Was misdiagnosed at hospital and had requests ignored, now billed $7000, help?

[Johnathan]

I apologize that this is so long.

Here's my story. I am 22, male, unemployed, live in Florida, not married, no kids, no Medicare or insurance or anything like that, live with my grandmother, don't own a house or car, have one bank account with a debit (not credit) card. I dunno how much of that info matters in this situation. Anyway.

So about 6 months ago, I had this weird pain in my mid-back area, on my right side. A stabbing pain. It hurt when I breathed in deeply or twisted or stretched in certain ways. It felt a bit deeper than the muscle, so I figured it might be the following:

1. Liver damage
2. Kidney damage
3. Lung damage
4. Cracked rib maybe?
5. Simple back muscle pain
6. Hernia

I didn't know what it was. Over the course of six months, it would go away, come back, go away, come back, just fluctuate. It would never FULLY go away, it was always there non-stop, just some days it would be almost not noticeable unless I twisted a lot. Until recently.

I woke up, and had to do something to my heavy air conditioner, the kind you put in a window. Anyway, when lifting it, I had this extremely sharp stabbing pain that basically paralyzed me. I could hardly move, this was the worst pain I've ever felt.

I know, I should have just laid down, maybe went to a doctor's office (not a hospital). But I was thrown into a sudden panic, I was freaking out, was scared something was wrong, possibly internal bleeding, I dunno, so I called my friend and girlfriend who both took me to the hospital.

The fact that it was heavy lifting that caused more pain is evidence that it may be just back muscle, but evidence that it's something else is, how long it's lasted, and how deep the pain feels. Beneath the muscle. Even when I have someone press their elbow down hard on that spot, I feel it on my muscle and can sense the pain seems to be beneath it.

Anyway. I can't afford to just speculate, I have to know exactly what's wrong with me. So we got to the hospital. On the way there, my friend tells me about how he got a CAT scan once for something, and he had to be injected with barium, and it made him feel sick. I didn't want that, so I decided to just get an X-ray, not to mention I know an X-ray is only like 100 - 300 bucks, CAT scan's gotta be a lot more.

I sit down with some lady who is writing down stuff and typing down stuff in the computer while she asks me questions. I tell her everything I told you just now. She suggests it might be a kidney stone. I say no, it is not a kidney stone. She asks if I have bladder problems, no, urinating too much or not enough, no, painful urination, no, how much I drink alcohol, I don't, never have. I tell her I know it's not a kidney stone. She basically disregards me saying stuff like "You can't know, only we can know" and "well, we'll see."

I directly request for an X-ray and directly say I do not want a CAT scan. She does not deny or confirm anything and just takes my info down.

I go to the waiting room, they tell me to put on one of those hospital gowns. I wait for a long time, nurse comes in and takes a blood and urine sample, gives me some saline drip then a painkiller drip, didn't really request that, I don't care about pain, I even like it; it lets me know something is wrong inside, lets me know I have something to fix and get rid of, not cover up with meds, but whatever.

I ask the nurse doing the bloodwork if I'm gonna get an X-ray, like she has any idea, she says "we'll figure out what's wrong with ya, don't worry babe." I told her I didn't want a CAT scan. She finishes up and leaves.

Doctor comes in, asks what's wrong, I explain it all to him. Told him the lady who took my info said it was a kidney stone and I said it was not. He also asks about my bladder and if I drink alcohol, I say no. I ask for an X-ray, I request not to get a CAT scan, he basically just says that they'll find out what's wrong with me. He doesn't really say much, and just leaves.

I wait for a long time. Then another lady comes in. She does some stuff to my IV and bed, and begins wheeling me out, and she says she's taking me to the CAT scan machine. I say something like "Whoa, wait a minute, uh... can I just get an X-ray? I really want an X-ray. I don't want to get sick from that stuff." She explains she'll give me a CAT scan without drinking or being injected with barium. I say I still would rather have an X-ray. This is as she is wheeling me through the hospital. And she explains "Well an X-ray is just one scan from the front, a CAT scan machine goes all the way around you." I told her I knew what a CAT scan is and kept complaining, she keeps saying stuff like "Don't worry, we're gonna find out what's wrong with you, don't worry, you're in good hands" etc.

I just want to know what's wrong with me. So they do the scan, then she wheels me back. I wait in there for an hour before the doctor comes back.

He says "You don't have a kidney stone."

... I say "I know. What is it?"

He shrugs and says he doesn't know. Couldn't find anything wrong. He's assuming it's muscular.

I ask if it's a hernia. If it's my liver or lung. He shrugs. Has no idea what it is. He says again, "It's not a kidney stone." Which I knew.

He gives me a prescription for pain pills and muscle relaxers, and leaves. I'm free to go.

I still have no knowledge of what is wrong inside of me. I am thinking of going to an actual doctor's office and getting an X-ray, but that's besides the point. Now we come to the thing I have problems with. The bills. First bill was for the bloodwork, paid for it, 27 bucks. Then I got the following bills:

From Medical Center:
DRESSING TEGADERM ******** 58.25
T CONNECTOR ************* 49.50
SET ADD A LINE ************ 81.00
NORMAL SAL 1000 CC ******* 155.25
TORADOL 30 MG SYRING ***** 209.75
UA W O MICRO AUTO ******* 139.50
IVP SINGLE/INITIAL DRUG **** 176.00
IV INITIAL UP TO 1 HOUR **** 191.25
IV SET W FILTER *********** 90.25
CT PELVIS W/O CONTRAST * 3,265.25
CT ABDOMEN W/O CONT *** 3,660.75
EMER DEPT LEVEL 1 ******** 246.75
BASIC METABOLIC PANEL **** 725.50
CBC PLATELET AUTO DIFF *** 336.25

TOTAL CHARGES ******** 9,385.25
CONTRACTUAL ADJ ****** 2,815.57-

DUE FROM PATIENT ****** 6,569.68


Then a separate bill a few days later from the Radiology Group:
CT ABDOMEN W/O DYE * 146.68
CT PELVIS W/O DYE *** 134.43

TOTAL ************* 281.11

$6596.68 + $281.11 = $6,850.79
So, now I owe almost 7000, for absolutely nothing. I wasn't fixed, I wasn't even diagnosed. I was tested for a kidney stone, even though I knew I did not have one, after requesting not to get tested for a kidney stone, requesting not to have a CAT scan, requesting an X-ray, requesting to be tested for other things. I came in complaining about pain in the mid-back. And they scanned my pelvis and abdomen. My pain is ABOVE my abdomen, so the CAT scan did not even catch the area I told them where the pain is.

So now that you've spent all this time reading my story (if you have, thank you) I hope some of you can know something, anything, how to help me. I have a few questions:

1. I have heard that not paying simply "messes up your credit." I can live with that. But someone else told me I can be sued, and other bad stuff can happen. What all will result from not paying?

2. Is there ANYTHING I can do to get these charges voided? Or at least lessened? I really need help, hopefully someone out there will have good advice.

Thanks,
Johnathan

[Viriatha]

Call a lawyer. Seriously.

[cschin4]

If you are going to the hospital for treatment and care, then they are obligated to assume you want their care and treatment. Medicine is not
X + Y = Z. Medicine involves a series of ruling out what something is NOT. Usually ruling out more serious problems before getting to the lesser problems. In your case, an X-ray is not the state of the art technique and if you had a more serious condition, it would possibly have missed it.
However, it does seem that they could have communicated with you much better. And, it is your right to refuse treatment as well but you often have to sign a waiver stating so. In the future, when you have problems, I would advise you NOT to go the ER if it is something that can be looked at by your private doctor. Most things can wait a day or two and be seen in the office by your physician. The ER doc is obligated to make a quick diagnosis and rule out serious conditions. You had the pain over a course of 6 months. You certainly could have looked into that prior to an ER visit.
So, next time, don't let things go. As far as the hospital bill, they provide you care and you should pay the bill. Just because a test is negative does not absolve someone of paying the bill.

[asmom]

A few points here:

1. You cannot go to the ER and "order" whatever test you think you need like you order a burger at Mickey D's. It is the treating physician's duty to order whatever diagnostic tests and procedures he or he thinks you need in order to diagnose your problem.

2. Having said that, you have the right to refuse any and all services. If you didn't want an IV, IV meds, or labs you should have said so. I guess you're going to tell me that you did refuse but I find that hard to believe. After 16 years as a RN, I can't believe that you refused every procedure and treatment that you are protesting on your bill and they did it anyway. That must be one very well-staffed and slow emergency room.

3. The fact that they weren't able to give you a definitive diagnosis does not mean that you were "misdiagnosed". Often times there may be no obvious explanation for your symptoms and you are not guaranteed an answer. It's true. If your pain continues, I suggest you set up an appt with your primary care physician so they can do more in-depth exam than you might receive in an ER.

4. If you truly did refuse the CT scan and the other treatments, then you need to contact hospital administration. You can start with the nursing director of ER and go from there. That is an egregious offense and it should be addressed.

5. To answer your questions, those charges cannot be voided although you might be able to negotiate a lower price in lieu of you simply not paying. As for suing, they will probably turn you over to collections if you are not willing to pay anything. Good luck.

[cschin4]

If you are "refusing" procedures, etc. You can simply get up and walk out. Nobody is going to tackle you and force you into the CT scan. You went to the ER to find out what was wrong. What if you had a ruptured aneurysm and they didn't do the CT scan? You would have died. It is the perogative of the physician to determine the neccessary tests.

[Johnathan]

If you are "refusing" procedures, etc. You can simply get up and walk out. Nobody is going to tackle you and force you into the CT scan. You went to the ER to find out what was wrong. What if you had a ruptured aneurysm and they didn't do the CT scan? You would have died. It is the perogative of the physician to determine the neccessary tests.

No, I would have died anyway because they did not scan the correct area. The area where I told them the pain is located, mid-to-upper back, was not even scanned by the machine.

[eisor]

Don't hospitals usually work with people who have a hard time coming up with the money to pay the bills? Talk to the financial department of the hospital. Maybe you can work out a deal.

Lastly, try going to a chiropractor. It's worked for my family and a lot of other people we know.

[fake_usa]

Lastly, try going to a chiropractor. It's worked for my family and a lot of other people we know.

Don't go to a chiropractor, they are a total joke, go see a regular doctor.

The hospital bill sucks, you're going to get screwed no matter what,,, but if your spainish and say "Me no speck englash" it would be free.

[Exile]

I also think that you shouln't have tried to call the shots and select the treatment that you wanted. You still wound up with an outrageous bill, which if you don't pay you may well face a lawsuit and a seriously damaged credit rating.

It's not clear if you have legal grounds against the hospital, but consult an attorney who works on contingency. This way you will have to pay very little if anything for a consultation.

[catlinye_maker]

Don't go to a chiropractor, they are a total joke, go see a regular doctor.

*shrug* Your mileage may vary but going to a chiropractor has saved me and my family a lot of pain and a lot of money in doctor's visits. We use our chiropractor in addition to regular doctor's visits as needed. It has made a big difference in quality of life for all of us. In one case of chronic neck pain ending up with a visit to a neurologist, the chiropractor was recommended by our regular doctor and was the only thing that worked.

On topic: there are certain tests, CAT scans among them, that the hospital is obligated to do in order to rule out more serious diagnoses than muscle ache. As someone else said, you can't pick and choose which tests you'd think would be best for you (unless, one supposes, you are an MD.) Pain in one area can be a symptom of problems in another (frex: heart attacks, which may manifest as pain in the arms.)

I'd talk to the hospital and see what could be worked out in terms of payment plans or bill reduction. Ignoring the bill is going to work out about as well as ignoring the pain did.

[Scanner]

Don't go to a chiropractor, they are a total joke, go see a regular doctor.

I'm a pretty funny guy, I know.

Actually, I work in CAT scan (per diem) and work as a chiropractor for 10 years so you have hit upon both my fields of expertise.

It does sound like a musculoskeletal functional problem you had (based on internet info - it sounds like a chronic functional problem that went acute) that could have been addressed by a chiropractor. Too bad your hospital didn't have one in the ER dept. as more and more are opting to have them on staff, seeing the value.

However, I have to say, as a provider who straddles the "alternative, joke" world and the mainstream healthcare world - the ER doc was not out of the norm in ordering that for flank pain. A CT w/out contrast of the abdomen/pelvis is the accepted norm of practice as when I cover weekends and evenings; that's a mainstay test for flank pain.

I think the poster who noted that you have the right to refuse has hit upon the best point.

Use the word, "I refuse to have that test" or "I refuse to have that procedure."

The word "refuse" in the medical world carries a lot of weight. That word shows you know your shinola. And you don't have to have a good reason. You can refuse for any ol' reason you want. I can tell you if I walked in the room and you used that word, I'd turn around and walk right out or it would mean my rad. tech. license would be in jeopardy.

If you refuse a test, and I perform it on you against your will, that's basically assault.

And frankly, I'm too busy at night to put up with ER doc/patient conflicts.

"NEXT!" is my philosophy.

Now. . .to the x-ray. . .you wanted an x-ray. . .I'm only a total joke of a chiropractor but an x-ray would have yielded low diagnostic value unless it's for fracture, and I don't see what would have been fractured given your case history. It's possible you could have cracked a rib but in 22 y.o. males, that's just very unlikely unless you get clobbered there.

I have to say gallbladder disease seems a likely suspect and now you are getting into other expensive imaging.

No matter what, healthcare is this country costs serious money.

So. . .if all imaging is ruled out at the ER because you are refusing (MRI's are usually not done STAT), all they can do for you is give pain meds, which an ER physician is on the guard for anyway, for obvious reasons. They just don't want to hand out a fix of a pain releiver and muscle relaxer and discharge. They get a lot of addicts showing up on the doorstep.

Do you understand their position?

No, of course you didn't - you were just in pain, young and inexperienced, and not privy to the politics of the situation. But I am just educating you.

That being said, they should have understood your position in that you had a right to refuse.

You may have a legal case if they did not make you aware of your Patient Bill of Rights but I don't really know what lawyer is going to take this unless he can get a settlement for his time and money.

You could file a complaint with accrediting agencies but it sounds like you got the normal protocol at the ER so I don't know your bill would be affected. But filing a complaint is important in changing the way hospitals in the US do business.

Still, it won't hurt to try to approach billing and go through channels and present your side of the case, that you weren't informed of your rights - they make knock a percentage off the bill.

Good luck.

[Gailete]

What you got charged was 'reasonable and customary' as a bill for what your physical complaints were. You went to the ER because you were in pain and they worked to try and rule out any life threatening problem--none was found, you should be happy. You owe this bill. Not sure why a 22 year old guy has no job and is living off his grandma, but perhaps you can still apply for Medical Assistance for the bill.

It is obvious that you have no medical background of any kind and to go to an ER and start trying to direct your care is nuts. To reject a CAT scan because a friend had a bad experience with it is not a good reason to reject one of the better diagnostic tools for your kind of pain. And the reason they were trying to rule out a kidney stone, is that is what your symptoms sounded like. Have you ever had a kidney stone? How did you know you didn't have one? Believe me they are PAINFUL! Take this as a good learning lesson--
1. For chronic problems, go to your doctor or a clinic not the ER
2. Health care is expensive, but not a reason to not pay the bill
3. Get a job and start paying your own way in life instead of living off of granny

Do I sound harsh? Yes, I am. You sound like a totally irresponsible guy and it is time to grow up. You also sound like a hypochondriac, imaging all sorts of horrible diseases with no knowlege--Liver damage, kidney damage, internal bleeding? Get real, if you really thought that, why weren't you at the doctors or ER sooner. To me it sounds like you want us to feel sorry for you because you now have a big bill to pay.

My husband had to go to the ER and was admitted for 3 days due to heart problem. The bill, basically the same as yours ($7000). What did we do, we paid it off over the next 4 years with never a thought of not Paying it. It is what responsible people do! Was it hard yes! When the last cent was paid we had a terrific feeling of accomplishment.

[neguy11]

One thing I will say is avoid the ER at all costs. After being charged 30 bucks for an immodium I said never again. Good Lord, if I had seen the price tag I would have stayed at home and said my prayers. I've got the high deductible insurance and it sucks.

I would first speak to the billing office to find out if there are any programs for assistance, payment plans, negoations, etc. Do some generic reasearch first...otherwise they might put some notes or flags on your account! Then I would speak with the administrators and explain your story to see if they will waive some of the charges.

I really think the hospitals should provide you with an estimate of charges because I certainly wouldn't have stepped foot in the ER if I had an idea of what the bill would be. It almost seems like a scam to me. Like they could say, sir a catscan costs $3,000. Do you agree to this charge and would you like us to perform this? And then you have to say yes. And if you are out of it maybe they could give you reduced rates. Hopefully this is part of the healthcare reforms proposed by the candidates.

Unfortunately I have heard the ER is the "cash cow" to make up for the people who don't pay, but I don't know how accurate this is.

Good luck!

[Scanner]

No, actually, the ER is a "loss leader" - because you have indigent and deadbeats who don't pay their bill and by law, a hospital has to take care of them.

Actually, radiology is, or has been, the "cash cow" for hospitals, usually the one of the few departments that makes the money for the rest of the hospital.

And sure, I'd have no problem disclosing charges to everyone.

The problem is people don't care when there's insurance. I could say, "A CAT scan is going to cost 1 ga-gillion dollars. Wanna have it?" and people w/ insurance would say, "Sure. . .I'm not paying. Here's my credit card. . .I mean my Blue Cross card."

That's just American health care thinking.

But yes. . .avoid ER for health problem care. . .however, intractable pain is an emergency.

I'd like to give the poster the benefit of the doubt and not assume this is hypochondriasis.

Pain right below the right scapula that varies from very intense to nothing and usually following meals can indicate gallbladder disease. However, this is just guessing at best over the internet. I would say a visit to his PCP is in order and then if cleared of internal problem, sure, go to the chiropractor.

That would be the most cost effective approach.

However, cost effective and American health care usually don't go hand in hand.

[sweeps]

I'm surprised that the OP even got through Registration. We get absolutely grilled whenever we've had to go the ER. And we have fairly good insurance...