Complaining About Va Medical Care?

[Vync]

I would like to know the best and most effective way to complain about poor medical care at a VAMC.

I was recently injured by an x-ray tech at the VAMC. During the same visit, I was also given large amounts of IV and oral steroids, which resulted in me missing almost two weeks of work due to an adverse reaction (i.e. severe side effects).

Should I deliver my complaint through:

- Patient representative at the VAMC

- The IRIS web site

I have everything ready to go, just need some opinions on the best route to take.

Thanks!

[carlie]

I would file my complaint with the Director of the VAMC.

jmho,

carlie

[Pete53]

I agree with Carlie that would be my route. The Patient Reps serve other needs but I doubt act on complaints.

[Vync]

Good plan!

Thanks!!!

[Berta]

One suggestion to add-

I have been through the complaint route with the VA-

When I saw the Director here twice with complaints regarding my husband's care,I made sure he noted our meetings and his recommendations into the Medical records.One suggestion he had made was for a new medication.

Luckily no one followed through on the med he recommended.I never saw these actual entires in the record until many months after my husband died. The med he recommended would have compounded my husband's medical problems and probably killed him sooner.

Make sure the director enters the meeting and your concerns into your clinical record.This might generate an incident report.

"During the same visit, I was also given large amounts of IV and oral steroids, which resulted in me missing almost two weeks of work due to an adverse reaction (i.e. severe side effects)."

The VA must be fully aware of the 'incident' and its results to generate this type of report. I think the Chief Med director is responsible for them at each VAMC.

When I discovered the day after Rod died that the VA had sent him another vets meds by mistake - I went to the VA pharmacy and raised hell and then went up to the director's office and raised hell. This generated an incident report.

The incident report - as serious as this situation was- contained more info on me then on the pharmacy error.

The VA attempted to blame the Post office.I found the other vet who lived a few hills away from me- the same time I was griping to the VA director he was trying to get his meds and they kept telling him, his meds had already been mailed to him.This was NOT any PO error at all and I could prove that.

They finally gave the othr vet a new supply- his lack of these meds could have killed him- in my case- it was the right meds my husband should have been on for 6 years.

If an incident report is done ask them for a copy of it. They might not release it but under FOIA I think they have to.

This should have generated an incident report as long as the VA was aware of the serious reactions to the meds you had incurred.

Incident reports could at some point be evidence for negligence if the 'incident' directly caused a ratable disability at some point.

Edited January 10, 2010 by Berta

[broncovet]

I agree with what the others have said, that you should document this in case you should ever have an 1151 claim. I am curious as to how an Xray tech would injure you..did the tech move you in such a way to take an xray that it caused pain or damage to a joint he was trying to xray? It sounds like you had 2 incidents..an xray tech injury and "large amounts of IV and oral steroids". Can you find out if this large amount was ordered by the doctor, or is this perhaps a nursing error?

You can go to the steriod company's website and probably find out what the "normal" dose for this steroid is, and find out if the website says this drug dosage should not combine oral and IV dosages.

An overdose of steroids or other drugs, of course, can have serious long term or short term problems.

If you were administered the company recommended dosage, then it may just be that your system responded negatively to the drug.

I think I would look into these things..just in case the symptoms re appear for this possible overdose of steriods.

[Vync]

I really appreciate the additional information. I'll need to reword some things on my complaint based on your recommendations.

I posted this under another topic, in great detail, but here's a quick overview of the situation:

I am 10% SC for TMJ (inter-incisal range 31-40 mm) and 10% SC for asthma/exercise induced asthma.

Background

Pain was getting worse. Existing pain meds were not controlling pain. My VA PCP doc increased me from tylenol 3 to tylenol 4 and added a mild laxative. The increase caused severe constipation. The laxative did not work. Going to the bathroom required agonizing effort, a lot of grinding teeth, and exhausted me. TMJ pain was significantly increased. Asthma attack frequency and severity also increased, but my rescue inhaler was working.

I had to go to the VA ER twice last month.

Visit 1

I could not control my asthma with my rescue inhaler. The effort to go to the bathroom also exacerbating my back and TMJ pain. I got a breathing treatment, a six-day prednisone taper (10 mg/pill), and some stronger laxatives.

Visit 2 (the next day)

TMJ pain was worse, pain at 7 of 10. I had an asthma attack in the ER, which I could not control with my rescue inhaler. They gave me two breathing treatments, which also failed. The doctor gave me 125 mg of solumedrol (liquid prednisone) via IV, which helped my asthma. They took a chest x-ray. They gave me a third breathing treatment. They also gave me two rounds of morphine via IV, which got my TMJ pain under control.

X-ray injury

The tech failed to check my chin clearance prior to quickly raising the vertical x-ray target. The target struck my under my lower chin, causing my lower teeth to impact my upper teeth. The shock of the impact went straight into my TMJ. I instantly collapsed, pain was at 9 or 10 of 10. The tech apologized. I told the doc and nurse, but neither logged this in my records.

TMJ pain

The doc gave me two rounds of morphine via IV, which got the pain under control. When given a third breathing treatment, I could insert the mouthpiece between my front teeth. I was also sent home with some lortab pills.

Steroid problems

Within a 24 hour period, I had 60 mg + 50 mg + 125 mg = 235 mg of steroids in my system. The most I ever had before was 50 mg. I also finished my prednisone taper over the next four days. The next week, I saw the doc who treats my asthma and allergies. He reviewed the records and noted that I had an adverse reaction to the increased amount of steroids.

The adverse reaction was comprised of: insomnia, depression, mood swings, confusion, fluid/electrolyte disturbance, hypertension, muscle weakness/myopathy, gastrointestinal problems, abdominal distension, ulcerative esophagitis, increased acne, increased sweating, vertigo, headaches, hypoglycemia, vision problems, and weird nightmares. It was the most awful experience I ever had.

TMJ exacerbation

The next day, I visited the VA oral surgeon and he did a comprehensive examination. He said my TMJ was now bilateral. Inter-incisal range was now 10 mm and 18 mm when he forced my mouth open. Lateral movement range was less than 4mm. I was given ibuprofin 800 mg 3x/daily and put on liquid/soft diet for six weeks. 19 days later, my inter-incisal range is about 23 mm, even with 800 mg ibuprofin 3x/daily. Lateral movement range is still severely limited. My movement range and pain gets worse after I eat, during the work day (on the phone frequently). This makes me wonder what the range would be without the ibuprofin.

TMJ VA rating

(I am currently within the ranges shown in bold)

9905 Temporomandibular articulation, limited motion of:

Inter-incisal range:

0 to 10 mm 40

11 to 20 mm 30

21 to 30 mm 20

31 to 40 mm 10

Range of lateral excursion:

0 to 4 mm 10

Note—Ratings for limited inter-incisal movement shall not be combined with ratings for limited lateral excursion

Asthma exacerbation

I now take inhaled steroids daily. In the past year, I received oral and/or parenteral steroids four times.

Asthma VA rating

(I am currently within the conditions shown in bold)

6602 Asthma, bronchial

FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications

100 %

FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids

60 %

FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication

30 %

FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy

10 %

Note: In the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record.

VA Claim Increase

In addition to filing my complaint, I also am filing for an increase for my TMJ and asthma (see bold items, above).