diabetes 1151 For Failure To Diagnose Diabetes?

[Ethan'sGrandma]

First of all...Hello to All!!

I have been pondering and researching as much as I can 1151 claims, but still am not sure if I have a potential claim for VA doctor's failure to diagnose diabetes. At the time of my actual diagnosis by outside provider, I was not even aware of 1151, nor FTCA. From what I have gathered, FTCA claims have a two year limit, so too late for me, but am trying to inform myself about 1151 claims, which I first saw the information on Hadit, so any suggestions will be greatly appreciated.

A bit of background: In '04, I was being treated at the VAMC outpatient clinic, solely, due I'd lost my private health insurance. I went to the clinic severely complaining of what I now know were diabetes symptoms. The primary sent me for a fasting test, but said the test was not showing sugar levels for diabetes, so nothing more developed from the clinic visit. The symptoms did not abate within several days, but did not know what to think/do, even as feeling so ill, since the VA doctor said she couldn't see what was wrong, but I was trying to come up with a different plan to get evaluated/treated, without health insurance and no funds to pay for it...out of work, out of insurance, and out of luck, or so it seemed. As lucky for me would have it, those same couple of days had my husband's 100% and ChampVA eligibility for me letter arrive in the mail. So, feeling at some critical level of illness, I got myself to the local immediate care facility, presenting symptoms of diabetes, which was duly diagnosed at the facility. The doctor there was very surprised that I was there with such high levels, not having been treated for diabetes, nor that I had not gone towards further complications of diabetes, such as confusion, or coma. He said that I must have been walking around with this for some time because the levels don't just go up that high, all of a sudden. I was treated there with several injections of insulin, over hours, until the level went under 300 before I was able to go home, with follow-up care referred to the Endocrinologist at their clinic.

I wasn't clear about a lot of things back then regarding diabetes. I'd been diagnosed before with Gestational Diabetes while I was pregnant while on active duty, but I was not aware that could heighten the risk to someday having DM II. Additionally, I'd been complaining for years with symptoms, but always disregarded, even as the one and only person that caught the testing was showing diabetes through VA blood tests (my psych. counselor at the time who was also a nurse and whose husband was a diabetic), but the medical side never concurred, or did further development to properly evaluate. So, I was perplexed that it had not been caught sooner, definitely on the last visit that I presented the symptoms to my VA primary doctor. I questioned the immediate care doctor of how something like that could be overlooked as I'd been in medical treatment with the VA, including complaining of what I now knew were diabetic symptoms in the last few days, but the fasting test came up normal. How he explained it to me made sense, sort of. He said that fasting testing does not always show high glucose levels, but when presenting symptoms of diabetes, the blood pricking test was what was going to get it, right then and there, or the A1C. He reiterated that there was no way he would believe that I'd just become a diabetic, due to high levels, but I had to have been walking around with this for years.

After the initial diagnosis, I am insulin dependent (different types have been tried), with additional oral medication, watching my diet, etc., but the levels still remain higher than they should be, for the most part. I am trying to not become discouraged, but, after the fact, I am now diagnosed with diabetic neuropathy. I don't know if having gotten evaluated sooner would have made a difference, but I was very put off by the VA doc's failure to diagnose, nor to take my symptoms seriously enough to do a further evaluation. I did go back to the clinic, to the PA, complained about the missed diagnosis, mostly because I insisted the doctor be switched as my primary for any further care at the VA clinic. Unbeknowest to me, I did have to see her once when she was placed in Women's Healthcare as the doctor for that department (I wasn't aware she had been placed as the doctor for that before I made it to the appointment). It was just for a pap/mammo, and general women's care (that's my one yearly visit to the clinic to maintain myself active), but once I was aware she was the doctor for that, I refused to obtain any further treatment from her in any capacity, due I do not trust her judgement in evaluating medical issues. She's still there, as she will surely be, and the clinic once again tried to place her as my primary doctor when the latest one was reassigned for certain cases, but I refused and insisted that I would follow all the available channels to see that she was not ever assigned as my doctor. So far, I have managed to be accomodated for that.

So, in my mind it brings up to question the section 1151 claims which I was not aware of before. Can a failure to diagnose a chronic condition be a factor? The most reason that I am interested is because the only other (besides Medicare) health coverage that I have is through ChampVA, but it is never a given that my husband's rating will remain at 100%, regardless of the P & T, nor the "no future appointment scheduled" wording, so there is no surety that I will always have access to that coverage. I have my own VA disability claim in the system, but as yet, there is no rating in sight, nor do I have a clue what they will decide on the last go-round of additional evidence that I've submitted. As it sits now for six years, there's no telling how it will go, nor how many more years before the appeal wings its way through the system, so I'm wondering if this could be another avenue for me? Thank you very much for any information/suggestions...

[Berta]

." Can a failure to diagnose a chronic condition be a factor?"

Failure to diagnose and treat any chronic condition to the point that it causes additional disability or death- is malpractice.

This is why I filed 1151 and FTCA and won them both.This is also why, due to discovering additional malpractice in 2003- the VA had to award my husband,posthmously, a direct SC death last year on top of the FTCA stuff.

And this is a factor in my pending AO IHD claim.

Malpractice can start with a misdiagnosis early on that snowballs into much more disability-and which can become fatal. The VA can even attempt to cover up the initial malpractice.

I proved they did that too in my husband's case.

The VA's failure to diagnose and treat my husband's DMII, heart disease and numerous strokes -coupled with 2 major medication errors caused his death and the VA concurred -after a battle.

a battle I might not have had if I had obtained a lawyer.

I looks like you missed the Statute for FTCA filings but this is something a lawyer should determine. You can still file under Section 1151.

My husband was symptomatic of diabetes 6 years before he died.

For my 2003 claim (I could not claim malpractice again so I had to be careful how I worded the claim) I obtained 3 IMOs-because although the VA had accepted my lay medical evidence under FTCA and 1151-I knew they would fight me on that this time around.

My IMOS concurred with all of the lay evidence I had sent to them so they had to cave in again on the 2003 claim. AO DMII caused his death ( accelerated by their malpractice)VA award 2010.

As this forum advises- you need to obtain a strong independent medical opinion and if that opinion supports malpractice, a good lawyer might well see a way to get the matter into a FTCA time frame.

The Section 1151 regs are here and clear as to "omission of an act".

An omission of any act that the "standard and usual medical community" would perform ( regarding diagnoses and treatment)

by VA health care professionals- that also causes any veteran a resulting additional disability or death-directly due to VA's omission of acts that concer with acceptable and know medical standards-is malpractice.

I would believe MOST FTCA claims that have been successful rest on that premise.

I would-(if I were you I would do both-) contact some malpractice lawyers on the net (some have their own IMO doc recommendations and many are familiar with VA cases)and at same time look for a IMO doctor in case no lawyer advises on one.

Edited June 14, 2011 by Berta

[Ethan'sGrandma]

Thank you very much, Berta...