$22M verdict against PAMF in malpractice lawsuit

Jury finds Palo Alto Medical Foundation negligent in treatment of Menlo Park woman's migraines

The Palo Alto Medical Foundation was hit with one of the largest medical malpractice verdicts in Santa Clara County history Monday, March 19, after a Menlo Park woman suffered a stroke while undergoing treatment for migraines.

Robyn Frankel, who was 43 years old in 2006, when the treatment paralyzed her, won a $22 million verdict from the jury of six men and six women.

Frankel had suffered from migraines her entire life, said Summer Woodson, one of her attorneys. She went through several non-invasive imaging procedures, such as magnetic resonance imaging.

In 2006, doctors decided to give her a cerebral angiogram. The procedure involved injecting a dye into a vein to inspect what doctors believed could be causing her headaches. But according to the lawsuit, Frankel was not told that the procedure was invasive and risky. The jury found she was not given informed consent, Woodson said.

"She had a reaction to the procedure and stroked out," Woodson said. "Nobody talked to her about why she is having it or the risks."

Expert witnesses testified that the cerebral angiogram was not medically necessary, and it did not provide any benefit. Nothing could be seen that wasn't already visible in the non-invasive tests. Looking at the vein as a cause of her headaches was "baloney," Woodson said the experts testified.

Frankel had two small children and a lucrative career as a property manager in her family's business, Frankel Properties, prior to the stroke. She was in a coma for six weeks and woke up unable to use her right side and with limited use of her left. She requires full-time, round-the-clock care, Woodson said.

Frankel said by email that she could not speak or move for months after the procedure.

"I was bedridden. I used to participate in all my children's activities in and out of school. I used to ride horses and be involved with vaulting, which is gymnastics on horseback. I can no longer do any of these activities.

"I have since been going to physical therapy, massage therapy, horse therapy, personal trainer, swim therapy, speech therapy and need 24/7 care.

"Thanks to the financial assistance from my mother and father, I was able to recover enough that I can now speak slowly, I have use of my left arm, I can stand with help, and I can sit in a wheelchair, but still need 24/7 care and need to be turned every 2 hours at night," she said.

The case was originally filed in 2008 but was dismissed in May 2010 with prejudice, which meant it could not be reopened, Woodson said.

Stanford University Medical Center, which was also a defendant, had petitioned the court for a summary judgment. Frankel's previous attorney felt he would have difficulty opposing or winning the summary judgment and dropped the case, Woodson said.

Frankel then hired David Bovino of Aspen, Colo., and co-counsels Emison Hullverson Mitchell LLP of San Francisco. The firms were able to get the case reopened by showing there were "triable issues of fact," Woodson said.

Stanford settled the case for an undisclosed sum on Feb. 21, the first day of the trial, she said.

The jury found Palo Alto Medical was negligent in Frankel's treatment and care and that negligence was a substantial factor in causing her harm.

The verdict includes $2 million for past economic losses in earnings and past medical expenses, $14 million for future economic losses and Frankel's future care, and $6 million for pain and suffering.

The pain and suffering award would immediately be capped at $250,000, however, as required under the Medical Injury Compensation Reform Act of 1975, Woodson said.

There aren't many medical malpractice cases in California, due to the pain and suffering cap, Woodson said. The large verdict is probably because of Frankel's young age and the long life she is expected to live with her disabilities.

Frankel's medical care costs between $300,000 and $350,000 per year, Woodson said.

Santa Clara County Superior Court Judge Carol Overton is expected to enter the final judgment on the verdict in a few weeks. Woodson said an appeal by the Medical Foundation is expected and is standard in such cases. It could be filed in about two to three months after the final judgment is entered.

Dr. Richard Slavin, CEO of Palo Alto Medical Foundation, said in a statement Wednesday:

"We deeply sympathize with Ms. Frankel and her family. While we respect the jury process, the medical group is presently considering its legal options. We believe that the care provided by the Palo Alto Foundation Medical Group was appropriate. We appreciate the trust that the community has placed in us for the past 80 years to provide the best possible care for our patients. The safety and health of our patients has always been, and will continue to be, our highest priority."

Frankel said her children are now 8 and 16 years old. "I am so proud of them, as they have been by my side for the past 6 years.

"I am so grateful to my attorneys and family for their support, and I am elated with the award of $22 million. I thank the jury for their understanding of what actually occurred and the generous award, which will allow me to take care of myself and my children for many years," she said.

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Posted by Cap
a resident of Evergreen Park
on Mar 21, 2012 at 11:26 am

That reminds me of when my wife choose to have a long elective surgery 15 years ago at Stanford. But the docs never discussed with her the problems of being under anesthesia for around 10 hours -- especially since her family had a history of heart problems. She suffered a heart attack toward the end of the surgery, and it took them a while to realize it, since she was just beginning to come out of anesthesia. Fortunately, it was a small attack that she pretty much recovered from.

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Posted by Mark
a resident of Palo Verde School
on Mar 21, 2012 at 11:37 am

Good for you!

Only you and others who have been malpractice on know the misery befallen you at the hands of another, that will travel outwards in waves to befall others in your life-- those who were and may or may not fit into your live now as a result of this horrific nightmare. But you are still here.

Remember: life in and of itself is a wonderful gift. Remember that it could be worse--it can always be worse. Others have suffered with no compensation. You still have your family and their love. It is going to be a different life--not necessarily a bad life, just a different life with bad things in it that you can reach down deep in yourself and find the strength to over come.

And most of all, remember that you did nothing to contribute to your horrific injury--sometimes bad things, really bad things, just happen to nice--really nice--people.

Dismiss those individuals who will indicate that these things are pre-ordained, deserved, are because you did something to deserve it--as if they would, or could know such a thing. It was just a thing that happened to you that day that should not have happened to you. And by the way, a good thing,a wonderful thing, has just as much of a chance of happening next that you cannot see from this vantage point, as the awful thing that happened to you.

You have a few years to become who you will be next. It is going to be okay.

Hang in there!

6 people like this
Posted by Jared Bernstein
a resident of Professorville
on Mar 21, 2012 at 11:58 am

We have the name of the injured and her former employer, and the lawyers' names. Can we get the name(s) of the doctor(s)?

2 people like this
Posted by Dianne
a resident of Old Palo Alto
on Mar 21, 2012 at 12:27 pm

Looks like I am not the only one who wants to know the name of the doctor(s) that were involved in this case. As someone who has gone to PAMF for a long time, it would be nice to be able to exclude this doctor(s), if I so choose.

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Posted by Tara
a resident of another community
on Mar 21, 2012 at 1:02 pm

I have a friend whose 29 yr old son suffered an embolism during surgery and is now a quadriplegic. They have virtually no help. Her husband, who was her law office manager, had to quit his job and is taking care of their son full-time. The whole family is exhausted, and I'm sure this story is repeated all over the country. Not everyone is lucky enough to get some financial help, even if from a court judgment. (My friend's son may have given his consent, but being 29 yrs old, I'm not sure how much he understood.) Tragic, of course, for all those affected.

3 people like this
Posted by Hmmm
a resident of East Palo Alto
on Mar 21, 2012 at 1:03 pm

Holly - it can be spelled either way. Iirc,using the 1st e is the British use.

4 people like this
Posted by Holly
a resident of Menlo Park
on Mar 21, 2012 at 2:16 pm

Judgment can be spelled either way, but is spelled without the "e" when being used in a legal context. I believe that includes England, as well.

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Posted by lynnda
a resident of College Terrace
on Mar 21, 2012 at 2:27 pm

How heartbreaking what happened to this woman. Justice prevailed however, you cant put a price on health and wellbeing. So sad.

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Posted by Cid Young
a resident of another community
on Mar 21, 2012 at 3:02 pm

Web Link

2 people like this
Posted by Walter_E_Wallis
a resident of Midtown
on Mar 21, 2012 at 3:12 pm

Walter_E_Wallis is a registered user.

$22M of health care not available to the rest of us.

2 people like this
Posted by PAMF Patient
a resident of Greenmeadow
on Mar 21, 2012 at 3:30 pm

It would be good to get the names of the PAMF doctors. Are they sealed? Wait...can't be, can they? Not a settlement but a verdict!

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Posted by Tyler Hanley
digital editor of Palo Alto Online
on Mar 21, 2012 at 3:32 pm

Tyler Hanley is a registered user.

The following comments were moved from a duplicate thread:

Posted by Wondering?, a resident of Another Palo Alto neighborhood, 5 hours ago

So why was PAMF the target of this law suit, rather than the doctors who called for the unnecessary procedure?

Why calls into question how many procedures called for at PAMF (or in doctor's offices everywhere) are really necessary?


Posted by Pearl, a resident of another community, 5 hours ago

What is the name of the doctor who ordered the procedure done? That is public information, so why didn't the reporter include the doctor's name in this news article?


Posted by Bob, a resident of the Community Center neighborhood, 5 hours ago

Usually, Medical personnel who are in a 'group practice' rather than 'private practice' are covered by insurance under a group policy. Medical malpractice insurance is almost prohibitaly expensive for an individual practice. It's extremely high for all medical personnel. This article does not make clear whether the suit was against the physician who ordered the test or the physician who performed the test. It was against the group as a whole. It could have been and probably was two different MD's.


Posted by Banounou, a resident of the Leland Manor/Garland Drive neighborhood, 4 hours ago

I hope that it is not my doctor. I'll call PAMF to see if they will let me know the name of the doc. I am very worried now.


Posted by Mom, a resident of the Old Palo Alto neighborhood, 4 hours ago

That is terrifying news. Can we assume that the doctor responsible for this malpractice has been fired? Is there any comment from PAMF?

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Posted by Oh Please
a resident of Crescent Park
on Mar 21, 2012 at 3:34 pm

Really Walter? If the 22M include paralysis, you can have my share of it. Blame PAMF for not following proper procedures.

2 people like this
Posted by Staci
a resident of Palo Alto Orchards
on Mar 21, 2012 at 4:09 pm

This occured six years ago and most likely the Physician/s no longer practice at PAMF.

Oh, and can the two of you stop fighting over the spelling of a word this is a tragedy and your comments are making light of the situation at hand.

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Posted by Hmmm
a resident of East Palo Alto
on Mar 21, 2012 at 4:14 pm

It won't be "your doctor" iirc, radiologists perform angiograms.

Thanks, Cid Young re judgement. Holly, thanks for the distraction!!

As for who the doc is, I'm thinking of the people I can ask...there'll be plenty of medical gossip on this horrifying incident. I'm sorry for everyone, especially the patient & family.

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Posted by Palo Alto Medical Foundation - Public Affairs
a resident of Old Palo Alto
on Mar 21, 2012 at 4:31 pm

Palo Alto Medical Foundation C.E.O. Richard Slavin, M.D., issued a statement today:
“On Monday, March 19, 2012, a Santa Clara County jury found in favor of Robyn Frankel in a lawsuit filed against the Palo Alto Foundation Medical Group related to a medical procedure that was performed at Stanford Hospital and Clinics by Stanford radiologists. We deeply sympathize with Ms. Frankel and her family. While we respect the jury process, the medical group is presently considering its legal options. We believe that the care provided by the Palo Alto Foundation Medical Group was appropriate. We appreciate the trust that the community has placed in us for the past eighty years to provide the best possible care for our patients. The safety and health of our patients has always been, and will continue to be, our highest priority.”

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Posted by Hmm
a resident of East Palo Alto
on Mar 21, 2012 at 4:36 pm

Take a chill pill, Staci. We weren't fighting, we were discussing. We can't changed what happened & were allowed to dumbs use what we want - its a public board. I found Holly's point interesting; if you don't, skip the posts.

So did the angiogram happen at PAMF or Stanford? Maybe Stanford referred her to PAMF or vice versa?

2 people like this
Posted by Reader
a resident of Portola Valley
on Mar 21, 2012 at 4:51 pm

All of you have got it wrong and this is why you pay so much for health insurance. PAMF doctors merely recommended the patient for further evaluation at Stanford Hospital. Stanford hospital doctors are the ones who presented and performed this incorrect procedure. Stanford knew their guilt and settled out of court. The victims then sued PAMF also, whom merely referred the patient. Thats right, merely referred for evaluation to the Stanford experts. PAMF Drs are not guilty of anything but doing their job as one would expect of them. So they fought and were penalized by another stupid jury. Now go and pay your increase in medical insurance or write to congress to stop this nonsense!

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Posted by Hmmm
a resident of East Palo Alto
on Mar 21, 2012 at 5:58 pm

So, Reader, we're stupid because we don't have facts, as you do? Get some manners, please. Sounds to me like you lack some crucial facts.

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Posted by Pepper
a resident of College Terrace
on Mar 21, 2012 at 9:33 pm

Reader and Wally:

"The pain and suffering award <$6M> would immediately be brought down to $250,000, the cap under the Medical Injury Compensation Reform Act of 1975"

Happy, now?

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Posted by Mom
a resident of Duveneck/St. Francis
on Mar 21, 2012 at 9:50 pm

This is why we pay so much for Health Care. People make mistakes. I feel terrible for the victim, I feel bad for the Dr who has dedicated their life to serve and I feel bad for all of us because now our health care costs will continue to rise... It is madness. :(

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Posted by no name
a resident of another community
on Mar 21, 2012 at 11:15 pm

This is a hard one, I believe it was not right that this patient Ms. Frankel was not given informed consent. When I look at this situation based on the facts given in the article. I think PAMF doctors should have maybe stated possible risk factors, but in the end it seems to me that the interventional radiologist at Stanford performing the exam should have been "responsible" for informed consent. Because in the end they are the ones performing the exam they are very familiar with what is going on and do these exams on a regular basis.

What happen to Ms Frankel is so sad, But I don't think it should be the fault. I do understand the real argument here Ms Frankle was not informed of the risks that may be imposed on her due to this exam. Something you should you ask yourself.... is even if Ms Frankel was given consent would she have done the exam anyway?? We will never know.....We live in an era where we have so much technology Mammograms, CT scans MRI scans, Angiograms, etc... That save so many lives, but what are the chances of this happening???? I really hope what happen to Ms Frankel doesn't scare anyone else who might really need this exam. Yes a lot of us put our trust in the hands of our doctors to do the right thing but they are humans too! I'm just saying that we have to be our own advocates too when it comes to our healthcare Although we still need to trust are doctors advice in the end I feel that research is key.

Gosh if I had a choice Id rather be poor than experience what Ms Frankel has to go through for the rest of her life. I do hope this money really helps her and her family.

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Posted by Terry
a resident of Midtown
on Mar 21, 2012 at 11:25 pm

[Post removed by Palo Alto Online staff.]

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Posted by payer
a resident of Palo Alto Hills
on Mar 22, 2012 at 3:23 am

that explains my increase for the last 2 years...and consent forms given to me all the time..even for simple evaluation...

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Posted by midtown dweller
a resident of Midtown
on Mar 22, 2012 at 8:40 am

Whether this type of settlement is fair or not is individual's perspective, but I applaud the victim's family for taking the matter to the court by fighting a long and expensive battle. The victim's health will not come back, but it created an awareness among the community that PAMF and Stanford, the two institutions that an average person trusts, are not perfect.

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Posted by Pepper
a resident of College Terrace
on Mar 22, 2012 at 10:15 am

"This is why we pay so much for Health Care." No, it's not. But even if it were respnsible for some significant increase, the question remains...

The $300,000 a year in expenses just to stay alive should be paid by whom? (Frankel's medical care costs between $300,000 and $350,000 per year, Woodson said.)

Loss of earning potential and previous earnings paid by ??????

The victim? The one making the mistake? The community?

Leave the victim out with the trash?

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Posted by Terry
a resident of Midtown
on Mar 22, 2012 at 10:26 am

Last night I posted a factual account of my personal experience of a failed surgery. Now I am surprised to find that paloaltoonline pulled the post, probably because I included the name of the surgeon.

My point was, that instead of relying on malpractice lawsuits, we would be better served by a method to research the track record of the doctors we choose.

As it stands now, you know more about the person who sells you something on eBay than your doctor, and paloaltoonline is no help.

The following is my original post with the name removed, you can decide if it should have been pulled.

"A few years ago I had laparoscopic surgery by *****. He/She explained all the risks, including the 1% thing that was real bad, but assured me that it would not happen to me. Well, it happened. I was quickly released form Stanford after an apparent successful surgery, but was back in the emergency room a few hours later. It took two more extreme surgery sessions, a new doctor, and years to recover.

I happen not to believe in malpractice lawsuits, so I didn't go there. I do wish there was a better way to evaluate our physician's track record before we entrust our life to them. Dr. ***** is highly rated at PAMF, except by me.

I should also say that there was an "on call" PAMF surgeon that took my late night distress call, diagnosed the serious problem over the phone, and saved my life. "

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Posted by Math question
a resident of Southgate
on Mar 22, 2012 at 11:28 am

So she sued both Stanford Medical and PAMF for all her medical costs and lost earnings? Sounds like she's getting compensated twice.

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Posted by Walter_E_Wallis
a resident of Midtown
on Mar 22, 2012 at 11:40 am

Walter_E_Wallis is a registered user.

I believe the victim of a medical error should be compensated for the direct cost of alleviating that error. I do not believe any party to an error should be allowed to settle separately, especially if the terms of their settlement remain secret.

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Posted by Satisfied Migraine Patient
a resident of Another Palo Alto neighborhood
on Mar 22, 2012 at 11:58 am

This is amazing. The PAMF treated me for migraine headaches for years with medication.

Finally, for other reasons I had a full hysterectomy - end of migraine head acres. Obviously my migraines were hormonally caused, maybe Frankel's were too.

I still have great faith in the medical treatment I receive from the PAMF.

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Posted by Nora Charles
a resident of Stanford
on Mar 22, 2012 at 5:56 pm


I'd read your original post and am puzzled why PA Online didn't merely remove the name of your doctor. (Sounds like quite an ordeal and I'm glad you're okay.)

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Posted by Annoyed
a resident of Old Palo Alto
on Mar 22, 2012 at 9:27 pm

So, PA Online why did you remove Terry's post? If it was because she mentioned the name of her doctor and there's some legal consequence in your printing his name, so be it. Otherwise I don't feel that's information you have the right to censor - especially in a section devoted to "comments".

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Posted by Tim
a resident of another community
on Mar 23, 2012 at 1:59 pm

I don't know the details of this trial and am not affiliated with any of the groups involved, but I think it is very bad to think you can identify a bad doctor based a single lawsuit like this...

Sure there are circumstances or facts that would suggest a doctor is not safe and better avoided... for example:

1) not informing the patient of known risks to a procedure
2) performing a procedure such as an angiogram that you had little or no experience doing,
3) an individual doctor identified in numerous medical lawsuits

However, the reality is that probably 10-15 doctors were involved in the lawsuit and it would be very hard for you as a bystander to know who, if anyone, really did something negligent. As a patient, I would suggest instead you focus on the organizations that provide your care and understand better how they police their own doctors. Otherwise innocent doctors may lose their livelihood because of the dark realities of the law and public opinion.

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Posted by Fleur de Lis
a resident of Crescent Park
on Mar 26, 2012 at 10:53 am

To obtain the doctor's name involved with the case, perhaps one can get the name from the civil court transcript of this case.

One can look at the case under the Defendant's name at and make sure the years listed are correct for this particular case to come up. Often, there are court transcripts for civil cases, although not sure if they are sealed or open to the public. One can get the court reporter assigned to that particular judge's courtroom and buy a transcript from that reporter, at least if the person ordering is authorized. I don't know if transcripts are available to the general public.

I looked up this case, and it just lists both Stanford Hospital and PAMF, no specific doctor named.

Fee is not too exorbitant if one can buy an unofficial transcript sent via email (I obtained a court transcript as a plaintiff in a civil court when the defendant on my small claim injury case appealed-- defendant lost again of course. Transcripts aren't available in small claims courts, but are available in civil courts, which is where appeals to small claims are held, if the judge allows a transcript!).

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Posted by Michele
a resident of Woodside
on Jul 21, 2012 at 1:18 pm

I was really happy to hear about this verdict. Thank God for her Attorney. [Portion removed by Palo Alto Online staff.]

The statistics are pretty interesting - 92% of people who suffer these serious types of injuries NEVER take any legal action. Only 8% take legal action; only 2% ever sue. It should not be that difficult to find a qualified attorney to take your case if it has merits as this one obviously did.

[Portion removed by Palo Alto Online staff.]

By using contingency fees, this helps to eliminate the cases which don't have legal merits because lawyers are not willing to work for free without hope of recovery.

Great doctors are a gift; and sometimes doctors also make mistakes. But that's why there is insurance. And if a doctor makes too many mistakes, just like a lawyer, they shouldn't be practicing. These cases help professionals to give serious thought to the cases that walk through the door before they do too much or too little. Medicine is a very difficult science - and the decisions about what to do and when should not be taken lightly.

4 people like this
Posted by Avon
a resident of another community
on Dec 26, 2012 at 5:14 pm

Hi. I'm a medical malpractice lawyer in New York.
A lot of times, doctors' names aren't published because if the jury found their Group liable and not its doctor, a doctor might be able to claim that it wasn't really he himself who was negligent. Then, the publisher and author could be sued for defamation for naming him as negligent (even though a libel lawsuit is hard to win).
Just as a bus company, not its driver, is the one with the "deep pocket" who can pay a verdict (and/or who has millions in liability insurance coverage), a medical group, not its doctor, is the one any plaintiff's lawyer is going to pursue. And he did.
However, Bovino's own website happens to name the doctor - even while reciting that the nurse who proved he was the one is also a former patient who idolized the man. Just goes to prove that even a superb doctor - or bus driver - is capable of making a mistake. My own theory is that he was simply frustrated by years of inability to find a treatable cause of the migraines, so he decided to play the odds, knowing that this serious an injury from an angiogram is exceedingly rare, even finding a cure by angiogram would be a very long shot.
Anyway, the name is Dr. Paul Jackson of PAMFG.

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Posted by John Gruver
a resident of another community
on Jan 3, 2013 at 3:27 pm

I was given a Hallux Rigidus procedure by the PAVAHCS Podiatry Department, without being told one word about what was going to be done...hence, there was no "informed consent". I felt like I was a damn Guinea Pig for them to "have their way with me" with total disregard for proper legal procedure! The procedure shifted the presume points on the bottom of my foot and I wound up with a blister on the ball of my foot the size of a silver dollar. Went back to the Podiatry Department and an "unsupervised intern" proceeded to cut off the skin flap covering the blister crater [one side was providing blood to the skin flap]. This was not the right thing to do. Then I was put in a boot and sent home with "outpatient care" as the plan [I should have been hospitalized!]. Ultimately this led to my right leg being amputated below the knee as if "by design" through a whole series of mistakes. The amputation was screwed up initially and in a revision. After the first revision a VA Prosthetist tried four sockets and could not get one to fit. I went to the complaint department and the Prosthetist was reamed out for telling me the truth in that the Doctors performing the amputation and the revision did not properly prepare the end of the Tibia to fit in a Prosthesis. It turns out he was supposed to "Lie by omission" and to hell with the patients best protect management's ass and the "Alleged" Doctor's asses! I researched trans tibial amputation literature and obtained x-rays of my leg taken after the first and second procedure. The bone was not cut square and the front edge of the Tibia was a "Chisel"...hence it was cutting into my skin and preventing me from ever getting into a Prosthesis! My wife and I met with the "Arrogant, Narcissistic, Egomaniac head of Orthopaedics. He pulled up on a computer, the side view x-ray of my last revision. Then he used the cad features of their system to draw a cut angle on the end of my Tibia that would make the chisel sharper! I said "No way"! and proceeded to show him what I had learned! He backed off and said "We will do what ever you want"! I spent a total of nine months in the hospital and suffered such pain that was beyond belief. I was screaming and the nurse kept coming in and telling me to "Keep it are disturbing the patients". My room mate kept saying "Get that motherf****r out of here"! After begging and begging they finally got the "Beginning Doctor" in charge of my pain medication to order me enough Morphine Sulfate to get my pain under control! What a bunch of crap! They made me a cripple without batting an eye!

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Posted by Kim
a resident of another community
on Mar 12, 2013 at 1:13 am

Responding to John Gruver:
I am so, so sorry for your suffering and the loss of your leg. That is just awful. I too, have had a horrible experience at the hands of doctors.

I think the way medicine is practiced these days, is designed to protect the doctors and the medicsl facilities at the expense of the patient.

Recently, I found a very good book on how to communicate effectively with your doctor and be your own best health advocate. The title is:
"When Doctors Don't Listen: How to Avoid Misdiagnosis and Unnecessary Tests" by Leana Wen, M.D. and Joshua Kosowsky M.D.

Sorry, but further commenting on this topic has been closed.

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