Tag Archive | Surgery

Is That Your Final Answer?

It is hard to explain what I was feeling after reviewing my invoice for surgery and discovering ” Prolene Mesh” device on the invoice.  At first I just kept thinking ” This has to be a mistake” . There was NO way a surgeon would implant a device constructed from the same material that had caused such horrific injuries. Plus He said NO NEW DEVICE.  Quickly I called the University of Maryland Medical Center Billing Department. Instantly I explained to the agent in billing that there must an error here on my invoice. She asked ” What” I was referring to? The charge for ” Prolene Mesh”, I said. This has to be a mistake. She said ” Well lets see here, Ok Yes I see that charge, she said. Why do you think it is an error? I told her, My surgeon said NO NEW DEVICE would used, Plus There is NO way he would have used this type. He saw what that material had done to my body. She advised an ” Audit” would need to be performed to determine ” if” in fact this charge was in error. They match each charge to the list of items marked used in the operating room, this process would take a few days before I would have an answer. A week later a call came from UMMC billing, The agent said she was calling with results of audit. She said charge was ” valid”, this item was in fact used during surgery, however the item was not a surgical mesh she said, it is ” Suture”. ” Suture”? Really, description says ” Prolene Mesh 30cm x 30cm , What was this a ” Suture” for King Kong? No way was I buying this, So I called the patient advocate and made a complaint. Letting the advocate know, I am a ” High Responder” to this type of material, If it was used I need to know. She then took the same approach as billing, Have an audit performed. Another week passes. During that week I was seen by the surgeon Dr. “J”, So I confronted him. I told how invoice showed charge for ” prolene mesh” and that all I wanted at this time was for him to remove it. This explained why my complications mirrored those after original surgery when 1st device was implanted. He seemed sympathetic, He said he had no idea what this item was, and he asked if he could have the invoice to do some ” research” to find out. You can have copy, I answered quickly. Now being a seasoned patient in doctor betrayal I was not taking the chance of this disappearing. Day after visit with surgeon, the patient advocate phoned with audit results. Same Answer : Item WAS used, However it is SUTURE. Serious? I am offended by their answer, they must really think I have the intellect of a rock. The description of the item on the invoice alone is enough to know this item is no suture. Now it was time I did some outside research. Having a friend that is employed with a large medical supply company, We used the ” Item #” and was able to prove exactly  ” what” this item was. It was time I left University of Maryland Medical Center & Staff know, I had proof of what the item was. In fact, I even had the catalog page, item #, and manufacture of this specific ” prolene mesh” ” Ethicon” was the manufacture. Was ” Leadership” of UMMC aware of what was going on here, maybe I should tell them. Certainly this would NOT be permitted. The letter I sent to ” Leadership” ( CEO,CFO,COO & Every other ” O” ) was straight forward & to the point. I told them, My body does not like this material. I gave them all the gory details of the past injuries it had caused. I said, Look I am Not Angry, Simply I just want to be well again. All I am seeking is ” removal” of this device. Knowing once it was removed, I would be able to heal. ” Healing” is what is has always been about, just wanting my old life back. This would do it I thought, certainly SOMEONE will make this right, Someone in charge will realize this was an amazing offer I was making here. Realizing if it was admitted that ” mesh” was used, they would fear a ” lawsuit”, I went even further in my offer. If they admit that mesh implanted and remove it, then  I would sign a release of liability. Now this was a No Brainer, Right? Just in case there was any possibility that the item really was ” Suture”, I included a ” Cashiers Check” for the cost of the device $608.96. If this was a suture, then I needed University of Maryland to purchase the item again. Once I could see it, hold it, examine it, Then & Only Then would I believe the item was a ” Suture”, Until then I knew it was surgical mesh. About a week after the letter was sent to University of Maryland Executive Office, a Call came from Risk Management/AKA Liability Insurance Carrier, AKA MMCIP. The Manager there said ” Melissa you were correct, our LATEST investigation showed the item is surgical mesh”. Finally, Thank you God, Now I will be able to heal, Well….That is what I thought.” OK”, I said, At least I finally know now, Who will be taking this out, I asked? No One she replied. Do what, what do you mean NO ONE? It has to come out, this is what is causing all my health problems. I am having FBR, It has to be removed, The longer it stays inside the more damage it will cause. We need to act quickly I tell her, My health depends on it. No One has to remove it she says, because it was a billing error. ” Just wanted you to know” she says, ” Take Care” wanting to rush off the phone. Do NOT hang up I scream, I have some questions!!! 1st: How could this be a billing error, when 3 different audits have been performed confirming the ” items” used during surgery? 2nd: This Matter has been under investigation for almost 3 months, Why was this not discovered to be a ” Billing error” before now? 3rd: How do you explain that I am having the EXACT same complications as when original device was implanted constructed from same material? 4th: Considering University of Maryland had already been paid the amount listed on the invoice ( with item included ) That would make this ” Insurance Fraud” ( Billing for medical devices NOT used) . Sad to say but the ” Risk Manager” had no answer for any of the 4 questions I presented. So just to clarify, I asked, ” What exactly are you telling me here”? Are you saying that by ” researching” you have now learned this is indeed surgical mesh, But have now discovered this ” surgical mesh” was billed in error, Correct? Yes, she said, Thats right. Well at least you now have a final answer, she said. And that was IT, End of Call. 

As the dial tone buzzed in my ear my heart just sank. My thoughts raced, What has become of ” health care”? What about the ” Do NO harm Oath” A doctor takes? Surely this was not over $600, right? My LIFE has more value than $600, RIGHT? Was admitting a mistake really that hard? Was it pride or liability that prevented the ” truth” from being spoken? Guess some questions will never get ….A Final Answer. 

Advertisements

Ever Feel Like Something is Missing … It Could be an Organ.

After meeting the surgeon @ University of Maryland Medical Center, We actually thought there was hope. The Surgeon seemed very knowledgeable & Confident as well. Where other surgeons had turned in terror at thought of removing the ” Defective Device” this surgeon asked ” So When do want to have this thing taken out?” Music to our ears , both my husband & I were relieved to hear someone was capable of taking this monster out of my body. Surgery was scheduled that day , just 6 more weeks and maybe then WE COULD START to LIVE AGAIN. Funny how just 14 months of torture can age a person by 10 years. In any case, we felt blessed to have this surgeon. Dr. ” J” just really seemed to have it all together ( At least he was not pulling out his hair, lol Like last surgeon Dr. “G”). Before my initial exam by Dr. “J” , I decided to inform myself. Every bit of medical information I could find…I read. That day of exam, I had my “questions” all written down. ( This time would be different) . During the consultation We ( My husband & I ) asked ALL the Hard questions, Could ALL of the device removed? What was the recovery time? Would another ” device” be implanted, after the defective one was removed? ( This was a BIG ONE) Which, Dr. ” J” answered ” No” he said my POP( Pelvic Organ prolapse) was NOT actually the “grade” my previous surgeon had stated. Dr. “J” said, that if HE in fact had done the original surgery, He never would have used an ” Implant”. ( So ALL this suffering, was for Nothing) ??? Listening to Dr. “J” , we really felt God had lead us to the right surgeon. Day of surgery quickly arrived ( Could not had been soon enough). I was anxious yet excited also, Remembering life before the “Implant” & Longing for those days to return. Missing the wife & mother I once was & Hating the One I was now forced to be, I was ready to ” Live Again”. Surgery went well, waking in recovery I felt a “tube” extending out of my abdomen. Oh No’ I thought, My worst fear had come true, I had a colostomy. Quickly the recovery nurses assured me it was just a “wound vac” No Colostomy, BUT A WOUND VAC, AGAIN…WHY? However this time was different, the incision was “closed” “Vac” was just for negative pressure therapy, Dr. “J” did not want any collection of fluid. Because of past history of infection, Dr. “J” seemed to be taking all precautions. ” Great” I thought, I am in Good Hands. 

Discharged after 3 days, Home Health Care arranged because of “wound vac” . 7 days after surgery, My Home Health Care questioned the time frame Dr. “J” had for the wound vac, she wanted to make the work schedule for following week & only nurses trained with “wound vac” use could handle my visits. Not being certain of the timeframe, I got my discharge papers from University of Maryland Medical Center and gave them to the nurse to read. After a few seconds she asked ” Did you start hormone replacement therapy”? I said ” No, I still have my ovaries” She looked at discharge papers again  said ” Oh yeah you still have one ovary, But this says your right one was removed”. What? No One said anything about taking my ovary!!!  It was late in the evening at this time, Dr. “J” was gone for the day. I had to ask “someone”, “someone” had to be available, This is a LARGE hospital. So I called, As soon as I stated reason for call, I was sent to ” patient advocate” . Which was not in office, so I left voicemail. Next morning the patient advocate called very early. I told her my discharge papers say ” My right ovary was removed in surgery”, I said ‘ But How can this be, No One told me. Quickly she said she would have the surgeon ( Dr. “J” ) call me to explain. He called later that afternoon. When I questioned if this was true, He said ” Yes, sorry I did not tell you, It just “slipped” my mind. He said he was so relieved that a colostomy was not required, that he simply forgot to tell me he had to remove the right ovary & tube. Panic & Anxiety Gripped my heart! Had he ” Forgot” anything ELSE? How could a surgeon ” Forget” to mention that HE surgical removed an organ( one vital to a woman’s health at that)? Still, Even with this NEW discovery, I felt very indebted to Dr. “J”, After all HE was able to remove the ” Monster device” that had broken apart in my body. Still in a state of disbelief, I decided to pray over the matter & then leave it in God’s hands. Not realizing more ” surprises” were on their way. At 12 days post op, fever developed. A trip to the local Dr. confirmed i had another post op infection. NOT AGAIN I THOUGHT, WHY/HOW? Every instruction was followed, the wound vac was even still being utilized to prevent collection of fluid. So How did fluid collect? Powerful antibiotics started right away, and 6 weeks later infection persisted. One antibiotic turned to four, all at the same time. Weekly trips from PA to University of Maryland now to have infected fluid aspirated by needle in Dr. “J” office. One morning after a visit @ UMMC, I heard someone say ” Get your Invoice for surgery” ( Great Now I was hearing voices) and while I never HEARD this again, I felt this overwhelming need to obtain that invoice. Surely it was at the house somewhere, I was 6 weeks past surgery. We know hospitals bill the second you are discharged. But after an exhaustive search at home, I could not find a “bill”. Called UMMC billing office and requested a copy of invoice be sent. That is when I learned, None had been sent because insurance paid 100% of expenses. ( Great I thought) We already were swimming in medical bills from this ” nightmare”. In a few days it arrived…Yep..Normal Hospital bill I thought, each pain pill billed individual , each bandage, & bed pan…..That was until I turned the page………That is a where I saw a charge for ” Prolene Mesh 30cmx30cm ..Qty.(1) Cost $608.96. There it was the answer before my eyes. This explained why “complications” mirrored last surgery, this explained the infection that just persisted. This device was made from the exact same material as last device ” Polypropylene” ..The VERY material that caused all the injuries!!! Why was THIS USED..Dr. “J” said NO NEW DEVICE WOULD BE NEEDED!!!! Getting an answer to this question has actually proved impossible.  The response from UMMC, The Surgeon & Risk Management.. have ALL been very interesting…. So What did UMMC Say?   Answer coming up in next post.