"My 11 year old daughter was admitted to the Kosair Children's Hospital on 1/16, after being seen in their ER and released on 1/9/15. Main complaints were stomach pain, weight loss, poor appetite, gagging and prolonged diarrhea. Upon admit, X-ray was performed, lab tests run, IV was started. We were slated to see a GI specialist while she was ipatient- this was the actual reason her pediatrician wanted her admitted, as wait times to see GI specialists can be months.
On 1/17, we were told that xray and all labs were normal, but that the GI doctor had left for the day without seeing my daughter, and would not be back. My daughter was discharged and we were told we would need to obtain an appointment on our own with GI doctor. After 12 days post discharge, we finally got in to see GI doctor, who pulled up my daughter's xray from 1/16 and informed us that she had an impacted bowel on said xray, which had been missed by Kosair. We had another xray on that day (1/28), and she was still in fact impacted. To date, we are still trying to get my daughter well, as she still has ramifications from the bowel impaction. I filled out an online form informing Kosair of my concerns with the fact that they discharged my child home with an impacted bowel, they let the GI doctor leave without having her seen during her admit, and that per the GI doctor- had misread her xray while she was admitted. A Kosair rep called me on 2/27 (Scott Stanton) and said that they would have their legal department look into the matter, as Kosair took the issue "very seriously". Scott contacted me today, and stated that Kosair had spoken to our GI doctor, and the doctor said that she was wrong, and no bowel impaction was present on 1/16 after all. I informed Scott that clearly either Kosair had pressured Dr Jeffries to change her story, or Kosair was not being honest. Scott would not answer any more questions at that point. Clearly, there is moral turpitude here, and Kosair is covering their tracks on poor care.
Update: 3/23/15
Dear Scott,
I am writing in follow-up to the letter I received from Kosair dated 3/2/15, with regards to my daughter xxx's inpatient stay on 1/16/15.
As you will recall, xxx was admitted for issues of prolonged diarrhea, nausea, weight loss and malaise. Her pediatrician, Dr. Harold Livera, advised us to have xxx admitted, as he wanted xxx seen by a gastroenterologist as quickly as possible. Since obtaining an outpatient GI appointment could take approximately three months, Dr. Livera felt her symptoms warranted an admission so she could be seen by a specialist quickly.
When we initially spoke, I explained that xxx was discharged without seeing the GI specialist, as Dr. Laroia informed us that there was a "communication error" and the gastroenterologist left without seeing xxx. We were also informed that there was no reason for xxx to remain inpatient in order to see the gastroenterologist on Sunday 1/18, as Dr. Laroia stated that "they had consulted with the GI doctors, and checked for everything they told us to check for". I asked if Kosair could please help us obtain an outpatient appointment with the gastroenterologist group, and was told "We don't assist with that...you will have to take care of it on your own." We were NOT told that "we can't help because it's Saturday", nor were we offered for Kosair to assist us with an appointment when the clinic was open on Monday...we were simply told "we don't do that." Your letter stated that no follow up appointment was obtained for xxx because 'the GI clinic was closed'...so let's be clear that was NOT what happened- no offer was made to assist at all.
In addition, I informed you that since xxx was discharged on 1/17/15 still ill, that we ended up back at her pediatrician's office on Monday 1/19/15, and we were blessed that Dr. Livera turned out to be a personal friend of Dr. Thomas Stephen, a member of gastroenterologist group who didn't get the message to see xxx while she was hospitalized. Dr. Stephen was kind enough to work xxx in as a favor to Dr. Livera. We finally got in to see his partner, Dr. Angela Jeffries, eleven days after xxx was discharged from Kosair.
During that appointment on 1/28/15, I informed you that Dr. Jeffries asked if xxx had either xrays, a CT scan or MRI performed while she was inpatient- we told her that an abdominal xray was performed but that we were informed by Dr. Laroia that it was "normal'. I also explained to you that Dr. Jeffries immediately pulled up that xray on her laptop and told us the xray was NOT "normal", but that xxx bowels were full of stool. In addition, Dr. Jeffries explained that this level of impacted stool can cause all of the symptoms xxx had...nausea, diarrhea, weight loss, malaise. We had another xray performed at your Brownsboro facility on that day-1/28/15...and xxx was still full of stool, just as she had been on the 1/16/15 xray. We started an aggressive series of clean-outs directed by Dr. Jeffries...xxx took a gallon of Gavilyte on one day, which didn't clear the bowel...so we moved onto several days of 10+ doses of Miralax (also not successful), and then several days of numerous enemas paired with additional laxatives. To date, we have had three xrays performed to check on progress, and xxx still continues to fight this issue.
I passed all of my concerns onto Kosair- as it seems clear that several problems arose during xxx's short stay: first, xxx was discharged home without getting to see the gastroenterologist; second, no attempt was made to help us obtain an outpatient appointment AND she was still symptomatic; third- her xray showed she was full of stool. Dr. Jeffries showed us the xray from 1/16, and it was evident even to us. Clearly, Kosair is in the business of helping children...and I think xxx's story serves as a great chance for both Dr. Laroia and Kosair to make improvements for the next kids that present with this issue.
Yet instead of hearing xxx's story and trying to make improvements, you call me and tell me that we have "been referred to Kosair's legal department"- which I thought was odd, since I made no mention of litigation- I simply emailed a short account of xxx's story. Several days passed, and you called me again to say that Kosair had spoken to Dr. Jeffries- you claimed that she stated that she did NOT tell us on 1/28 that xxx's xray was abnormal, and that Kosair felt they had not missed anything.
I asked you during that conversation how you thought I came up with this information? Why did you think xxx was being treated with massive doses of laxatives/colon clean-out drinks, if my story wasn't true? Clearly, had I known that being filled up with stool would cause xxx's symptoms, I could have helped my child get well WEEKS earlier. I also explained that now that I had been educated, I realized xxx's symptoms were classic for this issue- not at all unusual, but very typical. You told me that I needed to talk to Dr. Jeffries if I had further questions, and that Kosair had absolved themselves of any error.
Well, we did speak to Dr. Jeffries- as xxx had a follow up appointment with her on 3/11/15. Dr. Jeffries told us yesterday that she explained to Kosair that she did NOT think the xray was normal, because "being that full of stool is NOT normal". She also stated that it was not her place to tell a Kosair radiologist that they "were wrong", but that's why xxx needed to see the specialist when she was inpatient...because, as Dr. Jeffries stated, she or Dr. Stephen would have caught the issue on the xray on 1/17- and xxx could have started treatment for the issue immediately. Instead, we waited almost another two weeks before we could wrangle an appointment and xxx continued to suffer needlessly.
I realize that we live in a litigious society, but it is truly sad that Kosair is more concerned with avoiding liability than learning from mistakes. We did not threaten to sue Kosair, nor were we rude or angry...we simply wanted your facility to be aware of our experience. The children of this community rely on Kosair, and it is the duty of your hospital to accept when the proverbial ball has been dropped and improve itself. We did not intimate that xxx had lasting injury- we simply wanted you all to know where things went wrong, and how Kosair could avoid this going forward.
When a parent has a sick child, there is nothing in the world that is more frightening. I sat in a hospital room with my daughter -a 10 year-old child who had lost weight, had prolonged diarrhea and dark circles under her eyes, and who could not eat, and I hear Dr. Laroia tell her, "xxx...I think you got lazy over Christmas break, and you just need to get up and do something." And it is that moment-when you KNOW your child is sick- and you also know...you will get NO help here. So, it is truly to add insult to injury when you call to tell me, "that's not what happened...Dr. Jeffries didn't tell you that xray wasn't normal... because we talked to her.." WOW. That makes it pretty obvious that Kosair is going to find the results it wants to find...never mind the truth.
The parents of our community need to know this story...and I can promise you that we are sharing it at school, at church, at work, at the grocery- to anyone and everyone who will listen. And, it's NOT because Kosair needs to make improvements...but because you refuse to acknowledge the facts here, and basically tried to intimidate a doctor into saying what you wanted said. I like to believe that most physicians enter medicine with a desire to help, and committing moral turpitude on behalf of your facility won't happen...but if enough pressure is put on them by your facility, it is a very scary prospect for the children and parents of Louisville."