First time asking but prayers are needed...UPDATE#3...it gets worse.

[SunFloridaDisney]

I am praying for all of you.

 

[Patty3]

Many prayers are being said for your BIL. I am so sorry that this happened to him and pray for his speedy recovery.

 

[ead79]

I am so sorry to hear about this. That is certainly a lot for anyone to handle. I hate the fact that medical bills are even a consideration when there is so much more they are dealing with. My prayers are with them. I know it seems hopeless, but God is good.

 

[4nana]

So sorry to hear and my prayers go out to this young couple facing such a terrible health crisis . Sending prayers that BIL's surgery was successful, he has a complete and full recovery. I had this happen to a good friend who spent weeks in ICU and fought his way back to a totally normal life. I'm glad they believe in the power of prayer, as miracles do happen!!!

I agree with all the advise you've been given - this hospital definitely seems negligent and SIL might want to keep notes. I'm sure her main concern right now is staying strong for all her DH has to go through. I hope they have some family near for support.

 

[Colleen456]

Does he still have his original hospital ID bracelet? That should have the admit date on it. Take Digital pictures and cut that baby off and save it!

I really hope and pray that he will have a full recovery. Prayers for your family!

 

[mannasn]

I am so sorry to hear about this. Best wishes to your family.

Just some info:

As a general rule, pain meds often are not given out in the ER until the reason for the pain is discovered (could be "covering up" a dangerous condition, otherwise). They may not have been neglecting his pain, but unable to treat it for that reason. However, it would have been more appropriate if someone had explained this to them.

I agree with the other poster that stated that his admission date may be accurate. Depending on when he left the ER and his admission orders were processed, it could have been Monday (since you say he was in the ER on Sunday). Is it a small hospital? I can't believe that he arrived at 6am and didn't get a CT until 8pm! Wow!

Best wishes to your family and I'm so sorry!

 

[Southern4sure]

Thank you again for the prayers and the encouragement.

As of today Bil is off the ventilator and the oxygen tube is removed. He can barely talk (expected) and still in pain (expected). He is alert and looks around and talks with his eyes until morphine is administered then he sleeps it off. We know he will recover....we claim it.

Bil was admitted and in a room by 1 pm on Sunday. His "bracelet" does show Sunday date of admission. I told sis maybe the new crew (nurses) were confused as to the admit date. To the poster who asked if this is a small hospital, no it is one of the top 3 in Mobile and is fairly large.

As a general rule, pain meds often are not given out in the ER until the reason for the pain is discovered (could be "covering up" a dangerous condition, otherwise). They may not have been neglecting his pain, but unable to treat it for that reason. However, it would have been more appropriate if someone had explained this to them.

I do understand this but bil had all the symptoms of Appendicitis. I know Appendicitis is hard to diagnose but usually surgeons think Appendicitis first.

At 14 my son had his appendix taken out. Sunday evening pain started, Monday morning Dr took blood work, Monday late afternoon referred us to a surgeon and Monday evening his Appendix was removed. Remembering how rushed his Dr was to do the surgery and comparing how the hospital bil is in I think the hospital/dr dropped the ball.

 

[tinatark]

I think the admit date is the date he was admitted to the hospital - when my ds was admitted to the hospital through the ER, we had to do all the ER paperwork, then when they decided to admit him, we had to do hospital paperwork - it was very frustrating, after hours and tons of paperwork in the ER, to finally get admitted - and do the tons of paperwork again!

It sounds like you've named your blessing - his recovery. I'll be praying for that!

 

[THE HAT]

prayers sent to all of you.
most hospitals have programs to help with the costs for those unisured. they will base it on there salary and a few bills (es heat, mortgage etc). also most hospitals have a philanthrapist(sp) program that will cover those in dire needs. talk to the social worker at the hospital and the billing dept. too.
please keep us updated you all are in my thoughts.

 

[piglet too]

I am keeping your BIL in my thoughts, I hope that this all works out.

 

[Dan Murphy]

Hoping your BIL continues to improve, Southern4sure, I know he will. He and all of you are in my prayers. My best for him.

 

[FreshTressa]

I've had him in my thoughts since I first heard your story. I'm so glad it looks like it will work out well for him.

I don't understand the whole wait to read x-ray thing...I thought that was the whole point of an ER.

What would they do if someone came in with a broken leg? Let is sit unread for 2 days?

Well, I'm just glad he is doing better.

 

[Pugdog007]

I believe in the power of prayer as do my sis and bil.

I do too and will remember your sister and BIL as I say my prayers this evening.

 

[nwdisgal]

Good thoughts and prayers for your BIL. I hope he gets better soon and they are able to work out something to help with the hospital bills.

 

[S. C.]

Prayers said.

 

[nliedel]

I am still thinking of you all the time. My husband works for a local top tier hospital and while he is not in patient care he administers many of the computer programs that do patiant care. He says the date problem is huge but they may not have done the admitting paperwork until after midnight which would change the date. The time he was admitted as a patiant may be different from the time he got to the hospital. If it is the date he got to the ER then you need to straight now because with the system most hospitals use the date has to be changed manually by someone and this is not just a mistake.

 

[MsDisney23]

Keeping your BIL in my Prayer's!

 

[Disney Doll]

You have more than one issue here.

The first is insurance. Ask to speak with the hospital's social work department ASAP. You guys need to get on Medicaid or whatever equivalent government-offered program is offered. And they are there, so make sure you avail yourselves of them. Some of them go back retroactively to the date of admission. Worst case scenario is that your relatives have to go on a payment plan and if so, they work that out with the hospital's finance department and as long as they are regularly paying, the hospital can't do anything to them, even if it takes 10 years to pay it back. Uninsured patients are not charged more, they are charged "rack rate" for their care. Insured patients are charged whatever rates their insurance companies have contracted with the hospital. That is the difference. As an example, a CT scan costs $500 "rack rate" or full charge. XYZ insurance company comes along and says "We can promise you that 50 of our clients will need to have a CT scan, and we are willing to pay you $400 per CT scan, because we are promising you 50 of them". The hospital takes the bet that XYZ insurance clients are going to come to their hospital at least 50 times for a CT scan, plus, if the hospital doesn't do business with XYX insurance and it is a big insurance carrier in their area, people may not come to their hospital at all...they'll go to the hospital that does take XYZ insurance. This is sort of a simplified explanation, as there are insurance adjustors, auditors, underwriters etc. also involved, but it boils down to this as the basic idea.

The next problem is admit date. Your relative has had a couple of different admit dates. Admissions to the ER or any other outpatient care are considered outpatient admissions. Admissions to the hospital for inpatient care (care which will require more than a 24 hour stay) are inpatient care. They are billed and recorded differently. The admit on his chart now is the admit date for his inpatient stay. If you got a hold of his ER charts, you would see the proper admit dates for those visits as well, and you would see that on his last ER visit, when he got admitted to the hospital, that it was recorded as such.

The next problem is standard of care. Based on what you have written it sounds as if things were missed. To be perfectly honest with you, I am a nurse and from the perspective of the caregiver, we don't give different care to someone based on their insurance or lack thereof....we generally don't even know what kind of insurance a patient has, if any. And we don't care. It's just not our problem, it's not our area to worry about, so we don't. That's not our issue. So if he received substandard care, it's probably not based on his insurance status. It may be based on other things...staffing levels, staff ability,acuity in the ER that day etc, but probably not based on insurance. As far as the pain medication thing...often they do not give someone with pain any medication at first because that can sometimes "mask" the symptoms, making it more difficult to diagnose and/or treat. Because your son had appendicitis and had the same symptoms means nothing. Sounds mean, but it's not meant to be mean. And, quite frankly, any decent caregiver does not like to see someone lying there in pain, but we understand the reason behind it.

The thing that seems to be negligence on the part of the hospital is the reading of the x-ray/CT scan...whichever one it was that was going to be read the next day. That long of a delay in the reading of a scan is unacceptable. especially for someone complaining of abdominal pain. There are so many things in the abdomen that can cause pain, the appendix being only one of them, that usually any ER x-rays/CT scans etc. are read pretty much ASAP. If it is a large hospital, they usually have a radiologist on call, and often also have interns or residents specializing in radiology who are capable of reading x-rays and CT scans.

As far as what to do about that...here is what I would do (I am a nurse who works in a fairly large acute care hospital). I would start with the nursing supervisor of the unit that he is on right now. I would tell him/her that I am concerned about the delay in reading the CT scan/x-ray in the ER, which caused a delay in treatment, which has obviously caused a very negtative outcome for your relative. I would ask if they need to report sentinel events and would inquire as to if this counted as one. A sentinel event is something that the hospital screwed up badly that makes for a negative outcome for the patient and in Connecticut, it has to be reported to the state hospital association. I would assume there is a similar mechanism in place in Alabama. I would ask that nursing supervisor follow-up with the director of both the ER and Radiology at the hospital, and put them on notice that I am planning on pursuing this to my satisfaction. Don't say sue, because once you say the word sue, everybody clams up. And plus, once you hear the explanantion, maybe there is no cause to sue, although based on the information at hand, that seems doubtful. I would also ask to speak to someone from the Risk Management Department, and share my concerns with them. I would tell them that I expect them to look into this matter, and respond back to me within 48 hours with an explanation, in writing, as to why the delay in treatment, why the delay in reading the scans. If I have been otherwise satisfied with the care, I would tell them that. And I mean that...don't go in guns blazing saying "this hospital sucks" because the fact is that the whole hospital probably doesn't suck. Some of what you encountered sucks, but if his surgery went well, the surgeon did a good job, the nurses are doing a good job, then you have areas that suck, but it's not the whole thing. And if you are logical and reasonable, it will take you a lot farther. It is up to you whether or not you choose to get a lawyer involved at this point, but keep in mind, once the lawyer gets involved everything changes, information is harder to get because the hospital will hold to the letter of the law as far as sharing records and HIPAA, and then the lawyer's fees will start piling up.

Best of luck. Sounds like your relative is doing OK post-op ruptured appendix...it's not a cakewalk, but all of what you posted about his post-op course seems pretty on target for what he's been through.

Feel free to PM me if you wish.

 

[nliedel]

I just read Disney Doll's response and I have to say what she says is excellent advice. She is correct about the pain meds btw. (I know this because I have a muscle near my bile duct that spasms and needs to be cut and the pain is horrible. Until they figured it out no pain meds for poor me. Seriously this is a 9 on the 1-10 scale and worse than unmedicated birth. Which I did three times).

 

[Southern4sure]

Thank you Disney Doll. You explained alot and it really makes sense. I'm going to print out this info and send to my sis and hopefully they qualify for some assistance. Please do not think I was complaining about level of care based on insurance or not. I do not think that was an issue. Sis was very upset (and vented to me) how the hosp/dr/nurses didnt seem to take bil pain seriously. I feel like something should/could have been done sooner within the first 34 hours of being admitted. The delay is my only complaint so far. I have not spoken to sis yet today but I will keep posting updates.