Tuesday, January 29, 2008

Dr. Malaria's License must be Revoked

Subject:
Medical Malpractice: Dr. Malaria

Thanks for the effort to inform the public about malpractice of doctors in the Phils. What happened to me seems trivial as compared to what was done or not done to others.

I went to the medicare center in our town here in Palawan because of high fever and intolerable headache. The doctor on duty asked me questions:

"Dr: Anong nararamdaman mo?
Me: Mataas po ang lagnat ko, tsaka masakit po ang ulo ko.

Dr.: Masakit ba ang sikmura mo?
Me: Hindi po.

Dr.: Mapula ba ang ihi mo?
Me: Opo.

Dr: Nahihilo ka ba?
Me: Opo.

Dr.: Ay, malarya yan!"

He then called the nurse who gave him a pen and a sheet of paper. He proceeded to write a "shopping list" of meds, etc. Then he left, leaving the paper to the nurse. I asked the nurse to show me the paper. There was no name of the patient (me), no date, no signature of the doctor. Only names of medicines. No other info like number or pieces of each. The nurse then told my "bantay, neng sunod ka na kay doc, baka magsara na ang botika nila!" I said, "paano ang bayad?" Nurse: "saka na lang po." When my "bantay" returned, she has a bag of what she got from the botika. It was pretty obvious that the doctor's wife in the botika knew the pack to prepare. All for malaria.

So that first night, I was given anti-malarial drugs like 'fancedar' and 'chloroquine'. Same until the 2nd day. Later in the afternoon, I complained because my condition did not improve a bit. Take note, there was no blood smear or urine test at least. I asked the nurse why so. The lab tech was on leave. I showed signs of irritation to the nurse. That was only the time when someone took my blood and urine samples.

No one told me the results until I asked the nurse again.

Me: "Anong result ng test? may malaria ba ako?"
Nurse: Negative "po".

Me: "O, e bakit pinapainum nyo ako ng para sa malaria?
Nurse: "Yon po kasi order ni doc."

I told her that I want to change my doctor... and I did after much "kulitan".

The new doctor confirmed my suspicion. "Wala akong malaria. UTI ang meron." He gave me antibiotics and in less than 4 hours, I was relieved of fever. Imagine, for 2 days they administered 'chloroquine' to me? All the while I have UTI "pala..."

Not only this. There was this patient in the same hospital who has fever when she arrived. "May lagnat ka? Malarya yan. Yon pala, ang dalagita, nadulas dahil maputik ang daan sa kanila." Two more cases were judged with malaria.

This doctor is known here pala as DR MALARIA. "Kasi laging malaria ang sakit na nakikita sa patients nya. At sa store lang nila bibili ng gamot ha! "

thanks for your time.. .
Unfortunately, the contributor has requested anonymity. However, any reaction can be posted in the blogspot or passed on to:

Sunday, January 27, 2008

Another Misdiagnosis which Led to Death?

From: joyce marie c. alvarez
jm_joycec@yahoo.com

Subject: Another Misdiagnosis which Led to Death?

On April 27, 2005, my mother complained that she was not feeling well and vomited. We brought her to Capitol Medical early morning. The doctors at the emergency room asked her medical history. We told them she had ischemia. The doctors gave her medicine for dizziness only and just let her lie down on the emergency bed. My husband and I were there the whole time. After a few hours, around 11 am, my mother said she was fine, (though she still looked weak), and wanted to go home. I asked the doctor if she could go home and they allowed us to go home with a diagnosis of vertigo, and just reminded us to see her doctor after a few days for follow- up.

But after a few days, my mother died.

I woke her up that Friday morning, April 29 but she didn’t wake up anymore. We were all so surprised with her sudden death because she never complained of anything except that time we brought her to Capitol which they said was just vertigo. We brought her back to Capitol that Friday morning (since it was the nearest hospital), and I saw the resident who gave that diagnosis, and you know what I told her: " You said that my mother was fine and now she's dead". In her death certificate, they wrote as cause of death: myocardial infraction. I was not able to get the resident's name but I would still remember her face. I also remembered after her death, her blood pressure was not checked before we left the hospital. Maybe, if they checked her BP or did some other tests or observed her more, maybe they could have detected something else and not just vertigo. After giving her medicine for dizziness, they just left us and did not do anything anymore.

I am not a doctor but I believe that there may have been a misdiagnosis or they didn’t care much to the patient (who was my mother) because she was just complaining of dizziness and vomiting water and they had other things to do. Its been three years but I guess your email gave me an opportunity to let you or others know especially the doctors to take time when looking into their patients and be responsible.
To the doctors, we seek for your advice because we believe in your expertise. Do not let your patients lose faith in you or the hospital where you are serving because you also carry the hospital's name whenever you treat a patient.
Joyce

Thursday, January 24, 2008

A Biopsy that Led to Death

From: "Cubacub, Maria Irma C" Maria.Cubacub@phs.com

This is so sad.
I can relate with your family because we had same experience when my father in law was admitted just for liver biopsy on a week-end and he died the next day unexpectedly. My father in law was ambulatory and strong when he was admitted. He survived the open heart surgery in the same hospital 8yrs ago but did not survive the simple liver biopsy.
The hospital is responsible in making sure all healthcare personnel are competent and should not make excuses and justification to these incidences. It's one of the best hospitals, people seeking health services at SLMC should be safe. I understand that some patient who are admitted very sick dies but these victims are sick(healthy) individuals and are just victims of circumstances, it could have been prevented & patient should survive given the best attention and care. They should treat everyone who come through their door cautiously and anticipate the worse that could happen before we lose our loved ones.

My sympathy goes with the family, may you have strong faith with the Lord. God bless you all.

Irma C.

Wednesday, January 23, 2008

Relleta's Complaint Letter to St. Luke's


Hello again!
Below is my friend's story. It's actually the letter of complaint she submitted to St. Luke's after the incident.

Kristina T. Subido protransph@yahoo.com


LETTER OF COMPLAINT TO ST. LUKE'S
SENT BY JOSEFINA DELA CRUZ RELLETA

Good day.

I would like to bring to your attention my complaint regarding the medication and diagnosis that was given to me by doctor Raymond Vincent Jurilla.

I went to his clinic to complain about my ear, which seemed to be clogged. I also gave him a brief history of what happened. I told him, almost 2 weeks before I came to see him, I was traveling uphill on a zigzag road and I felt so dizzy that time. I also felt sensation of some pressure in my ears, somewhat same as descending and ascending in an airplane. I never experienced being that dizzy before. Thinking that something maybe wrong with my cochlea, because I could not keep my balance, I decided to see an ear specialist last October 2. Doctor Jurilla was the ear specialist on duty that day. He requested that I should go for 3 tests: pure Tone Audiometry, Speech Audiometry (Oct 5)and VNG (Oct 8). I had all those tests there at St. Luke’s.

I went for my Audiometric Examination, the result of the examination was Mild Sensorineural hearing Loss; while the conclusion for my VNG was suggestive of positional vertigo.

On Ocotber 11, Dr Jurilla said, I have Meniere's Disease and Positional Vertigo, and prescribed the following: LASIX, duxaril and vit b-12. I took all the above that same day; but I took Lasix around early evening, since i wanted to sleep early that night. He said I should take it at bedtime. That’s all he said. After 2 hours of taking Lazix, I felt some dizziness and discomfort. I went to the bathroom to urinate and pass stool, but immediately after going to toilet , I felt so weak, I was sweating cold, and my world seemed to turn around, my body was cold, I was fainting. My son carried me, as I could not walk anymore. He made me sit down to relax, but I knew something really bad was happening to me after taking Lazix. My son took my BP and found that it had tremendously gone down to 70 and I had a hard time breathing. After 2 hours, I had another attack. This made me decide go to a hospital.

At the emergency room, the attendant and nurse took my ECG..there was T-wave, she said. I had Urinalisys, random blood sugar test, CBC tests. I requested to be allowed home the following day so I can better rest in my house.

After 4 days, I went to see an Internist doctor, who requested that I should see another Ear doctor and a Cardiospecialist on that same day and I did. This time, the Ear specialist was able to give a better diagnosis of my problem. She did endoscopy on my nose, looked at my ears, throat and found the reason. It was my sinus being clogged which affected my ears and was triggered when I was going uphill that time. AS SIMPLE AS THAT! And not Meniere's disease, as Dr Jurilla was saying. She prescribed medication and I am thankful that my ears feel better, though my body still has to recover.

Dr Jurilla, did not even ask me about my Blood Pressure, neither took time to get my BP before prescribing Lasix. I found out later that this will cause BP to fall. My normal BP is 100/70.

When I took Lazix, I had hypotension, and my sugar went to 165, I had hyperglycemia, and had difficulty of breathing. In other words, my condition worsened.

I have no intention to file case against the doctor. I just want to bring this to your attention and properly address the issue and concern.

People in the medical profession should try to be more dedicated in treating their patients. They are dealing with lives and not commodities. I hope we can do away with too much commercialism and politics in this field, rather more dedication and sincerity to serve.

Thank you.

Sincerely,

Mrs. Josefina dela Cruz Relleta

Tuesday, January 22, 2008

Horror Story at the Geriatic Floor: St. Luke's Medical Center

From: Marlene Chance chancesr@bellsouth.net

I am so sorry to hear about your loss.

My mother was only one of the many victims of the negligence, incompetence, and malpractice of St. Luke's Hospital, many of it's doctors, and every single nurse who was assigned to my mother, no exception! As a graduate of nursing from the University of the Philippines, I had the great misfortune of witnessing first hand, the incredible lack of compassion, basic nursing care and professionalism that nursing stands for, as well as the serious lack of basic intelligence from all the hospital's nurses that the St. Lukes employs and tolerates.

The nursing duties and functions that were so simple and basic, and that should have all been mastered while in nursing school prior to graduation and licensure, all turned into major disasters and complications that could have ALL been prevented. These are only a few of the negligent and incompetent acts: (1) bed sores on my mother's buttocks on the third day of admission, not having been turned, moved or changed, (she was actually stuck to the soiled linen from old urine and feces) until I arrived from the United States to change her myself...there was absolutely no reason for decubitus ulcers on a third day, or any day for that matter, if basic nursing care is carried out. She was in a private room on the Geriatric floor where nobody changed patient's beddings for weeks at a time, or until forced to by the family of the patient.

(2) fecal impaction which resulted in acute rectal bleeding and anemia, and subsequent and multiple blood transfusions, plus a stat colonoscopy that required anesthesia of course, in an already compromised patient. I begged for the attending (Sotomayor) to check her bowels DAILY, because she had not had a bowel movement in several days, and only on the 10th day, did I finally get an order in the chart for an INTERN (another incompetent future doctor at the time) to disimpact my mother, which resulted in bleeding and hemorrhage.

(3) misuse of the appropriate antibiotics, having had a urine culture done, the attending ordered Amoxil which was not sensitive to the bacteria in her urine, and a few days later, she became septic and gradually deteriorated from untreated Urinary Tract Infection. This is a disease that we treat in the outpatient settings in the United States, it is basic, easy to treat, if standard care and protocols are followed.

(4) As a Diabetic, drawing blood out of the lower extremity is an absolute CONTRAINDICATION, but the phlebotomists continued to take blood out of her feet when nobody was looking, or intentionally at dawn, when my mother's attendant was sleeping, and before I arrived for a visit. I posted signs all over the wall and bed, and informed the nurses and laboratory supervisors never to allow blood drawing from any other part of her body aside from her arm, but nobody heeded my instructions. My mother died of a Massive Pulmonary Embolus after 45 days of admission at St. Lukes. This clot was a direct result of drawing blood from her lower extremities, simply because the medical technologists were too incompetent and too lazy to find any other vein elsewhere.

(5) Physical Therapist burned my mother's left arm and shoulder while applying the ultrasonic heat, and not bothering to test before using on a patient. I found the burns myself, they were never reported. My mother sustained first and second degree burns that again, were dismissed as "normal and usual effects of being a patient at St. Lukes." That is not tolerated in the United States, would have required an incident report, which was never completed, and would have easily been grounds for negligent action and malpractice.

(6) Tube Feedings. Not a single RN on the floor had the basic knowledge or skill as to the proper use and feeding process of my mother's PEG tube. They practically shoved the container of food as fast as they could, causing abdominal discomfort, unless I stood next to her bed to watch and supervise. Nobody on the floor even knew how to use the feeding tube machine on that Geriatric Floor. We had the supervisor, head nurse and director of nursing in my mother's room trying to figure out how to use this very simple machine that they should have been trained to use properly. Needless to say, because of the delay in feedings, my mother's nutritional status was compromised even more, resulting also in occlusion of her PEG tube, which of course required a replacement. The skills or lack of, in these nurses were pathetic, and unacceptable.

(7) This was rather interesting. At 9 o'clock every morning, a clerk from the business office would knock at my mother's door to hand me the hospital bill, and ask how much I was paying that particular day! It did not matter how much of the expense these incompetent employees were costing me for their negligent actions, all that mattered is that I made a deposit towards the multi-million peso bill that multiplied every hour! And if I did not go down to make a payment, they would call to remind me until I did. At the ER, the hospital refused to treat my mother until my sister made a P10,000 deposit in the middle of the night, when the banks are closed! And on discharge, after Dr. Abraham-Lim's professional discount (the only decent doctor my mother had), we paid a 2 Million Peso hospital bill that did not include the pharmacy and mutiple professional fees.

I can go on and on with the numerous disasters, these are only a few that stick out in my mind and that I will never forget!

There were clearly several instances where St. Lukes failed to meet the standard of care which directly caused injury and subsequent death to my mother. I made every effort to litigate, but unfortunately, there were no malpractice attorneys available in the country, and nobody was willing to take the case in the Philippines. I tried to publish the detailed scenario of the many terrible mistakes committed that eventually led to my mother's death, but the lawyers of this big corporate institution paid Manila Times and other newspaper publications not to publish my article. I wrote to the Secretary of Health, but got no response. I wrote and sent letters by certified mail, to the President and CEO of St. Lukes and to the Director of Nursing and the Nursing Department, and again, did not get any response.

As a Filipina myself, I must say it is rather unfortunate that Filipinos and others who reside in the Philippines, have to fall victim to the poor and negligent, but very, very expensive medical care at St. Luke's Hospital every day. There must be a way to put a stop to this negligent care!

Best of luck with your case!

Marlene Cataylo Chance, ARNP, MSN, PhD, EJD
Board Certified Family Nurse Practitioner
Primary Care Physicians of Pembroke Pines
2488 University Drive
Pembroke Pines, Florida 33324
954-983-9191

The Story of Jessie Bass

25 December 1953 – 17 November 2007

Mid morning of 16 November 2007, complaining of stomach pains, Jesus (Jessie) V. Bass (53) walked into the St. Luke’s Medical Center so he can get the best possible health care.

Jessie was attended to and examined by Dr. Edgardo M. Bondoc who eventually diagnosed him for acute appendicitis. Nonetheless, Dr. Bondoc did not refer Jessie, nor called the attention of any surgeon. In fact, Dr. Bondoc advised Jessie to go home and be an out-patient to await the results of the clinical tests.

Jessie, however, worried about his condition, opted to be confined at the world-class medical center convinced he would be given the necessary attention. He was alone then, as his entire immediate family lived in the United States. Upon confinement, Dr. Bondoc ordered an emergency contrasting CT Scan to rule out “possible gastro intestinal infectious diseases”. Jessie, however, waited until 7 pm before he was wheeled in for scanning. This was postponed due to alleged chills, fever and elevated blood pressure.

Finally, at 11:55 pm, Jessie’s scan proceeded.

Ten minutes after injecting Jessie with a test dose of the contrast dye, Optiray, a team composed of radiology technicians and 1st year Radiology resident, Dr. Gilbert N. Sy, administered the full dosage. The CT Scan followed.

Jessie was pronounced dead at 1:20 am, November 17, 2007, on the 64-slice CT Scan table - one of the most modern equipment of this world-class medical center. The National Bureau of Investigation’s official autopsy confirmed Jessie had an inflamed appendicitis.

In a fact finding meeting on 14 December 2007, Dr. Joven R. Cuanang, Senior Vice President for Medical Affairs, confirmed that the Medical Center did not have the ideal staffing at the CT Scan Unit at such unholy hour, with the most senior personnel being only a 2nd year Radiology Resident, Dr. Miguel B. Zamora.

It was noted that St. Luke’s Medical Center and the inexperienced junior team did not follow the important precautions that the OPTIRAY manufacturer indicated for its use :

personnel competent in recognizing and treating adverse reactions of all types should always be available; and

the possibility of a reaction, including serious, life-threatening, fatal, anaphylactoid or cardiovascular reactions, should always be considered.

It was further noted that the CT Scan plates recorded a time fixed at 00:03:42 while the Radiology Unit’s incident report indicated that Jessie was given the full bolus dose at 12:15 am, and got through with the procedure 10 to 15 seconds after. How soon after the “Code Red” team responded to give him the anti-dote was never accurately determined.

The presence of such inexperienced junior staff, Dr. Sy, only a 1st year Radiology resident, with two radiology technicians, was one main reason for the wrong diagnosis of what was happening to Jessie when he was wheeled out of the CT Scan gantry gasping for air.

Not recognizing the severity of the allergic reaction to the contrast material, the technicians even tried to question the patient before calling in a resident.

Dr. Sy admitted on 19 November 2007 that he turned Jessie on his side, thinking Jessie was trying to vomit. On subsequent formal meetings, however, Dr. Sy denied his initial admission.

There was, therefore, a critical gap caused by the lack of a full experienced team, and the diagnosis of an inexperienced staff that resulted in the loss of precious time to inject the needed anti-dote, and to immediately resuscitate him to effect a reversal of the adverse reaction.

Despite their subsequent claims of following protocol, or maybe because of its strict observance by young inexperienced staff, it was too late when “Code Red” was called and the first dose of anti-dote given.

Jessie, whose death on the table of one of the most modern CT Scan equipment available for medical practitioners in the Philippines, should be the first and the last to be sacrificed for the sake of many more seeking similar medical assistance, especially at the famed world class, and Joint Commission International accredited St. Luke’s Medical Center.

Unfortunately, despite the above factual incidents, the St. Luke’s Medical Center claims that it did its best and has denied any responsibility whatsoever on Jessie’s death.

See Korina Sanchez on Jessie Bass –

http://youtube.com/watch?v=mYcpx_bUBHk


NOTE: Please share and email Jessie.vbass@yahoo.com “ if you, your relatives or friends have a similar experience with St. Luke’s Medical Center, its doctors and staff, or with other hospitals and medical practitioners in the Philippines.

Jessie Bass: Medical Risks vs. Rewards

Many have responded to “The Story of Jessie Bass”. One was a blind email from Mr. Rene Rava of Quezon City who said: “Jessie's death is a senseless one. These things could have been avoided.” Jessie’s family also thought it could have been avoided. They demanded an assurance from St. Luke’s that his death be the first and the last on the gantry of their modern 64 Slice CT Scan equipment. St. Luke’s, however, continued to claim no responsibility on the death of Jessie Bass. They said “Severe reactions requiring aggressive treatment…is only 0.04%... Fatal reactions are exceedingly rare…” The impression was that Jessie Bass, unfortunately, was on the wrong side of the statistics.

It was risks versus rewards for Jessie who was the most senior Filipino officer at Marubeni, Philippines. As a businessman, he too learned that “higher risks: higher returns”. When he came into the hospital complaining of stomach pains, he really just wanted to be relieved of his pains. But I suppose, he had no choice but to literally hand over his life entirely to his attending physician, Dr. Edgardo M. Bondoc, or to St. Luke’s Medical Center, with its cadre of experts, for that matter. After all, it was their accepted responsibility to know, to cure and to save lives. They have the training, the experience and the most modern medical equipment to exactly pinpoint and diagnose one’s condition. While Jessie was being sent home, he asked Dr. Bondoc if he could be confined instead - since his family was abroad. Dr. Bondoc confessed he promised him: “I’ll take care of you”.

This was Jessie’s personal conviction. He had so much faith in this “World Class” institution, which unfortunately failed to avert possible allergic reaction even given more than 12 hours he waited for an emergency CT Scan, which of all hours was conducted at 12 mid-night. There was a lot of time to have reinforced the initial diagnosis of appendicitis, to do further clinical tests and to confirm that his family did have a history of allergies.

The ordeal then started after confinement. As Korina Sanchez said, “Little did he know that he was walking to his death.” If I were Jessie, I would have asked why I had to sign a waiver before I could undergo a CT scan. What was I waiving? Was I agreeing that no matter what happened to me, the doctor, the medical staff, and the hospital were not at fault? All risks then were on me, as the patient, even though it was a doctor and a hospital induced contrast dye. But, this dye was not even a medicine to cure my illness. It was to help the doctor and the hospital to know more about my condition! How legally strong then is a hospital-crafted waiver form to completely absolve it, and/or its staff, especially if it caused harm, or worse, the life of a person?

If I were Jessie and it was clearly explained to me that there was a risk I might die from severe allergic reactions to this contrast dye, I would have asked if both the dye and the CT scan were needed in the first place. After all, did not my attending physician previously diagnose it as acute appendicitis? What added value would more information be? Can a CT Scan detect and rule out infectious deceases, as Dr. Bondoc wanted? If the doctor laid out the cards on Jessie, clearly giving a picture of risks and rewards; I am sure Jessie would have opted to immediately be cut up for appendicitis, which other doctors say is a 20 minute procedure.

I wonder if issues of risks and rewards are discussed at the level of the Board of Trustees and Board of Advisers of St. Luke’s Medical Center. Are they, in fact, willing to take risks of fatal reactions even as small as 4 out of 10,000 among their CT Scan patients? Rather, would they not maintain the position that life should be preserved at all costs especially under an improved protocol? What value should hospitals, especially non-profit, non-stock medical centers give life?

Many have agreed with Rene Rava. Jessie's death was a senseless one. The CT Scan was an unnecessary procedure. This lapse of judgment could have been avoided. At the least, the CT Scan protocol should have been tighter under the direct supervision of experienced medical personnel.


See Korina Sanchez on Jessie Bass –

http://youtube.com/watch?v=mYcpx_bUBHk



NOTE: Please share and email Jessie.vbass@yahoo.com if you, your relatives or friends have a similar experience with St. Luke’s Medical Center, its doctors and staff, or with other hospitals and medical practitioners in the Philippines.