Negligence and doctors

[resaebiunne]

Hello all. I have some thoughts about my experiences over the past few months and I'd like to get an idea of what you all think. I am considering pressing charges (in two separate cases) for medical negligence that various doctors I have seen in the past few months have affected me with.

The first case of negligence was my (first) ER visit back in early July 2016. I had a tonic-clonic seizure while at my mom's house and they (at my request and before I had the tonic-clonic seizure) took me to the ER because I was status epilepticus. The ER did nothing for me except a few tests and maybe some blood work. I was not put on any medication. Then about 4 days later, after I had driven from my mom's house to St. Pete (where I have lived for the past 7 months), I had another tonic-clonic seizure. I wound up unconscious on the floor of my apartment for nearly 2 days before I was able to call out for help. I had fallen on my stomach and fractured/dislocated my right shoulder resulting in surgery and a 4 day hospital stay. It was this particular hospital visit where I was started on Keppra (without my consent, I might add).

The second case of negligence revolves around getting my drivers license and my neurologists recent completion of a form from the Florida Department of Highway Safety and Motor Vehicles. This story takes off where my other story ends. While I was in the hospital, I was started on Keppra (2000 mg a day total). After a few weeks of being on Keppra, my focal (simple partial) seizures returned. Upon contacting my doctor, she immediately scheduled me for an appointment (the next day) and increased the dosage of my medication to 3000 mg a day. She also ordered an ambulatory EEG which I took about 3 weeks later. After about 2-3 weeks of pestering my neurologist office for results, they stated that the EEG was abnormal. (I recently got hold of the EEG along with the medical form that the doctor was to sign, and the report shows seizure activity throughout the brain suggesting that these may not be focal seizures. Despite the EEG and my complaints about the continuing seizures, my doctor did not schedule a follow up appointment (other than the 3 month checkup which was this past January). At the checkup appointment in Jan. I mentioned I was still having seizures when asked by the doc, but again, the neurologist did nothing for me and kept my medication the same. Now, upon having retrieved the medical form from my doctor (signed), she recommends that I do not be issued a drivers license because I'm still having seizures. How is that supposed to make any sense? I'm at the mercy of the Florida medical review board in Tallahase to let me drive. Did I mention that I got laid off 3 weeks ago? What am I supposed to do for work if I can't live in 90% of this country because of my lack of driving priviledges? I just moved here (to St. Pete) in July. FFS.

Anyway let me know your thoughts. I'm hopefully hooking up with an attorney here pretty soon and will recite this same spiel to him and we'll see what happens.

 

[AlohaBird]

Your experience with your shoulder injury sounds horrific. And I'm so sorry to hear about your job situation.

I get it that you are pissed and frustrated. The legal definition of "negligence" however is pretty specific and narrow. The doctor has to have caused the problem either by the wrong action (a.k.a. a screw up) or by failure to act. It's not coming through to me from what you wrote exactly where/when you feel that a particular doctor did something wrong or should have done the right thing but didn't. And to say they could/should have done something but didn't, you would have to prove that they could/should have known better. 20/20 hindsight does not meet the legal definition of negligence.

Also failure to get the outcome you would like (a pill that makes it go away) is not the same thing as negligence. By that definition all the people out there with refractory E have negligent doctors.

Res, you and I have butted heads before but I hope you get it that I genuinely am fond of you and hate to see you in such pain.
So take this in the spirit of "tough love" in which it is intended *please*.

You have repeatedly stated that you choose not to change anything about your diet/lifestyle including smoking/alcohol/late nights and have even counseled others here on CWE not to give in and change anything due to their diagnosis.

The doctors can only do so much. They do not get magic wands issued with the white coats. You have to step up and take some responsibility for your own health too.

And yes, it is frustrating when the doctor is not as available as you would like. I think FedUp has the all time trophy in that department, being put on a wait list of over a year for an appointment. That doesn't make your doctor perfect of course.

Go ahead and be mad at me if you want. But if you want to blame it all on the doctors, you have to get more specific about an action or inaction that is directly attributable to a particular MD or an institution.

I will still adore you even if you're mad at me.

 

[Cint]

I agree with Aloha. The docs don't work magic because of their white coats. There have been many times I've ended up extremely frustrated because of the outcome of my seizure situation, but at least I did try to change my diet and lifestyle. Furthermore, why should you be driving if you're still having seizures, especially since you've had TC seizures? I had two accidents because of CP seizures while driving, totaled my cars, and now I DO NOT and WILL NOT DRIVE. I am uninsurable now. I could have killed others had I been on a well traveled road. Fortunately, I only hit a brick wall and my car was the only thing that was hurt (plus the wall). If someone has seizures and still drives, that could be DEADLY!!

I had to move closer to public transportation so I could get to places I need to go. And because I have refractory E, I do not and haven't worked in years. You can check into disability.

Sorry, but life IS a B!()H ........

 

[Jezy]

İ can't imagine going through with it puts things in perspective for me. I have been disatisfied with past doctors not giving the time and consultation before prescribing medicine but I imagine it is a long and hard road to prove malpractice but you need to make that decision yourself obivously

 

[Kgartner]

As far as the first part of your story is concerned, it is actually normal to NOT diagnose epilepsy or prescribe AEDs to someone after their first seizure. The majority of people with one seizure do not go on to have a second one - about 70% of the time a first generalized seizure is a "one-off". An epilepsy diagnosis and medication is generally only given after a second seizure. So while your experience sounds absolutely horrible, I don't think that you have grounds for saying that the ER doctors were guilty of negligence in this case. They probably could have done more for you, but in general they adhered to the standard of care for a first seizure.

However, I am quite surprised that you were permitted to continue driving at that time. I know that the rules are different in every state, but where we live (in PA) you cannot drive for at least 6 months after any seizure that impairs consciousness. So I am more surprised that you continued to have driving privileges for so long than that they have been suspended now.

My daughter has not had a tonic-clonic seizure since November 2014, but does continue to have simple partial seizures (she doesn't lose consciousness). After 9 months in which she did not have any seizures with loss of consciousness, her neurologist finally did approve her to drive last July, but it was really his call. If he had felt it was unsafe then he would not have approved it - in fact it would be "negligent" for him to have said yes. If she has even one event in which her consciousness is impaired, she will lose her permit again. We are even more cautious than he is: she hasn't driven since November when she had a very strong focal seizure - even though she did not lose consciousness it was strong enough that she didn't feel safe behind the wheel of a car. Her safety and the safety of other people on the road is way more important than any other consideration.

So depending on your neurologist's analysis of your specific seizure type and the rules of your state, she may be REQUIRED to suspend your driving privileges - particularly if she suspects that your seizures may be generalized and not focal.

I do think that you may want to switch to an epileptologist because there may be more that can be done to address the seizures you continue to have. But you could see the best doctor in the world and still be having seizures - that's just the nature of this condition.

Unless there is some major part of the story that you are leaving out, I think it may be the epilepsy that you are angry at (and believe me, I understand), not your doctors.

 

[Cint]

The second case of negligence revolves around getting my drivers license and my neurologists recent completion of a form from the Florida Department of Highway Safety and Motor Vehicles. This story takes off where my other story ends. While I was in the hospital, I was started on Keppra (2000 mg a day total). After a few weeks of being on Keppra, my focal (simple partial) seizures returned. Upon contacting my doctor, she immediately scheduled me for an appointment (the next day) and increased the dosage of my medication to 3000 mg a day. She also ordered an ambulatory EEG which I took about 3 weeks later. After about 2-3 weeks of pestering my neurologist office for results, they stated that the EEG was abnormal. (I recently got hold of the EEG along with the medical form that the doctor was to sign, and the report shows seizure activity throughout the brain suggesting that these may not be focal seizures. Despite the EEG and my complaints about the continuing seizures, my doctor did not schedule a follow up appointment (other than the 3 month checkup which was this past January). At the checkup appointment in Jan. I mentioned I was still having seizures when asked by the doc, but again, the neurologist did nothing for me and kept my medication the same. Now, upon having retrieved the medical form from my doctor (signed), she recommends that I do not be issued a drivers license because I'm still having seizures. How is that supposed to make any sense?

Read here, maybe this will make sense as to why she doesn't want you to drive:

If a physician fails to report a patient under mandatory reporting laws, they can be penalized with a monetary fine. However, an accident can lead to a lawsuit charging wrongful death or injury, with a large judgment against the doctor. In states that require mandatory reporting, compliance varies widely among doctors.

Doctors who state that it is safe for a person with epilepsy to drive and recommend licensure could also face some liability in case of an accident, although it appears to be minimal. Doctors should not be liable for recommendations made to the department of motor vehicles if their opinions are reasonable and consistent with good medical care. Some states grant immunity from liability to doctors who make recommendations about driving privileges.

I'm at the mercy of the Florida medical review board in Tallahase to let me drive.

Here is what the Florida DMV has to say:

http://www.epilepsy.com/driving-laws/2008686

Florida Driver Licensing Laws

A person with epilepsy may be licensed to drive upon their doctor's recommendation after they have been seizure-free for two years. If under regular medical supervision, the person may apply at the end of a one year seizure-free period. The application is reviewed by the Medical Advisory Board of the Department of Highway Safety and Motor Vehicles, which makes a recommendation to the Department. If the MAB approves an applicant for a driver’s license after a one year seizure-free period while the applicant is on medication, the applicant must submit to a follow-up medical evaluation at the end of one year. [FLA. ADMIN. CODE ANN. r. 15A-5.004(1), (2) (2011); See also Fla. State §§ 322.126, 322.221; FLA. ADMIN. CODE ANN. r. 15A-5.002 (2011)]. Applicants with chronic recurring seizures, or those who have been treated for such within one year, and medications have been discontinued are not eligible to have their licenses issued for a two year seizure-free period. Medications should be continued through a three year seizure-free period. If discontinued, the person is not permitted to drive during the period of drug withdrawal and within the subsequent three month period. [r. 15A-5.004(3)]. The cause of a seizure or seizures may be the basis for special consideration by the Medical Advisory Board, which will contact the licensee’s physician on its own prerogative for medical information. [r. 15A-5.004(3), (4)]. Applicants with low therapeutic blood levels, only nocturnal seizures, absence seizures or partial seizures with complex symptomology, and syncopal episodes without a clear diagnosis will be considered on an individual basis and upon physicians’ medical reports. [r. 15A-5.004(5)-(8)].
A person whose driving privileges have been cancelled, suspended or revoked may petition for a hearing. Application for a hearing must be made in writing. [FLA. ADMIN. CODE ANN. r. § 15A-1.0195 (2011)].

Board members cannot be held liable for their opinions and recommendations [Fla. State. § 322.125(5)]. Also, no criminal or civil action may be brought ]
Florida Driver Licensing Laws

Did I mention that I got laid off 3 weeks ago? What am I supposed to do for work if I can't live in 90% of this country because of my lack of driving priviledges? I just moved here (to St. Pete) in July. FFS.

Maybe your lawyer will help you find a new path down this dark road.

 

[seagull]

Shit happens that not doc fault what did you think you get in ER unit that's what it is car crash surgery tide you over.
Second NO you should not have licence back at this point in life comensense surely tell you that.NO DOC GOING to endorce that and if they do that's bad medicine apart from illegal
Your e is not yet controlled could you live with yourself if killed someone knowning you could black out on driving..Case in this country 6 people killed due to guy with e not disclosing his problems to doc.
You have to accept life is crap at times..ER gave you keppra what is your problem you went to ER FOR EMGENCY treatment and got it no one forced your mouth open to take it.From what you posted the hospital and docs did right thing but you most definatly are not/
I shoot from the hip

 

[knothing]

We all have to deal with the laws and our conscious over driving. My state has easier laws where it is 3 months and up to us for monitoring but if I violate the law I lose my license for life. It was a tough even at 3 month and it happened 3 times. You drive all the time and then think how can I go to work and live my life without a car. Everyday you want to just hop in and drive down the road to do it.
Doctors are not all the same but they are doing the best that they as individuals that they want to or can do. The goal is to find a doctor that you can work with in unison for treatment. I am curious as to how you ramped up to 2000mgs of Keppra. It took a couple months for me to get to that level. Keppra can have harsh side effects and jumping right to a high dosage can be very difficult. I would investigate the side effects and see if you are experiencing them. The do not nickname the drug Keprage for no reason. I don't know you so I can't tell but re-read you comments and ask yourself is that you before Keppra? I went through many issues with Keppra at first and had to learn to control my anger.

 

[Jezy]

That is good advice by Knothing, I started on Keppra a few months ago and have ramped up to 2000 MG in addition to my lamictal. The side effects are real ask your friends and family if they notice changes mine did.

 

[JJR1956]

Sorry about that Resaebiunne. I had my first grand mal in NYC. I lost my license for a year...and I was a tractor trailer driver. Good thing I’m a Teamster. They got me off the truck and into the warehouse, so I kept my job. (I had to get a ride to work every day though)

As far as doctors and those alike.....the 2 people in the ambulance that were taking me to the hospital when I had my first seizure gave me Nitroglycerin to put under my tongue. Dumb, huh? They almost freakin' killed me. I remember waking up in the ER with doctors all around me trying to get my BP up. It was way down. I was new to seizures and all that stuff.....that's a good case for a law suit! That was about 15 years ago.

Anyway, you feel better and I hope everything works out. I'm new here and this is a great place to get answers and advise.

Joey

 

[resaebiunne]

Hi guys,

There are some very good words here and I have only skimmed the thread. I honestly forgot I wrote this post and I'm only just now catching up on it. You all have given me some interesting perspective. For that I thank you. Even AlohaBird

 

[Nakamova]

Hi res --

You mentioned that you were put on Keppra without consent. I think that in many cases if someone comes to the hospital because of a seizure, it's not unusual to start the patient on anti-seizure medication as a precaution, based on a number of factors including physician preference and patient history. Usually the med of choice is Dilantin or Keppra, since they can be ramped up to a therapeutic dose very quickly.

In an ideal situation, the treating doctor at the hospital is a skilled epileptologist familiar with the patient — but that's rarely (if ever) the case. As a result, some treatment decisions (such as putting you on medication without your knowledge) may be made as the safe default, even if it ends up being a less-than-optimal choice for the patient down the road.

 

[seagull]

I been hiked off to hospitals before now where mostly slept until better often the choice to stay if I feel not controlled. Things like e and diabetes is very much down to the Indervidual do research find the right spelalist again as others have said they few on the ground that why know your condition the sort of tests the medications a lot is trial and error.
if you are having status e then wanting your licence back is wrong at this point in life.The one thing I do find odd if you have had status they should have admitted you.You don't say how long you had e if it something that started out of blue last year I would thought scans etc should be done what your triggers could be.but medical mal practice that unfair on doctor from way I read it they done nothing wrong

 

[Cint]

Usually the med of choice is Dilantin or Keppra, since they can be ramped up to a therapeutic dose very quickly.

:agree: Years ago, I was put on Dilantin immediately because I ended up in the ER, due to a very serious burn, due to a bad TC seizure in the shower. The previous dr. said I was hypothyroid, due to the CPs I was having. It usually is the best scenario for the ER docs to put a patient on one of these meds if they have a TC seizure, even if it is only their first one and only, until they have an EEG or other tests.

In an ideal situation, the treating doctor at the hospital is a skilled epileptologist familiar with the patient — but that's rarely (if ever) the case. As a result, some treatment decisions (such as putting you on medication without your knowledge) may be made as the safe default, even if it ends up being a less-than-optimal choice for the patient down the road.

It is much better to be SAFE than sorry!! One can go off meds. One can't remove burn scars.

 

[Kgartner]

Hi res --

You mentioned that you were put on Keppra without consent. I think that in many cases if someone comes to the hospital because of a seizure, it's not unusual to start the patient on anti-seizure medication as a precaution, based on a number of factors including physician preference and patient history. Usually the med of choice is Dilantin or Keppra, since they can be ramped up to a therapeutic dose very quickly.

Good point! This is exactly what happened with my daughter. She had her first t/c seizure at home so we called the EMTs - then when she had another one in the ambulance on the way to the hospital they started her on IV keppra as soon as she got to the ER. No permission asked or granted: they were just doing what they needed to do to halt her seizures. She did stay on Keppra for 7 months with good seizure control, but needed to stop taking it due to side effects.