One woman's sad story of HMO failure resulting in premature death 
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 One woman's sad story of HMO failure resulting in premature death

October 1999
Atrocity of the Month


Let me tell you my story.

This is on behalf of my deceased mother who died a devastating and premature
death due to the negligence and greed of her PCP.

For at least 6 months my mother complained to her Humana PCP of neck and
shoulder pain in addition to headaches, loss of appetite and generalized
malaise. Every visit made to this doctor resulted in the same scenario - she
was told he could not find anything wrong, the neck and shoulder pain was
probably arthritis and given an RX for Darvocet. As time went on she found it
difficult to even stand up straight due to the severe pounding in her head.
Since it was time for her annual checkup, a chest x-ray was done which revealed
3 small nodules in her left lung. The radiologist recommended a needle biopsy
but her PCP decided this procedure was not necessary and told my mother a
repeat x-ray would be done in 3 months. It was repeated and now there were 4
nodules in the left lung and 2 in the right lung. Still unconcerned the PCP
dismissed my mother as being fine.

In December of 1997, my mother could no longer stand up straight due to the
pounding in her head. She was no longer eating since she had no appetite, was
vomiting at the slightest sight or smell of food, and she was experiencing a
weakness on her left side of her body. Her {*filter*} pressure, which was always
quite low, was now extremely elevated. She was mentally confused most of the
time, and her symptoms somehow appeared to look like someone who had suffered a
stroke. She went to her PCP for 5 days straight with these symptoms -- he
disregarded them as her being 'anxious' over the chest x-rays. He told a family
member that there was nothing wrong with her, take her home, give her some
chicken noodle soup because her worrying was all in her head. That evening she
was rushed to the ER - against her PCP advice. She was run through a battery of
tests that indicated the possibility of a brain dysfunction. A MRI was
performed which revealed a brain tumor (most definitely malignant) and surgery
was indicated. Even at this point the PCP refuted her diagnosis and tried to
get her discharged from the hospital. The ER physician stood his ground and
would not let her be discharged...Surgery was performed. The neurosurgeon who
performed the surgery had a grave prognosis for the family. He could not get
the entire tumor and her condition was terminal. It was determined that her
cancer had spread from her lungs to her brain.

My mother was NEVER seen in follow-up by the neurosurgeon. She was transferred
out of intensive care in one day - sent to a regular room and one day later was
transferred to a rehab nursing home where she was supposed to receive physical
therapy in order to get her to start ambulating again. While in this nursing
home she never saw her PCP nor any other physician related to her medical
problem nor did she receive any follow-up care, recommendations or treatment.
The dressing covering her hideous scar on her head drained profusely on a daily
basis. No mention was ever made of this in her chart - it was just changed
daily with no one ever questioning why it was draining. The staples remained in
her head until I asked a nurse when they would come out. No one seemed to know
so I placed calls to the surgeon's office only to be told the doctor was not on
staff at that nursing home and that she needed to come to his office or a
nearby ER where he was on staff in order for him to remove the staples. He did
acknowledge the fact that they should have been removed within 10 days of the
surgery - here it was the 20th day and it was pretty {*filter*} looking with the
skin now growing up over the staples.

Since my mother was in no condition to be moved to his office or an ER I asked
the PCP if he would remove the staples. Now, mind you, he had never stepped
foot in that nursing home since my mother arrived. He said no!! To make a long
story short, after many heated phone calls to the Humana office, the PCP
removed the staples but he wasn't happy about doing so.

My mother's time was up in the NH so I decided to bring her home with me in the
central part of the state. She wasn't in my home 2 days before she became quite
ill - an ambulance was summoned and she was rushed to the hospital. The
drainage from the incision site was an 'oversight' on the part of the surgeon
and since he never saw her in follow-up, had no idea this as there. Spinal
fluid was oozing from her head. A second brain surgery was performed in order
to close the gap.

There is so much more to this story - little details that made it so evident
why this PCP refused my mother the proper and adequate medical care she
required and deserved, but due to the expense, my mother was treated as what I
refer to as a 'throw-away patient' simply because of her age (she was only 74
at the time) and the nature of her illness, which was terminal. His theory was
she was going to die anyway so why even try to prolong her life.

My mother, once a very active and independent woman, was now an invalid in a
hospital bed, never to walk again or care for herself. She was dead in 6 weeks
after being diagnosed at the age of 74 years old.

In Florida, we have what is called The Wrongful Death Act. This means because
my mother did not have a surviving spouse OR any children under the age of 25
years old, any type of malpractice suit or wrongful death suit could not be
filed against ANYONE responsible for the blatant neglect that caused her
premature death. So, in essence, this means that physicians - not only HMO
physicians - can do whatever they choose in caring for elderly patients with no
threat of repercussion. I elected to go further with this since I feel it is a
ridiculous law and should be changed. I filed my own personal complaint against
Humana Health Care and also filed a complaint with the Department of
Professional Regulations in Florida. I understand the state is still looking
into my allegations against these physicians. I feel that although my mother
had a terminal illness, had she been properly diagnosed and treated adequately,
her impending death would not have occurred so quickly and in such a
devastating fashion.

Thank you for letting me tell my story.

(submitted from HMO home page)

Thu, 18 Apr 2002 02:00:00 GMT
 [ 1 post ] 

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