Was my doctor negligent? Your opinions please.

[bunnies]

Last edited Mon Aug 19, 2013, 01:38 PM - Edit history (2)

I was having a conversation about my situation the other day and the person I was talking with thinks so. It hadnt crossed my mind until she mentioned it, Ive just been really, really pissed. Heres the issue:

I started losing range of motion in my dominant arm about 8 or so years ago. It was very painful at first, but because I didnt have health insurance (or money) I never went to the Dr. about it. It went on to bother me for a couple of years but I just learned to deal with the pain. When it finally stopped getting worse, I was left with an elbow that didnt bend or straighten all the way, but it stopped hurting and I stopped worrying about it. From my internet searches I'd diagnosed myself with really bad forearm tendinosis and figured I had scar tissue built up at the elbow.

Fast forward to early 2011. I decided to take a job in the floral industry that involved a LOT of heavy lifting as well as hours of repetitive motions (pruning, arranging bouquets, scrubbing display buckets). To be safe, I decided to get a physical and finally have my arm looked at. I wanted to make sure it wouldnt get worse again. The x-ray, according to my Dr., showed that I had broken my elbow, not known about it, & that it had healed poorly. I was kinda surprised by this. Who breaks an elbow & doesnt know it? But whatever, she's the Dr. So I took the job.

Fast forward again to November 2012, when at the height of the holiday season, I was suddenly unable to use my arm in any meaningful way. The pain in my elbow was suddenly excruciating. I tried to work through it but would spend half my day sitting in my car in tears. So I went back to my Dr. She said she suspected nerve entrapment of some sort and told me not to work. My job made me file a workmans comp claim and the insurance co insisted I see an orthopedist. Upon my first visit to the Ortho, he reviewed that x-ray from 2011 and informed me that the pain was most likely due to the fact that my Degenerative Joint Disease had progressed.

My WHAT?

He ordered an MRI which confirmed that I have severe degenerative osteoarthritis of the elbow and also in my wrist as well as the significant tendinosis I had originally suspected. The MRI report was issued by the same company that read the 2011 x-ray. I obtained a copy of the report which clearly states evidence of DJD/OA was visible at that time. My doctor never told me that I had the disease.

As a result of her not telling me, I took a job that made my condition worse. I did EXACTLY what a person with my illness should never do. And now, Im at a point where I need my elbow replaced at 40 years old.

Had she told me, I would not have taken that job. Or I would have purchased their ridiculous excuse for insurance. It was over-priced and had a massive deductible, but I could have had the surgery and been back to my job under the FMLA.

I was denied workers comp due to the fact that I had DJD before I ever started working there. I was denied unemployment because I was "unfit" to return to the job I had. And now I have to live with this horrific pain every day and cant even lift a glass of water to take a drink. Im out of work, have no income, and sit around all day depressed because of the situation Im now in.

So... was my Doctor negligent in not telling me about the DJD? Is it reasonable to expect your Dr. to tell you somethings wrong? Would you expect your Dr. to tell you something like this?

Thanks for your input.

on edit: This is the language at the beginning of my latest MRI report.

"The prior studies demonstrated what appeared to be a large osteophyte from the radial aspect of the radial head and what appears to be an old radial head/neck fracture. Severe degenerative change at the radial capitellar and ulnar trochlear joint was also noted at that time. 05/03/2011 "

[nadinbrzezinski]

1. Yes, under current laws and practices they are supposed to

[bunnies]

2. Thanks.

Im not a litigious person. But Im starting to think she really screwed me on this one.

[Baitball Blogger]

41. Don't waste time finding a lawyer that specializes in medical malpractice.

Sometimes the they take into account the length of time it took you to respond.

[bunnies]

43. Yes, I was just reading about the statute of limitations.

Very short in these instances. I'll take your advice.

[LordGlenconner]

75. Tough call

I can't say I'm surprised though. I like to get second opinions but in your situation at the time that was probably not possible which is unfortunate because doctors, as much as we like to transform them into rock star status sometimes, make mistakes, too.

My best to you in an obviously shitty situation.

[LordGlenconner]

73. Those laws vary by state, FYI

[fasttense]

3. I would find a good lawyer

Yes, if you had a disease in your elbow and your doctor didn't tell you, I would consider that negligent. I would talk to a lawyer and apply for Social Security disability.

[Coyotl]

4. You are seeking advice from the wrong place. See an attorney at law.

[bunnies]

10. I guess thats what I was asking...

whether or not I should see a lawyer. Looks like a resounding yes. Thank you.

[Aerows]

69. YES

If you want it to be said louder. Good luck, my friend. You do have a case, IMHO. Attorney is in order.

[bunnies]

72. Thanks, Aerows.

I can be a little thick, but I think I've got it.

[Aerows]

74. I do my best :)

[petronius]

5. Certainly sounds like it - and I would be pissed, too

Did the ortho say anything about a poorly-healed break, or had that actually never happened? Either way, based on what you describe, I think I'd be seeking some legal advice (and a new doctor).

I'm sorry you're dealing with such unpleasantness...

[bunnies]

12. The ortho didnt mention a break.

Just the DJD. So I dont even really know if the "break" ever happened.

[Yo_Mama]

70. The X-Ray says fracture

I guess consulting a lawyer is the way to go.

[hlthe2b]

6. I doubt it... Not knowing exactly what the first physician said, it is hard to say, but

he did tell you that you had evidence of a broken elbow that had healed poorly. In medical parlance that equates to seeing evidence of degenerative joint disease.

Perhaps he/she didn't explain it in terms that were understandable or failed to fully make you realize what would increase its rate of future degeneration, but I would truly doubt that a medical board (or a civil proceeding with expert witnesses) would determine that the physician was guilty of negligence. Sorry, but in all likelihood (and I FULLY understand your hands being tied from lack of insurance that prevented your being seen at the time the problem first arose), a review panel or jury would conclude you to be negligent for failure to seek care earlier (at the time the elbow injury first occured, that might have prevented the start of DJD).


'Wish I could provide you with a more favorable assessment. I really DO understand and empathize with you.

[bunnies]

9. So its fair of her to just assume that I know that?

Ive broken many bones (back in my gymnastics days) and none of those breaks resulted in DJD.

[hlthe2b]

15. I never said it was "fair". You asked if the physician would likely be guilty of negligence.

I think many physicians fail to adequately explain things to their patients... (and likewise, many patients are too intimidated to ask questions, letting the physician know they don't understand).

Properly healed fractures typically do NOT result in DJD. That you had a fracture that was not properly treated certainly can.

I am sorry, but based on what information you provided, that would be my conclusion.

A lawyer could certainly speak with you more to the point, but be sure to go to a reputable one and not one that will string you along ($$) with little hope of prevailing.

What might be more helpful would be to go to a good orthopedic specialist, ask them what can be done at this point in terms of treatment (and AFTER they've provided that assessment, ask whether the previous physician was negligent in their opinion)...

[bunnies]

17. Thanks for the advice.

I already have the best orthopedic surgeon in my area. My only option at this point is a complete joint replacement. Im long passed anything else that could have been done, unfortunately.

[hlthe2b]

20. It is possible that might well have already been the case, had you seen the orthopod at the time

you saw the other physician. Might help to reassure you, if you asked your orthopod that specific question.

I wish you all the best. I have a bad ankle with DJD, despite having received the best care (surgery) available. So, I can really appreciate the devastation of having this chronic problem.

[bunnies]

33. I had a complete loss of surface cartillage during the time between x-rays.

I also have cysts in my bones and effusions that were not there before. You may be right though, it may have been considered "severe" at that time as well, but I never would have taken a job that I KNEW for a fact would make it worse.

Im sorry about your ankle. I feel your pain.

[Hekate]

25. "none of those breaks resulted in DJD" --> that you know of yet.

You are much too good at ignoring pain, bunnies. Yes, it IS possible to break a bone and not know it, if you refuse to go to a doctor and get a diagnosis even when the whole arm becomes nearly useless. That's called "denial" and it isn't the doctor's fault.

I write with a certain degree of sympathy, because my mom was like that, and no need to go into the details because this is your thread.

Reading x-rays or other imaging is an art, but afaik telling you that you had a break in the past is not inconsistent with telling you that you now have DJD. The bone was injured and not treated and now it is worse.

I hope at this point you allow yourself to get adequate medical care, including physical therapy. Please write down all your questions in advance -- and write down the answers. Then follow instructions.

All the best to you in the future.

[bunnies]

26. Thanks, Hekate

Thing is that I had DJD in 2011 but was not informed. She gave me no indication that my elbow would ever get any worse than it was at the time. Which was pain-free and functional.

Ive already had 3 months of PT, hyaluronic acid injections, 6 different medications and no relief. It so frustrating. I wont let something like that go again, thats for sure. Ive learned my lesson.

[hlthe2b]

34. "telling you that you had a break in the past is not inconsistent with telling you

Last edited Mon Aug 19, 2013, 03:29 PM - Edit history (1)

that you have DJD" YES.... (I originally misread what you wrote, Hekate, but I agree)....

The physician said they saw a "poorly healed" fracture at the elbow joint according to the OP. That "poorly healed assessment at the level of a joint" would almost assuredly relate to DJD seen at the time.

[kestrel91316]

28. Broken bones can only lead to DJD if they involve a joint.

I broke my tibia as a kid and it has never affected my ankle OR knee. The fracture didn't go anywhere near the joint surfaces, lol.

I do know how this works. We studied that in vet school, and I see the consequences of intraarticular fractures in practice.

[bunnies]

30. Heres what the report said about the break:

"The prior studies demonstrated what appeared to be a large osteophyte from the radial aspect of the radial head and what appears to be an old radial head/neck fracture. Severe degenerative change at the radial capitellar and ulnar trochlear joint was also noted at that time. "

[hlthe2b]

32. Her original injury was of the elbow, which if untreated, almost assuredly will lead to DJD.

[kestrel91316]

35. Yes, assuming it was intraarticular.

[sweetapogee]

39. yes

I agree with you. Suppose as an example a patient suffers a tib/fib fracture. So there are two issues, 1. the obvious fracture and 2. arthritis in the nearby ankle joint. The bone fracture mends but the arthritis develops and becomes part of the equation. The two go hand-in-hand. And there is in many cases nothing that can be done to prevent it. It's just the way things are.

I believe it would be very difficult to find fault in the Dr., in theory and not knowing all the details but rather difficult especially given the time involved, the lack of patient follow-up (medical and physical therapy) and not knowing what information is in the patients medical files. Generally we are responsible for our own health and a health care provider doesn't have to insist that the patient know every last minute detail of an injury. Not intended as an insult but the Dr. probably mentioned that arthritis was there, it's just as patients we get a bit of "information overload" at times like this.

By the way, medical malpractice is quite difficult and expensive to prove. The plaintiff lawyers and expert witnesses generally make their case by appealing to the emotions of the jury, leaving out details and boring the jury to tears. The defendants expert witnesses go by hard fact and established protocol and generally tries, usually sucessfully, to get the plaintiff expert witness to agree that in the same position, he/she would act in like manner. As I understand it, in this case it all basically comes down to what is in the patients files.

PS Workman's comp may be out but state disability is a possibility. In any event good luck!

[one_voice]

7. I would go and talk to a lawyer..

about this.

It sounds to me like you were misdiagnosed? I didn't see where the second doctor mentioned a broken elbow. Did he confirm the broken elbow in addition to the DJD? Even if this is the case, you should have been told of all your diagnoses.

I hope you find some relief, financially, physically, and emotionally.

[bunnies]

18. Thanks one_voice.

[Yo_Mama]

80. Not misdiagnosed

An untreated, badly healed elbow fracture can cause wear and tear on other joints in the arm, and according to the quote given, the old fracture was present in the X-ray, therefore the doctor can in no way be negligent for that. The reading says that there appeared to be a radial head-neck fracture. If never treated, other problems in the arm would not be uncommon:
http://www.assh.org/Public/HandConditions/Pages/ElbowFractures.aspx

The legal liability issue here would be whether the doctor failed to give the correct medical advice about dealing with the situation, thus causing other injury.

It's not a slam-dunk at all, and would depend upon what other doctors say. An uninsured patient with such a diagnosis has just about no treatment options. Appropriate medical advice would depend upon what the patient reported about her subjective experience.

The basic first-line treatment for this is pain management, movement, and exercise to build muscle, which seems to have a cushioning effect:
http://www.ucdmc.ucdavis.edu/welcome/features/20100414_osteo/index.html
I have really severe degenerative joint disease myself, and for me, what works is heavy muscle exercise. But some of the damage cannot be undone in these cases. You just want to stop the progression. Mine was caused by infection and so I stay on antibiotics to quell it, plus do the heavy exercise to maintain mobility.

If the patient had gone to the doctor when the symptoms first appeared and had not been diagnosed, then I can see that a suit would be successful. But in this case, who knows? Usually the advice to a patient with this situation is to stop doing anything that causes significant or worsening pain, but otherwise to MOVE.

As to the job worsening the injury, it may have. Or the joints may have worsened on their own regardless. Unless the patient specifically asked the doctor "Can I do this sort of job?", it's not clear that there's a malpractice case. And the correct medical answer to the question if it were directly asked would have been a referral to a specialist, which this patient probably could not afford.

[Harmony Blue]

8. You may want to seek legal help

this is fairly complicated.

[cynatnite]

11. The best way to tell if that doctor was negligent...

Is to get all the medical records and x-rays from that doctor and have another physician look them over.

Only another physician can say one way or the other.

If you suspect that the previous doctor was negligent, you might want to consult an attorney who knows how to handles matters like these.

[bunnies]

13. The ortho saw the DJD in the 2011 x-ray.

So did the radiologist who read it. My Dr., however, failed to fill me in on that little detail.

[cynatnite]

16. Accusing doctors of negligence isn't an easy or simple...

As I said, a thorough going over of all your records would be needed and an attorney experienced in these things would be the way to go.

I have spent a lot of years in the medical field and I can tell you for a fact that it's always complicated. If you can find an attorney willing to take your case, that might be your best option. They will have all your medical records reviewed by professionals who may not give you the answer you want.

[bunnies]

21. Im fine with whatever the answer is, really.

Im not chomping at the bit to sue my Dr. I dont want to make a case out of nothing... I guess thats why I was looking for input. I understand its quite possible she did nothing wrong. I just wish she'd have told me. My life would be much different right now.

[Xithras]

14. I think you should absolutely talk to a lawyer.

I'm a law school dropout, so take my legal opinions with a wheelbarrow full of salt, but you may have a case. Or you may not. It may be a good one. But maybe not in your area. That's the most accurate answer you're going to get in this thread.

More importantly, however, is the fact that very few people on DU really have the knowledge to tell you that you DON'T have a case. You might get a unanimous chorus of "you have no case" statements here, and they could be 100% wrong. Find a lawyer who deals with this kind of thing, and ask the lawyer...he or she is the only person who can really give you a correct answer. You also have to remember that it's not just a question of whether or not you "have a case", but what the actual value of that case is, and what your realistic odds are of winning it. A case like this may fly in New York, but fail to find traction in Omaha. Many lawyers will provide you with an initial consultation at little to no cost, and can provide these answers quickly. Unless you find an attorney on DU who specializes in medical malpractice cases within your own jurisdiction, and has experienced cases dealing with the kind of work aggravated injuries you're describing, you're not going to get an accurate answer here.

[Egalitarian Thug]

19. From what you've written, I would certainly seek out an attorney. But be extra-vigilant in

making your decision on which attorney. It is of course not legal, but the fact is that when you sue, you will likely never be employable again. Once that is done, you will most likely get to go through the disability process, so you have to make sure you get enough at each step in the process.

[bunnies]

23. Why would suing make me unemployable?

Not that Im employable now... but Im curious.

[Shrike47]

29. Suing labels you as an injured troublemaker.

I know an attorney who sued her first employer after law school and could never get a job again.

[bunnies]

31. ugh.

I cant win!

[Egalitarian Thug]

38. Unwritten and completely unlawful blacklists that have existed probably forever.

Sue your doctor(or more likely his or her limited liability company), sue your employer, sue a bank or insurance company, or sue anyone that matters, and your life becomes more difficult in all kinds of ways and finding employment is one of their favorites.

It's not hard and fast, and maybe you are established enough in your community, just go in with your eyes open and don't let yourself be talked into a settlement that won't get you what you need.

[bunnies]

42. There seems to be a never ending list of ways...

to kick people when theyre down. I feel like the system simply abuses people. What an eye-opener this experience has been.

[Egalitarian Thug]

50. I'm sorry to say that I agree completely. It's all terribly wrong, but most people

simply refuse to believe it until they are on the receiving end or they make their living from it.

All that's really changed over the last 30 years is that more and more Americans have found themselves on the receiving end of what's been going on for a century.

Anyway, I'm sorry for what you've gone through and I really hope you can make this work for you. I do know that New Hampshire is a bunch of very small and tight-knit communities, so work those connections hard. Having the right people on your side makes all the difference.

Good Luck!

[bunnies]

55. Thanks Thug.

I appreciate your sympathy and advice.

[zipplewrath]

22. Depends upon what you asked her

Her attorney is going to try to make it your fault. What did you ask her? What did you put on your "new patient" intake forms. Did she have reason to believe you already knew?

I'd probably get an attorney, but in the end what you're really going to need is to either get "cured" or to get some sort of disability coverage.

[Boudica the Lyoness]

24. I have ran into this

Here's one example;

I had an autoimmune doc who wouldn't bother to tell be the results of MRI's, blood work and other various scans he'd ordered. So I thought everything was fine. As one appointment was ending I asked him about all the X-rays and scans I'd had 4 months prior. He had forgot I had them and looked them up on his computer. After looking at them he said my back was very bad and could easily fracture. He'd known for 4 months how bad my back was and never warned me! What if I fell off my horse? I quit riding once I understood my condition.

I've had to endure two back surgeries this year and I suspect the neurosurgeon screwed up the first.

I hope you look into what you can do about your doctor. They need to be held accountable.

If you can afford a replacement, do it ASAP. Don't suffer. I had my ankle replaced and wish I'd done it sooner.

[bunnies]

27. !!! Thats HORRIBLE!

What if you had never asked about the tests? Im so glad nothing happened in the 4 months your Dr. knew. You obviously know exactly how I feel except in my case something did happen in the interim. My Dr. is SO bad that she almost didnt go over the MRI results of my wrist until I reminder her I had one. And to this day she has never mentioned that she knew I had DJD in 2011 when she did the first x-ray.

As for the replacement, my ortho wants me to wait as long as possible because they only last 15-20 years. My rheumatologist, otoh, says I should do it ASAP since I have so many cysts in my bones. She even gave me the name of a surgeon at Mass General who will do it... but I cant afford it at all. Not even close.

Im so sorry to hear about your back. I can't imagine what that must be like.

[Raven]

36. Take your medical documents to a

personal injury lawyer who specializes in medical malpractice. He/she will "rate" the case. These types of lawyers usually work on a contingency fee basis.

[lynne]

37. Who read and interpreted the initial x-ray? Your physician or the radiologist?

Many times physicians go by the radiologist report as to what the x-ray is showing. Am guessing they'd need to determine how much the disease had advanced between the two x-rays and what, if anything, could have been done at the time of the earlier x-ray to prevent worsening of your condition. They'll certainly look at those 8 years where you had the condition but did not see a Doctor as not seeking medical help then may have made your condition worsen at a more rapid rate now.

Either way, you should talk to an attorney.

[bunnies]

44. The same radiologist that read my new MRI.

I added to the OP the exactly language that the radiologist used when referencing the initial x-ray from 2011. It clearly states that severe degenerative changes were noted at the time.

There is no question that the job I took exacerbated the condition. I'd never have taken that job had I known.

[Quantess]

40. Wow, that sucks. I am sorry to hear it.

[msanthrope]

45. I am a lawyer, but I am not your lawyer, so, let me give you this non-legal advice:

Call your local Bar Association and see if they have low-cost referrals....you get a 1/2 hour at a set price with an attorney. See if you can get more than one.

Call your local law school and see if they have a clinic where you can get a referral.

Call around to different medical malpractice attorneys. See if you can schedule a low-cost interview.

You need a malpractice attorney. Not one who specializes in "personal injury" but in malpractice, since this is a highly technical and difficult area of the law. You should be looking for a contingency basis--but be careful with the fees charged. You don't want someone who is going to take 40% of your settlement and THEN is going to tack on excessive fees. Ask for references and past clients.

Okay--here is my semi-legal advice--suing a doctor is difficult, and most states make it so that you can only sue if you get enough medical evidence against that doctor--i.e. the testimony of experts. So you need someone who is used to doing this--not some hack who does personal injury car crashes, but someone who has done medical malpractice cases.

This will be a long, long process, but YOU MUST GET YOUR BODY TO A LAWYER SOON because if you note the date on your first x-ray, you are two years past that test, and I worry that you may be in a jurisdiction that might have some sort of statutory limit on how long after you can claim.

And you must do this--because what you have is serious enough that you may be facing a lifetime of pain and debilitation. Good luck!!!

[bunnies]

48. Thank you so much.

I just (moments ago) found a guy in my town that does only medical malpractice. His website says he doesnt charge anything unless a settlement is reached. Id love to get a lawyer from a city like Boston... but I have a standard and cant really drive anymore... certainly not that far. It seems there are WAY more personal injury lawyers than those in med. malpractice. I was wondering if there was a difference. Thanks for explaining it to me.

I hate to be in this position but I feel like my Dr. not telling me about the condition led me to take a job that was certain to make my disease worse. To this day, she has not acknowledged that I had DJD in 2011. She acts as if the 2013 MRI is the first she's heard of it.

[pnwmom]

77. Helpful, informative post. n/t

[MineralMan]

46. No, the doctor may not have been negligent, really.

You neglected an injury and visited the doctor only after your elbow had healed incorrectly. That was the cause for the degenerative changes in the joint. You didn't say whether you asked the doctor whether the job you were about to take would cause further injury or what the doctor's answer was.

The second doctor ordered an MRI because the injury had become acute from your work. That MRI detected the degenerative changes, and confirmed the previous doctor's diagnosis. The degenerative changes may not have shown up in the initial x-ray.

The job clearly made your injured elbow worse, since you had to do lifting with an elbow with limited movement. Damage was done by that work. However, the injury existed before you took the job, so you don't qualify for workman's comp. You opted out of the available health insurance, so you have no coverage.

This started with the original injury, which was neglected, as often happens. It healed, after a fashion, but not properly. Had your elbow been x-rayed after the original injury, it might have healed properly and you might have avoided your current situation.

Did the first doctor make a mistake? Perhaps he did, especially if you asked him about the job you were considering. If not, then probably there was no mistake. He told you about the poorly healed fracture, which he saw in the x-ray.

Sadly, the high cost of healthcare is probably why you attempted a self-diagnosis of your injury and did not seek treatment. A lot of us have similar injuries that were allowed to heal as they might, without being treated. I partially tore an ACL in my knee, skiing in my 20s. I did nothing about it, and it seemed to heal. Now, I'm 68 years old, and have discovered that it did not heal properly and my knee is now in crappy shape. My fault for not seeking care at the time of the injury, but I had no insurance and it got better on its own, sort of.

The fault is the high cost of healthcare, really, and there's nobody to sue, I'm afraid.

[bunnies]

49. The degenerative changes DID show up in the original x-ray.

Thats why Im so pissed about it. The excerpt in my OP contains what the radiologist noted from his review of the original x-ray on 05/03/2011. I accepted my responsibility in the poorly healed fracture, but had no reason to think I was at risk for additional deterioration. She knew I had DJD in 2011 but neglected to inform me. I'd have never taken a job that was certain to make my elbow worse.

In the course of doing that job, I developed bone cysts, effusions, hypertrophy and lost 100% of my cartilage, among other things. The degeneration has been rapid due to my accepting that job. I just think she should have told me I had the disease. Instead I found out after it could be treated.

But youre right. Were I able to get it treated initially, I'd probably be fine right now. Lesson learned.

[MineralMan]

51. That was a couple of years ago.

The thing is that it can be difficult to remember exactly what was said by anyone from two years ago. The doctor did tell you that your elbow had healed poorly. At that time the degenerative disease might not have been very advanced. If the doctor didn't know that you were thinking of taking a job that required lifting and arm extensions, he or she may not have mentioned the degenerative disease, figuring your limited motion problems would limit your use of that elbow.

I don't know, of course. But it also may have been mentioned and been forgotten. I don't know that either, but I know that when I visit the doctor, I stop immediately after the visit and make some notes about what he or she said to me. That's because I know that I will forget some of it within a reasonably short time.

I have tendonosis in my left elbow, too. It's diagnosed. If I overuse that arm, which is my dominant arm, by lifting and carrying heavy things, it gets worse. My doctor diagnosed the tendonosis, but didn't offer any suggestions about limiting activity. I learned my limitations myself. Now, I carry loads with my right arm, and avoid overextension of my left arm, out of habit. So, there's no pain, normally. However, if I forget or have a reason where I need to use that arm more than usual, it lets me know that I need to be careful.

It does sound like you chose a job that caused further injury, and that's not a good thing. I'm very sorry that you are experiencing additional pain and suffering, but I doubt that there is any case against your physician. Since what you were told or not told can't really be proven, I doubt there's much recourse in a legal sense. Since it was a verbal thing, it becomes simply one person's word against another's. It's all very unfortunate.

I hope you can get treatment that will help.

[bunnies]

56. Thanks for your thoughful, reasoned responses.

Thing is, Im very OCD about medical issues. I research every diagnosis extensively as soon as its given. There are several people in my life who remember my telling them about the break. It seemed very weird to me at the time. Im certain she never mentioned anything about the OA. She also didnt diagnose the tendinosis which led me to believe that I had misdiagnosed myself. There is also no mention of arthritis in my medical records from 2011, despite the fact that the radiologist stated it in his report.

If she had told me that I had arthritis and tendinosis I definitely would have learned what activities to modify myself. I just wish Id been given the information I needed to do it.

Anyway... thanks again for input. This is why I asked the good people of DU. I knew you all would give it to me straight.

[MineralMan]

60. I try to help. Sadly, I couldn't offer much in this case.

I hope you have success in finding treatment. You could talk to an attorney, but I think he or she will tell you much what I have. I could be wrong, though.

[bunnies]

62. You've helped me a lot, really.

Suing hadnt occurred to me at all until my friend mentioned it and Ive been waffling about it since then. I dont even want to consider a frivolous suit and while there are lawyers who are happy to attempt them, thats just not the kind of person I am. Your input has been valuable to me.

[Yo_Mama]

81. Yeah, it really is the unaffordable nature of healthcare

But a lot of us do this. Most things do heal on their own, and people can't afford to spend hundreds of dollars to be told "take it easy for a while", and then if we can't afford to do that, what would we do if we were told "you need some really expensive care, but it may not work too well?"

It's a mess. But we're all supposed to be working till we're 70, any way.

I think TPTB are going to get an awful surprise when they find out what disability awards look like when they try to raise the full SS retirement age again. An awful lot of us just aren't physically able to to work to 65, much less 67 or 70.

[REP]

47. Not really ... (not siding with doctor)

DJD is a catch-all phrase for arthritis. And there's many kinds of arthritis. DJD can be from wear-and-tear arthritis or from inflammatory arthritis or from hereditary arthritis or a combination etc. and it can be made worse by your job. You should fight the WC ruling; you may have had arthritis but the job caused the injury.

The doctor may have not have specifically said DJD because it doesn't really mean anything different from arthritis. If no guidelines were given, such as to avoid activities that increased the pain in that arm (etc), that would be negligence I believe.

I have the same catch-all diagnosis, but my problem is in my elbows and shoulders. I'm having my second shoulder surgery in six weeks (I need a full replacement on one side but don't want to do it) and will have my elbows worked on next year. You have my empathy; it hurts like hell.

[bunnies]

53. She never even told me I had arthritis.

thats the point. ALL she told me was that I had a break that healed poorly. Done deal. She never told me to avoid doing anything with that arm. Never told me that I could expect it to get worse. Never told me anything about it. I didnt even know what DJD was until a few months ago.

Severe Osteoarthritis is one of the things I have. Ive tested negative for the RF but am HLA-B27 positive. Lucky me, right? Im currently suspected of having psoriatic arthritis as well. But the OA was visible in the 2011 films.

You are the first person Ive encountered that has it like I do in the elbows. I didnt mention in the OP that I have shoulder pain as well. And since I have OA in the elbows and wrists, I pretty damn sure its the thing thats getting my shoulder too.

I really, really, really, feel for you. I know how much pain you must be in. My threshold is high (obviously) but when you shoot up out of a dead sleep because the blanket moved slightly under your arm, its a kind of pain you just can't get used to. Sometimes I think it would be easier not to have the arm at all. Sounds crazy to most people, but I bet you know what I mean.

[REP]

66. Actually, I got used to it - don't like it, but it's my normal

I have no cartilage in my upper joints anymore, and have developed bone cysts. There was a 3" bone spur in my right shoulder that was tearing my rotator cuff every time I moved - for over 20 years, and it wasn't visible on MRI (the tear that never retracted was; the spur wasn't). I have hypermobile joints and that may be why I have such bad arthritis; I've had problems since my teens. It's in my spine as well; this month I'm having trouble walking because a spur is pinching a nerve pretty badly but it seems to be getting better.

For years, I didn't have a diagnosis; it was only because I insisted I have the shoulder surgeries that the first one was done; no one thought it'd do much good (I had the end of my collar bone cut off; bone spurs removed and the partial tear repaired) but once they got in there they saw what I could feel It's not really OA; it's more of a SA or IA or a WTF A. Basically, I'm growing bone everywhere I don't need it!

And yes, I've considered removing one or the other arm. They wouldn't go for it.

I did use to get 7-8 cortisone injections in my elbow at a time and another 7 in my shoulder. And looked forward to it!

Good luck and good drugs

[bunnies]

68. Holy crap!

Now I feel like a total whimp! I have a spur that catches my ligament every time I move my arm. omg, that sound! But thats just one of the spurs I have at this point. My cartilage is gone too, subcortical cysts, edemas, effusions, hypertrophy... pretty much every horrible thing associated with WTF A. I try to explain it to people by asking them to imagine getting their elbow smashed with a sledge hammer and having that pain never, ever, go away.

We skipped the cortisone and went right to hyaluronic acid with no improvement. I had such high hopes for that. Anyway, Im in complete awe of the strength you possess. Really. Im totally blown away. Ill be keeping you in my thoughts and sending vibes for a successful surgery. Id love to hear that it all went well, when it does.

[REP]

91. Have you tried PRP injections??

(Platlet-rich plasma, from your own blood) If not, you totally should. You know what the elbows are like, so start from there and I looked forward to having needles jammed into the reduced joint space for cortisone. Then I exceeded my lifetime allowance of injections and my doctor retired ... and I got referred to ortho, where the elbow specialist said Let's Try This before doing a Tommy John so I said hell yeah (repairing the tendon surgically hurts more than the injury for the first YEAR, ow, but it was horrible). Well, the PRP hurts more than cortisone and doesn't work immediately, but holy shit, the epicondylitis went from 1000 to about 20 - mostly okay, with rare bad days instead if rare good days. Check it out - it's noninvasive and could bring significant relief!

And remember: it's not a contest! The worst pain is the pain you have to deal with But complaining is fun.

[bunnies]

93. No. I havent even heard of them!

Thank you so much... I'll definitely talk to my ortho about it. He basically says theres no hope for the epi until the elbow gets replaced. But Ill try anything at this point. I almost passed out on my third HLA injection. heh. But Ill try another shot if it could even remotely help.

[Deep13]

52. The only persons who can give you a competent answer...

...are either another doctor in this field or else an experienced malpractice lawyer.

Do not accept legal advice from amateurs. Statutes of Limitations in particular is a nuanced area of law that often depends on when the patient discovered possible negligence, not necessarily when the injury happened. So, talk to a pro, not to DU.

[unblock]

54. talk to a lawyer, but this is hardly a slam-dunk:

if the doctor can show notes and/or a follow-up visit or call after the initial mri, it's going to be tough for you to prove that the doctor didn't fully explain what was in the mri report.

"negligence" is a whole lot easier to prove when the a condition gets progressively worse over a series of office visits during which the doctor fails to prescribe something they should have, or the do prescribe one thing they shouldn't have.

my brother once had a doctor prescribe him a medication (cleosin) which was specifically contraindicated for patients with allergies to mycins, which he was. that was a relatively straightforward case.

simply failing to inform or explain thoroughly is a lot harder to prove and win.

[Avalux]

57. You had a fracture that healed poorly, with a lot of scar tissue.

The doc who made the initial diagnosis neglected to tell you about the OA/DJD, but they all are related. Have you had an MRI done of any other part of the body, such as your spine, to confirm OA or DJD elsewhere?

If it's confined to the elbow/arm, then it's a direct result of the injury, or fracture. Defined as post-traumatic osteoarthritis.

I'm sorry but I don't think you have a case of negligence.

[bunnies]

61. Ive had an mri of my right wrist as well...

which showed OA in my wrist and thumb joints (though not as severe as my elbow). Its also suspected in my right shoulder, though Ive yet to have tests confirm that. In fact, I recently saw her about my shoulder pain and she said it was nothing. Didnt even bother to write it as the reason for my visit on that day. Thats how incompetent she is. Ive also recently tested positive for a genetic marker shared by 90% of people with arthritis. Because of that I now know to expect more joints to be affected.

She has yet to acknowledge that I had either OA or tendonosis prior to the most recent testing. And I had no idea that OA was related to breaking bones. She didnt tell me any of that. I wouldnt be in this situation if she had.

[Avalux]

67. Do you have the option of going to another doc?

I'd recommend that as your next step, since this one has lost your confidence and doesn't appear to care about your concerns. You can fire her, and hopefully you'll be able to and then take all of your records and visit a doc who will listen to you.

I'm sorry you're going through this and hope it all works out.

[Warpy]

58. Your doc's major lapse was in not

referring you to an orthopedist back in 2011. That doc likely ASSumed that since you didn't have much money, you couldn't afford a specialist.

Now you need to file for SSD. Lacking the use of one arm, you are disabled. You also need to visit the local welfare office, see if they can set you up with TANF and Medicaid until the SSD and then Medicare kick in.

And if it makes you feel like less of a freak, I blew off a stable broken neck. It didn't hurt that much more than usual.

[bunnies]

63. A broken neck?!!!

Good gods, warpy! Thank you. I do feel like less of a freak. Im in the process of SSDI now (my initial claim was denied) and waiting to hear from the state about medicaid.

Do you know... she NEVER referred me to an ortho. She never referred me to anyone. What she told me (in 2012) was to get health insurance and let her know when I had it. I brought myself to the ortho on my own after that. My ortho, otoh, referred me to a rheumy and a neurologist in an attempt to figure out what the hell is going on. I'd have been a candidate for procedures in 2011 that are not available to me now. As per my ortho.

She should have referred me. Youre 100% right.

[Warpy]

87. You might have enough of a negligence case

to settle out of court, but I doubt if it would get to court and survive there. It's even a long shot for a settlement.

It would be a case of he said/she said because that doctor documented it in the chart, just failed to inform you of it or make a referral. She, of course, would probably say she informed you fully and it was up to you to find an orthopedist.

[bunnies]

89. She actually *didnt* document it at all.

The documentation I have that mentions arthritis from 2011 came directly from the radiologist. My 2011 records from my primary care Dr., make no mention of the arthritis at all. I have them (the records). This SAME Dr. failed to note that I saw her as a result of sudden symptoms brought on while I was working. She effectively killed my workers comp case with that omission. A real piece of work, my Dr.

[Warpy]

90. That omission from her records just improved the odds

I think it's worth talking to a lawyer since the problem was treatable had she not withheld information and is not treatable now.

The lawyer will give you a better idea of your odds of a settlement versus compensation for the lost use of your arm and lost ability to work.

[bunnies]

92. Thanks for all your help, Warpy.

I guess it cant hurt to contact a lawyer to see what they have to say. It probably further helps that she neglected to note that I was hurt at work, and that when I went to see her last, for shoulder pain, she made no mention in my records of that either. She just shrugged me off and said "dont worry about it" despite the OA in my other joints.

[Aristus]

59. Did your previous provider look at the actual x-ray, or read the interpretation

from the radiologist? If she saw the actual x-ray, and interpreted the results herself, she may have misinterpreted the finding on the x-ray as an acute fracture, rather than DJD. Misinterpretation is not the same as negligence.

However, if the radiologist interpreted the results as DJD, put it in his report, and your doctor read the report and failed to assess and treat for DJD, then she is negligent.

In the future, if something like this happens again, don't wait a few years to get it evaluated. A community health clinic may be able to see you for a low, up-front flat fee, plus billing on a sliding scale according to income. The ACA may make acute care more affordable, however. I certainly hope so.

[bunnies]

64. She read the interpretation.

Just so happens that the same company interpreted the recent MRIs. The radiologist report notes "severe degenerative change at the radial capitellar and ular joints" as well as a "prior radial head/neck fracture". She told me about the fracture, nothing about the degeneration, which was already severe at that time.

Ive learned my lesson about letting injuries go though. I wont be doing THAT again. Too bad I had to learn the hard way.

[hunter]

65. No, Congress is negligent.

This nation needs a single payer health care system, a generous publicly funded disability, welfare, and retirement system, and a very tightly leashed private insurance industry.

From my personal experience the insurance companies do everything they can to shed you as a customer once you are diagnosed with a chronic health problem.

My wife currently has insurance through her work, but we've previously run out COBRAS, leaving me uninsured, and my wife in the state's high risk insurance pool.

Joint pain sucks. I usually get up in the morning because it hurts too much to sleep anymore. I used to take a lot of ibuprofen, which worked, but then it messed up my stomach. Then my doctor put me on celebrex, which was advertised heavily at the time, but our crappy insurance wouldn't pay for, and I paid for it myself and that messed up my stomach too. (The makers of it had simply lied about that, throwing out studies that showed it to have the same side effects as other NSAIDS.)

I know my complaints don't help you, and I don't know if your doctor was negligent or not, but I hope you find some mild drug that helps with the pain, or if it comes down to that, some way to get the bad joint replaced. (I'd have to be hurting pretty damned bad for that... I hate knives and needles and hospitals...)

Good luck.

[bunnies]

71. Agreed.

If we had a singer payer system I'd have gone to see a Dr. when I first started hurting and things would be much different now. I wish I had gone anyway... but I just couldnt afford it.

I know what you mean about losing sleep. Damn, do I know. And absolutely none of the 5 drugs they've prescribed me thus far have helped out one bit. Celebrex was one of them but now they're just giving me pain meds (which I HATE). And like you, I dont feel like the side effects are worth it. Especially when they dont help the pain at all.

I even went through (very painful) joint injections as a last stab at easing the pain. But it hasnt worked for me either. Honestly, Ive never wanted to be in the hospital at all never mind actually wishing for surgery. But I'd go through ANYTHING to make this stop at this point.

Joint pain sucks. Amen to that.

[pnwmom]

76. The best way to find out if you had a good case against the doctor

would be to go to a lawyer specializing in malpractice cases. Usually you won't have to pay because the fee structure is based on winning. If they win a case, they get a percentage of the proceeds. That also means they won't take you on unless they think you have a strong case.

Good luck!

(If you were denied U.I. because of a disability, could you qualify for Social Security disability?)

[bunnies]

78. Im fighting SSDI now, also.

They denied my initial claim. Shocking, eh? Cant use an arm? Tough shit, get a job. They have no idea what job, though. Heartless bastards.

Thanks for the advice on the lawyer!

editing for clarity.

[pnwmom]

79. On SSDI, I've heard that they almost always reject people on the first try.

So don't give up! Wear them down, if you can . . .

[Glimmer of Hope]

82. Did you challenge your worker's comp denial? I think it is standard practice

for insurance companies to deny claims. It seems your floral industry job certainly contributed to your disability. There are lawyers who specialize in this too.

Sorry this is happening to you!

[bunnies]

84. I didnt, actually.

Because my wonderful Dr. neglected to write down that the injury happened at work. She put NOTHING in my records about it whatsoever. There is only a passing mention of "now crying after work". The ortho recorded it correctly, but since it was a couple of weeks later, a lawyer advised me that it would look like I lied about it happening at work.

[FarPoint]

83. Doctor is not negligent....

Degenerative Joint disease is comon arthritis. You yourself seemed surprised about the old elbow fracture ....which would escalate the arthritis process. Unfortunately ...due to hard times...prudent care was difficult ...I completely understand.

[bunnies]

85. So, it was ok that she never told me I have arthritis?

I had no idea a fracture would result in osteoarthritis.

[FarPoint]

86. It's very common ...

It would of been nice for her to share the report ...you probably were being treated palatively with anti- inflammatory meds already which also addressed the arthritis . The elbow fracture happened ...the arthritis probably contributed but not the cause. You do have long gaps in treatment which also hinders effective management. Sorry for your suffering. I wish I could help. Maybe you could process with the doctor for a more aggressive treatment plan. I heard Remicade IV is therapeutic. There are several good options to explore.

[bunnies]

88. She actually never treated me for anything.

Not until just recently, with pain meds. Prior to the pain meds in 2013 she didnt give me anything for my elbow/arm at all. As far as which came first, the fracture or the osteoarthritis, its not really clear at this point. *sigh*

Im not sure the Remicade IV would help since my OA isnt inflammatory. Ill definitely ask my ortho though. Thanks!