Negligence?

[nicolas]

Dr. Friedman,

I have a 5 year history of what I consider negligent treatment. As you will read - it is a long story - much of it relates to a series of independent events that I think each on their own represent unacceptable service, together they have been hell for me an my wife.

I am 39 years of age. 7 years ago I had a seizure in my sleep. I had an MRI, an EEG, a Sleep-deprived EEG, all were clear. The neurologist recommended no action but he suggested that I was to go in for a further consultation if it reoccurred.

Over a year later, I had another seizure in my sleep. The neurologist, a different one, recommended Dilantin. No other determination of the underlying cause was suggested. I decided against taking the medication.

The frequency of the seizures increased. At one point I had 2 in one week, but in general they were approximately once a month(all of the seizures that I have had were in my sleep). I saw yet another neurologist who again suggested dilantin. During this time I was constantly tired and my wife noticed that I stopped breathing in my sleep. I told this to the neurologist and he said that i was "not fat enough" to have sleep apnea. Dilantin disoriented me. I found it difficult to concentrate and found that I forgot what I had said minutes before. He suggested changing the dose.

I saw my 4th neurologist. I brought my wife with me. He again ignored the problem of breathing in my sleep and suggested changing medication to depakote and suggested an Insomnia Therapy course.

The psychologist at the course phoned my neurologist when she heard my wife describe my sleep problem. Due to her intervention, a sleep study was ordered. I have mild apnea and frequent arousals due to snoring.(In the Insomnia class, DR. Marcus, an intern of Dr. Phadke, who evaluated the sleep study - as he is the sleep specialist, announced in class that he had seen my results and that I did not have apnea. 2 weeks later, when the results were made available to me, I found that I did have apnea. He said in the following class that he had read the wrong results. He did not apologize to me directly, which is a feature common to all of the doctors/clinicians that are referred to in this story. I was put on a CPAP. After about 4 months, I found a CPAP/mask combination that I could tolerate(at the time I was a mouth breather, and the first CPAP malfunctioned - the pressure rose to 24 when I was awake, the technician's response when I said that I woke in pain and could hardly walk was "it takes time to get used to these machines").

With the full face mask I was still snoring. The seizure frequency reduced to one every six months but I was still constantly tired.

The seizures had damaged my teeth and a rapid palatal expansion was recommended to fix my cross bite. I found that I could breathe through my nose. I changed mask to a nasal mask and that cured the snoring problem. I was still constantly tired but the seizures stopped.

A year and a quarter later, I found that the CPAP was at the wrong setting(it was still set for a full face mask). I found out about this randomly online. I phoned my clinician and he said it would make no difference. I phoned the maker of the CPAP, resmed, and they said that it would(different leak compensations for different masks). They explained how to change the settings.

Since then I have been sleeping like a log and my concentration has improved tremendously. Also, hair is now growing on my stomach and legs(at 39 I am having my second bout of puberty).

I read some journal articles about sleep and seizures and contacted one of the researchers who recommended yet another neurologist. My insurance company has refused to pay for this consultation. I am going ahead with this consultation to double-check certain issues; namely: that a sleep study should have been undertaken earlier, that dilantin and depakote aggravate sleep disorders, that physicians cannot discuss your test results in front of others(and, obviously, cannot report the wrong results in front of others), and that malfunctioning CPAPs can be damaging(or at the very least lead to a lower quality of life).

If I get these verified, what legal avenues are open to me?

Thank you in advance(and apologies for the "long story" - there are other issues that I omitted to shorten it).

Myles

[Hughie]

Myles,

First off, I am glad you took your health care seriously and became your own advocate.  Too may patients believe healthcare providers are infallible and completely science based.  The reality is that "practicing" medicine is an art that is based on a science and the patient has to advocate for him or her self.

I suggest you speak to an attorney in your area who specializes in malpractice cases.  You can check with the State Bar or with the National Board of Trial Advocates www.nbtanet.org.  Based upon the fact you appear to have corrected the health problems, you may have a difficult time finding an attorney to file a lawsuit.  Usually, malpractice attorneys work on a contingent fee and your damages(although devastating to you) may not warrant an expensive lawsuit which could range up to $150,000 to retain experts.

You also can submit claims to your State's Board of Medical Examiners or Board of Osteopathic Examiners. These are the licensing Boards for the physicians and generally complaints are public records. Some State Boards or proactive and some are less than stellar. I wish you the best in your continued recovery and hope these are helpful suggestions.

Very truly yours,

Paul D. Friedman, M.A., Ph.D., J.D.