Janet Davis
Patient Relations Coordinator
St. Elizabeth’s Medical Center
736 Cambridge Street
Brighton, MA 02135-2907
Dear Ms. Davis,
My wife received your response, dated February 12, to my January 26 letter to John Holiver. When coupled with the problems which prompted our letter, your appalling response is enough to convince us to never again entrust our family’s care to St. Elizabeth’s.
I will respond point-by-point to the claims made in your letter.
“… the physician and secretary made several attempts to contact Dr. L… and were unable to speak with her directly due to timing and her voice mailbox not accepting messages because it was full. We have alerted Dr. L…’s office to this issue.”
At our request, Dr. L… checked her records at the hospital and confirmed that her correct cell number is listed for first contact. There is no record on her cell of the hospital ever calling. Furthermore, you have her home number, office number, correct fax number, and a working email address, and there is no indication that anyone attempted to contact her using any of these.
Dr. L… also says that her office has not been notified by anyone at St. Elizabeth’s of any problem with her voice-mail system.
Dr. L… has been my wife’s and our children’s physician for almost a decade, during which we have called her many times. While we have occasionally encountered a full voice-mail box on weekends, we have never been unable to reach her on her emergency extension, and we have never during office hours been unable to reach the front desk or leave a message which was returned promptly.
Even if it were true that one of Dr. L…’s voice-mail boxes was full and you had an incorrect fax number as you assert later in your letter, you had three other working methods for contacting her, so there is simply no excuse for your failure to contact her in a timely fashion about my wife’s treatment.
“You visited Dr. L… on Tuesday, January 19, 2010.”
That is simply incorrect. As I told you in my last letter, my wife did not see Dr. L… until January 26, because Dr. L… told her there was no point in her coming into the office until Dr. L… had the test results. Of course, if we had known that would take nine days, my wife would certainly have gone in earlier, because Dr. L… could have repeated the same tests and gotten the results back days before the results from your ER were made available to her!
Dr. L… has spoken to the ER doctor who treated my wife. He said he had no reason to believe my wife saw Dr. L… on January 19, nor is such an appointment listed in my wife’s records. Neither we nor Dr. L… has any idea why you think my wife saw Dr. L… on January 19. This obvious, verifiable, factual error is indicative of the shoddy quality of your entire handling of this incident.
“St. Elizabeth’s physicians made several attempts to contact Dr. L…’s office with the results. Unfortunately, the fax number we had for Dr. L… was incorrect – something we have since corrected; and Dr. L…’s voice mailbox would not allow us to leave a message, or verify the fax number.”
As noted above, Dr. L… is unaware of any problem with her voice-mail system that would have prevented the hospital staff from reaching her or her staff. Also as noted above, even if it were true that you had the wrong fax number and were unable to reach her office by phone, there were three other ways you could have reached her that no one from St. Elizabeth’s ever attempted.
“The lab results were available at the lab at St. Elizabeth’s on Monday, January 18, 2010.”
Dr. L… reiterated to my wife that it was nine days before her staff was able to obtain my wife’s test results, and that at no point did anyone from St. Elizabeth’s initiate contact with Dr. L…’s office or return any of her staff’s calls. Every single contact with the hospital was initiated by Dr. L…’s staff. Dr. L… overheard one of the calls placed by her office to the hospital, and her staff’s utter frustration over the issue was verbalized to her repeatedly over many days.
Your letter ignores the repeated attempts by Dr. L…’s office to obtain my wife’s results and offers no explanation for why you were unable to provide them when asked. Do you mean to imply that Dr. L… and her staff are lying about having tried repeatedly to obtain the results? Or do you consider it so entirely unremarkable as to be unworthy of comment for a patient’s primary care physician to be unable to obtain test results despite repeated attempts over many days? Or perhaps you would like to reconsider your claim that my wife’s results were available in your lab from January 18?
As I mentioned above, Dr. L… has spoken to the ER doctor who treated my wife. He informed her that he wrongly assumed that she was still on active duty at St. Elizabeth’s and would therefore be notified automatically of my wife’s discharge from the ER. According to him, he didn’t even try calling her until several days later when he found out that he was wrong about her status at the hospital. Furthermore, he said he knew nothing about claims to the contrary made in your letter. To be blunt, if you’re going to perpetuate a lie to cover up your hospital’s misconduct, you ought to do a better job of making sure the involved parties on your staff know about the lie so they can play their parts properly.
Speaking of transparent lies… I called you on Friday, February 12 to ask why my we had received no response to my letter. You called me back on Monday, February 15 and claimed that a letter to my wife “went out last Friday.” This is odd, because although the letter to my wife was indeed dated February 12, the postmark on its envelope was dated February 17, and we didn’t receive it until February 19. Perhaps the five-day delay was needed for your legal department to review your response to confirm that you hadn’t done anything foolish like actually admitting to having done anything wrong?
“It has been determined that the care rendered based on your hospital presentation was appropriate…”
In fact it was not, and we are not the only ones to think so. Dr. L… has informed us that as a result of this incident and how you responded to my complaint about it, she will now strongly recommend to her patients against using your emergency room. This is especially damning given that Dr. L… has admitting privileges at your hospital and teaches there.
Furthermore, after hearing my story, a physician friend who did part of her residency at your hospital remarked, “From what I saw at St. Elizabeth’s, I’m really not surprised. If you’re ever in an accident and the EMTs want to take you to St. Elizabeth’s, get out of the ambulance!”
“…and the billing will be processed for your care.”
Aha! Now we come to the essence of your view of this incident. Of course you can’t admit to having done anything wrong, because that might compromise your ability to collect from the insurance company for my wife’s treatment! That’s truly appalling.
In summary, it is indisputable that mistakes were made in my wife’s care. I brought these mistakes to your attention with the expectation that you would acknowledge them, apologize, and use them as an opportunity for improvement. Instead, you evaded, lied, and falsely (and libelously) laid the blame on others. Because of this, my wife and I will never again willingly seek treatment for our family at your hospital; we will strongly discourage all of our friends and neighbors from doing so; and we will continue to aggressively pursue any and all third-party avenues of complaint that are open to us.
Sincerely,
Jonathan Kamens
| CC: | Dr. C… L… |
| CC: | Appeals and Grievances Department |
| Tufts Health Plan | |
| 705 Mount Auburn Street | |
| Post Office Box 9193 | |
| Watertown, MA 02471-9193 | |
| CC: | Division of Health Care Quality |
| Massachusetts Department of Public Health | |
| 99 Chauncy Street | |
| Boston, MA 02111-1212 | |
| CC: | Office for Civil Rights |
| U.S. Department of Health & Human Services | |
| OCRComplaint@hhs.gov | |
| CC: | Joint Commission on Accreditation of Health Care Organizations |
| Office of Quality Monitoring | |
| One Renaissance Boulevard | |
| Oak Brook Terrace, IL 60180 | |
| complaint@jcaho.org |
Do the patient advocates help? Complaints and Grievances department ?
I went through a traumatic medical experience at St. Elizabeth. The surgeon went straight from exam to procedure. No diagnosis, options, potential risks, discussion of pain management, etc. were discussed. No informed consent was given. I sent four portal messages. I did not see any responses to these. I copied my portal messages and faxed them to the office. I confirmed receipt and was told the doctor would receive my fax. Still no response from the doctor. Two of my medical questions came from two separate doctors. I thought these might get the doctor’s attention. They did not. I left the procedure barely able to drive and in pain. I was in bed for 1.5 days following. I was not even given a handout on the procedure or after care instructions. The doctor’s note states things that were never done such as “Reviewed the risks benefits and alternatives. She does wish to proceed…” “I counseled the patient regarding the post procedure complications such as possible bleeding and infection and asked them to see me in follow up in 6 weeks. Patient understands…” All untrue, never discussed, no follow up mentioned or scheduled.
my wife was treated there for a gall bladder removal and awoke half way through the procedure she peed herself and was watching the nurse txting on her phone she was there for a week when other patients normally go home the sameday she was moved three times 1 room had medical boxes stacked in the shower cubical and 1 had a patient who constantly pooped all over the floor she was scared of re surgery and no doubt had every cause
my wife was treated there for a gall bladder removal and awoke half way through the procedure she peed herself whilst the nurse was txting on her phone
St. E’s is a NIGHTMARE. Avoid avoid avoid.
I say this because of the experience I had with rude, inattentive staff I encountered while in the ER for an emergency I had related to a chronic medical condition. To the credit of St. E’s, my stay for treatment was, for the most part, a very positive one.
positive, meaning the staff were more attentive and kinder. please excuse me multiple posts…I’m trying to be objective here and just running in circles.
as dysfunctional as my agency is, serious problems are addressed and efforts are made to correct mistakes or negligence. JCAHO is always combing through records and making sure that we are providing appropriate care, including following up on patient complaints. I assumed that JCAHO or another accrediting agency would be all over this incident.
so why hasn’t the Mass Medical Board, amongst the other medicl agencies in MA, done *anything* about it? If the problem is so well known, why not make sweeping changes to correct the issues?
Oh, come on, Rebecca, as a social worker you work in this world, so surely you know the answer to that question. :-/ Some thoughts:
Doctors don’t like to rat each other out. They have oversized egos and God complexes. Most regulatory agencies are overworked and understaffed, and therefore most complaints are not fully investigated. Most people who encounter problems at a hospital or for that matter anywhere else don’t bother to complain about it or don’t have the time and energy to follow through on their complaints. The organizations which accredit hospitals are funded by the hospitals; they have a vested interest in downplaying complaints against accredited hospitals for that reason and because it makes them look bad when a hospital they accredited is proven to have done something stupid (FYI, the organization which accredits St. Elizabeth’s told me, when acknowledging my complaint, that they would investigate but would be unable to inform me of the results of their investigation). Sweeping changes are expensive. Dysfunctional corporate cultures are as hard to change at hospitals as they are anywhere else. Damages are capped by law to $20,000 for many malpractice lawsuits against non-profit hospitals such as St. Elizabeth’s.
I suppose it’s also true that not all of St. Elizabeth’s is so awful. My wife had three kids in their maternity ward, and they were fine.
Do you think the Catholic Church has made sweeping changes to how it does things in response to the Catholic priest sexual abuse scandals that have been uncovered recently all over the world, e.g., in Boston of course and more recently in Italy? Somehow I doubt it. Keep in mind that St. Elizabeth’s is part of a Catholic hospital network. It is not at all surprising that the culture of non-accountability which pervades the Catholic church would be prevalent at a Catholic hospital. And just as the Catholic church is extremely powerful and manage to hide the sexual abuse for many many years, so too St. Elizabeth’s has power.
When I went to the St. Elizabeth’s ER with appendicitis, the surgeon who did my appendectomy didn’t even mention to me that there was a laparoscopic method for the surgery. Why? Because he wanted to do the surgery himself, and he was an old doctor who wasn’t trained or experienced in laparoscopic surgery. I ended up having a traditional, large-incision appendectomy, with a much longer recovery time and complications (painful adhesions) that would have been avoided with laparoscopic surgery.
every trip to the ER that we’ve needed has been to Children’s Hospital. Even on Shabbat, when I had to drive him to Longwood. I have trusted them with Ben’s life on more than one ocassion, and have no problem driving there. Plus, they have valet si tehnically you don’ have to turn off your car.
Just to add my voice to this: my pediatrician has rebuked me twice for (twice) taking a child to their ER –the first time it was a true emergency and they were the nearest hospital (and it was quicker to run, child-in-arms, than to get into a car), while the second time it should have been a standard milk-run urgent-but-not-critical pediatric case. In neither case, but most damningly in the latter, they could not provide appropriate care. In the second case I was so horrified by the attending’s inability to recommend a course of treatment in the ER and so doubtful of his prescription that I independently sanity-checked both before agreeing to them. During that same ER visit for my youngest, we were placed next to a hallway-bedded psychiatric patient who was cursing at me and trying to converse with my child (after my request for a move or security went unheeded I palmed my pepper spray: that’s right, I had a weapon in hand in an ER because I feared for my own safety). I may note that the intake doctor had a guard with him while he attempted to interview her –also right in the hallway, so much for privacy for her! Atop that, the staff attempted to use a small adult bp cuff on his arm (he was 18 mos.), did not know how to zero a double-arm child scale, and initially wrote down his weight as lbs. when the scale was in kg. When I called her on it she left and returned with a pound scale, and *repeated her error in failing to zero it*. OMFG.
You have also heard before my own story of going there with what was initially diagnosed as a pulmonary embolism but turned out to be pneumonia. No guesses what a (needless) night in the RICU cost! or what continued anticoagulant would have done for me as I continued to have bacteria dancing in my lungs! In that case the ER doctor had left the decision as to which radiological technique to use up to me –I was pregnant, he was afraid to decide on anything involving radiation. I probably would have made a different decision regarding method (since I was being forced to make one, despite several hours of being mostly unable to breathe and 140 bpm tachycardia) *had he given me correct information regarding the three possible methods.*
To be fair, the one *other* time I went to their ER –to remove a large, deep splinter from my oldest’s hand (it was beyond my ability, and the pediatrician, when I described it over the phone, said it was beyond his too) they dealt with the problem quickly, efficiently, and what appeared to be correctly. Anything worse than a splinter, though –or requiring differential diagnosis– it’s Longwood Ave. for me!