this is a story of one too many mistakes, and potentially lethal ones. It can not go without notice.
I would inform the billing office that you are holding off on paying the bill as legal action is being pursued, and then pursue it.
My father is an attorney, and I know they have bad reputations of being ambulance chasers, but the truth is there are good ones out there, Christian men and women who got into the field to HELP people who are being or were wronged. You and Jim-without a doubt- fall into that category.
Also, if the hospital is forced to reimburse you in some way, or takes any type of hit for their incredible errors, they will be much more likely to shape up and to avoid getting "hit" again.
There's my two cents and then some...
hugs- kendra

phasejumper said...

I am so upset reading about all you went through. It really hit home as I am nine weeks along right now. I agree with Kendra's advice. Much prayers and love to you.

Sarah said...

Monica,
Thank you first for sharing a part of your story. I know it must be hard to relieve it.
After the birth of our twins we received care that was not up to par from one particular nurse and some questions went unanswered. After following up, Baptist Hospital here in Nashville paid for all of our in-house bills.
When we meet (yeah!) if you would like to know more about the story, please ask; I won't hesitate in sharing. Plus, I can give you the names of some doctors!
It's a difficult decision but I've learned that you are the only one who can be the advocate for your care, both in the past and in the future. You have every right to demand good service when it comes to your health.

Kelly&Marty said...

Oh Monica, I had no idea! I'm so sorry you went through all of that! I'm so mad at the hospital and so sad that you had to have such a horrible experience. I hope you send Seth to college with the money you win with a lawsuit!

Valerie said...

Monica,

I'm so very sorry to hear about all of this. You are doing the right thing, and I wish you the best of luck with the outcome.

Val

rosebud78 said...

Hi sweetie. I am nearly in tears reading this and reliving your experience again. I don't think it's a matter of service, I think it's a matter of severe incompetence and negligence and they are lucky they didn't kill someone - YOU. I had a very bad experience with my ruptured appendix where I was left with an 8" open hole after the surgery and then sewn up without anesthesia in my hospital room two days later - like a scene from medieval times. We didn't sue. I have regretted that every day of my life, considering that doctor is now behind bars because other patients after me DID sue. You deserve reparations, if not extra money for emotional damages. Sorry this reply is so long on your blog. You know I'm here to talk any time. I fully agree with legal action on a moral level - not much dilemma there in my opinion. Lots of love, D.

amy (metz) walker said...

Wow, I don't even really know what to say...I would definitely not want to pay for that kind of service, either..and especially those extreme amounts! Best of luck in resolving this!

Sarah said...

I've got your number written down to call you tomorrow (Thursday). I wanted to make sure you got home and were settled before being bombarded with an internet stranger! :)
Talk to you tomorrow!

Kelly @ The Beauty of Sufficient Grace said...

Monica,

I am so sorry for all that you endured...sorry for the loss of your babies...and terribly sorry for the horrible hospital experience. There is no excuse for such incompetence, insensitivity, and carelessness. Praying the Lord will guide you in resolving this, and that the hospital and those involved will be held accountable and learn from their negligence.

Praying His Peace for You,
Kelly

Kim said...

Are you kidding me??

VanderbiltWife said...

Monica, I am so, so sorry about your loss and experience.

I have a wonderful OB in downtown Nashville near Baptist if you're interested in a recommendation. I loved him dearly and he was so wonderful in the recent birth of Libbie.

Jessie

Kristin (kekis) said...

I'm just now reading this entry on your blog, and it INFURIATES me. What you experienced is based purely & simply on negligence. My mom is a former ER/Triage nurse, and while mistakes are made, a patient who is bleeding all over the floor takes priority over broken bones, bsd coughs & the likes.

Although you've been reassured that it went to the sentinel, I would follow up with an extremely strong letter that is addressed to directly to the President & CEO of the hospital with a cc to every possible department that should have been responsible for your care. I am so sorry that you had to go through all of that, and I wish I could have been there to scream and yell for you. And believe me, I would have yelled.