KOIN Investigators 5/24/99 http://www.koin.com/news/koinvestigators/news-koinvestigators-990524-174055.html

Medical Mishaps: Who Should Pay?

By Eric Mason, KOIN 6 News

Who should pay for medical mishaps? It's a question that's being asked more and more these days especially as doctors in managed care face more patients and have less time to treat them.

Carl Paul has gone through seven surgeries over two years, and he is still in pain.

"It's been a nightmare, a real nightmare. I just hope it never happens to anyone else," says his wife Carol.

Jane Williams entered the hospital for minor surgery and ended up in the intensive care unit.

"No one was informing me of what was really going on, and I decided that pretty much I was going to die," Williams says.

And when Michelle Miller broke her wrist, she says she asked her doctor why he was leaving the treatment room with the job half done.

"He was in an extreme hurry. He was very rude. I'm left with this crippling disfigured ugly non-functional joint," says Miller.

In all these cases the patients say they had trouble communicating with their doctors. In all the cases the records show that painful, expensive and perhaps unnecessary procedures followed. In two of the cases records show that the patients were in a fight for their lives.

Just three years ago Paul was a healthy and successful realtor in central Oregon -- specializing in ranches and estates.

Today after two years of surgeries and medical procedures he lives in constant pain. The only doctors he trusts are at the Veterans Hospital in Portland. Those are the doctors who are somewhat baffled about what condition to treat first.

It all started in November 1996 when he received his annual physical in Bend. Doctors found that Paul had an abdominal mass. In the records there are question marks. Doctors were scratching their heads. They settled on calling it a pancreatic pseudocyst.

The surgeries that would follow were ordered in an attempt to drain the cyst they believed was located near the pancreas.

But two weeks after it all began, Paul developed blood clots in his legs. Despite the written orders of one physician, according to Paul another doctor and nurse encouraged him to walk even though Paul told them the pain was excruciating.

Records show he collapsed. The walking might have caused the clots in his legs to end up in his lungs. That led to yet another surgery.

Now doctors had more than one problem. The cyst was not responding to treatment. In December doctors operated yet again. This time they realized their first diagnosis was wrong.

The December surgery found the pseudocyst was located on the adrenal gland, not the pancreas. Doctors removed the cyst and his healthy left kidney.

But wait, there's more. In the following month Paul's condition still did not improve. By January 1997 staffers at St. Charles realized they'd left a surgical sponge behind in Paul's stomach during one of the previous surgeries. They're not sure which surgery. Doctors had to open up Paul once again.

Today, Paul says he suffers in nearly constant pain and he spends most of his time in bed. He must now seek treatment for hernias he has after repeated surgeries. Psychologists say after so many surgeries he suffers from emotional trauma. Without a job, he has now lost his life savings and his home.

"The pain pills never take the pain away. It's very uncomfortable. It's hard to handle," says Paul.

"They've ruined him literally, mentally, physically, financially," says Carol.

The Pauls, who keep boxes of hospital records about the case, are angry. They say because no one ever told them the truth about why there were so many surgeries, no one, they claim, ever apologized for anything.

For all of his suffering, the Paul's are suing for negligence, a claim the hospital and the doctors deny.

St. Charles Medical Center officials would not talk about the specifics of his case because of a lawsuit now pending in Deschutes County court. They would agree to talk with us about what happens when there's a mishap.

"I can tell you the rates of complication are lower than the national literature of reported incidences," Dr. Dean Sharp.

Sharp is a surgeon and is in charge of peer review at St Charles. When mishaps occur he gets to the bottom of it.

"There is an ongoing active process of looking at care within this hospital that is participated in by all the physicians who come together to talk about the tough cases," says Sharp.

Those familiar with the case, who wish to remain anonymous, say that Paul's condition was a rare one, and the treatment was complicated.

Dr. Jim Davis is a gerontologist and a patient rights advocate. He briefly reviewed Paul's case.

"Somebody somewhere should pay for this, should accept liability and respond to this family that had this outrageous situation happen to them," Davis says.

Davis says Oregon needs a faster track than the courts. One idea is a health care ombudsman to review such cases and help injured patients find remedies short of a long and drawn out court process.

"If they cannot find an adequate result and get an adverse reaction from the process, than they should be able to go outside their plan and have an independent panel of health professionals look at their case and make a judgment upon it," says Davis.

So far this session, Davis says he has lost most of the battles he's fought with the insurance industry.

"It's just been an ordeal. St. Charles was just all pain. All I remember was pain," says Paul.

In Paul's case, the road to healing might take years. He's not sure where the money will come from. His wife says before someone is held accountable her husband could be dead.

"It's been a real nightmare, a real nightmare," she says.

Davis says new remedies are needed for patients who are injured during procedures, but so far there's been no movement on bills he's been pushing in the Oregon Legislature.

Eric Mason, Special to Channel 6000