[ScientiaOmnisEst]

I posted some time last month about my mother being hospitalized with lithium poisoning. She's been out of the hospital for a month, but is undergoing involved post-care, and has nothing but hatred for her former psychiatrist - even to the point of wanting to sue him or see him kicked out of medicine.

I watched all of this go down from illness onset to release from rehab. After some quick internet research, I think we at least have the prerequisites for a case - most prominently, negligence. This doctor possibly misdiagnosed my mother, then she went through six different medications. The most benign made her so nauseated constantly she could barely function, the worst landed her in the hospital for two weeks with acute kidney failure. The others resulted in rashes, illness, and worsened symptoms. Regarding lithium, the doctor apparently quadrupled her dose with little information, had no notification that she was ever hospitalized, then acted with no regard or concern when he did learn he nearly killed a patient - acording to my mom, he acted like it was just any other appointment and they were going to go ahead with another medication.

I'm no lawyer, but I think we would have a malpractice case. There were pretty severe damages incurred by something 100% due to this doctor's diagnosis and prescription: rashes, kidney failure (including 48 hrs of unconsciousness that had the hospital put her on a death watch), a mini-stroke, and a handful of other post-illness symptoms. Not to mention my mom's been wearing a heart monitor for the past few weeks and it's driving her crazy - according to her, it makes her sad to see that every day and be reminded of what happened, plus all the equipment is so cumbersome getting dressed and moving around is much more of a chore than it would normally be.

What I'm taking way too many words to say is, should she/we pursue it? Is it worth it? Has anyone here ever dealt with a malpractice case or taking some legal action against an incompetent doctor?

((((Hugs))))

I'm really sorry. I don't have experience with legal stuff or malpractice, but I do have a lot of experience with psychiatry as a patient and from looking out for others with lousy care like this.

This is not uncommon. My last psychiatrist told me about how he diagnosed someone with lithium poisoning, because other psychiatrists missed it. I know of 2 other people this happened to. And it doesn't seem like ER doctors know about this.

What often happens is that people's metabolism is affected by the other drugs they take, so what would be a normal/safe dose titration will put their blood levels over the limit. The interaction with other drugs, along with other health conditions (like liver dysfunction-which is more common these days), is a big thing. Psychiatrists often do not check these things or coordinate care. Sometimes it's because they are in another health facility who doesn't share medical records but the psychiatrist is too lazy to look.

Here are the clinical guidelines for psychiatry, maybe that help you figure this out. They are only guidelines though, there are often reasons not to follow them.

https://www.guideline.gov/search?f_C...erm=Psychiatry

You could probably get a free legal consultation by contacting a medical malpractice attorney.

This is so horrible. I feel for her. It's so sad how many negligent doctors there are out there. And many people don't know it and are lucky nothing happened to them. I experienced much of it myself but never sued. But I learned too that I have to spend time researching and learning what the appropriate treatments are and taking care of myself.

What was the diagnosis that you think was wrong?

[leejosepho]

Originally Posted by ScientiaOmnisEst

...hospitalized with lithium poisoning...undergoing involved post-care...

What is her current prognosis?

Originally Posted by ScientiaOmnisEst

This doctor possibly misdiagnosed...
...had no notification that she was ever hospitalized...

Why was he not notified?

Originally Posted by ScientiaOmnisEst

...according to my mom, he acted like [the next appointment] was just any other appointment and they were going to go ahead with another medication.

Any other doctor would have likely done essentially the same.

Originally Posted by ScientiaOmnisEst

There were pretty severe damages incurred...

Anything permanent and debilitating?

Originally Posted by ScientiaOmnisEst

my mom's been wearing a heart monitor for the past few weeks...

As a direct result of the above?

I believe my own mother's life was shortened (or at least its final days were made miserable for many) by two egotistical surgeons whose work caused her to spend the last four months of her life hospitalized (and even pushed to a lesser facility as insurance benefits were diminished) following what I believe was a botched surgery. However, I am sure those doctors have documentation proving she had agreed/consented to face the dangers of certain possible complications and even death.

I have a truckload of empathy toward you and your mother, but I believe you would have to be able to prove the doctor wittingly did *not* do something he already knew he *should* have done (or should have done differently), and then you would likely also have to show permanent harm in the form of impairment or disability resulting in significant loss of something tangible or else an added burden of some kind of great financial expense or stress.

[stopdog]

I would contact a med mal attorney in my state and talk to them - people here are not going to be able to tell you whether you have a viable case or not. What burdens and levels of proof, evidence etc will be jurisdiction based. I would not suggest anyone take the word of anonymous online people as to what you will have to prove or show in order to have a viable case. Med mal plaintiff's work is usually (in my jurisdiction at least) done on a contingency fee basis. Something to keep in mind is that the defense attorneys are not going to be nice to you or your mother -so one needs to be willing to be put through some unpleasant questioning and hostile attitude from the defense team.

[Ididitmyway]

This is definitely worth consulting with several lawyers and determining how strong your case is. I am not a lawyer and I've never sued a medical doctor so I can't speak from experience and cant' advice you. But what I'd definitely do is to talk to lawyers about it. If they tell you you have a strong case, it is your decision to pursue it or not. I would pursue it, absolutely, but that's me.

In my humble personal opinion, this is a crime and, in a normally operating, not upside down society, this case would go to a criminal, not civil court. A doctor who damages a patient to the extent your mom was damaged should go to jail. I am so sorry your mom and you had to go through this hell. My heart goes out to you, truly.

Im assuming you arent expecting legal advice from this forum and are just asking for opinions or experiences or support, so perhaps disclaimers are unnecessary.

About the unpleasantness Stopdog mentioned...ive read stories about how other doctors treat those who sue. Maybe thats another thing to keep in mind when making your decision.

Thinking maybe thats because attorneys are contacting the other medical doctors to get informatiom, theyll find out about the suit. Yes, even in atrocious cases like this, the other doctors could act in punitive ways. On the other hand, maybe theyd be horrified too. Id check into that if i were considering suing.

Best of luck.

[stopdog]

Originally Posted by ScientiaOmnisEst

?.....
What I'm taking way too many words to say is, should she/we pursue it? Is it worth it? Has anyone here ever dealt with a malpractice case or taking some legal action against an incompetent doctor?

This does look to me like the OP was asking for some legal advice. And some posters have tried to give some. As I am a lawyer, I think disclaimers are a good idea.

[atisketatasket]

If your case would rest on the possible misdiagnosis and accordant treatment, not only should you see a lawyer, but another psychiatrist to confirm that it's a misdiagnosis, if that hasn't already been done.

I think leejosepho has pointed out the basic questions that would arise - and presumably your mother consented to this treatment and signed forms to that effect - which ought to include statements like she'd been warned of side-effects, etc. I was on lithium briefly and told to stop or contact her at the first sign of x y z, did he not do that?

[ScientiaOmnisEst]

Originally Posted by leejosepho

What is her current prognosis?

Basically total recovery from the poisoning itself, though full recovery could take a year.

Why was he not notified?

We have no idea.

Any other doctor would have likely done essentially the same.

Really? Just acted like nothing was wrong after finding out his patient had just had a life-threatening reaction to a drug?

Anything permanent and debilitating?

At the moment, she's been having some IBS symtoms possibly due to post-incident medication, to the point where even going out is difficult. Otherwise, I don't think so.

As a direct result of the above?

Related to her stroke, I believe.

I believe my own mother's life was shortened (or at least its final days were made miserable for many) by two egotistical surgeons whose work caused her to spend the last four months of her life hospitalized (and even pushed to a lesser facility as insurance benefits were diminished) following what I believe was a botched surgery. However, I am sure those doctors have documentation proving she had agreed/consented to face the dangers of certain possible complications and even death.

I have a truckload of empathy toward you and your mother, but I believe you would have to be able to prove the doctor wittingly did *not* do something he already knew he *should* have done (or should have done differently), and then you would likely also have to show permanent harm in the form of impairment or disability resulting in significant loss of something tangible or else an added burden of some kind of great financial expense or stress.

Thanks.

What we keep thinking is that her dose was almost-lethally changed with little notification and no apparent reason. However, I don't know if there are any serious, incapacitating effects. There don't seem to be any stemming from the incidnet itself, just medications needed after. Checking waivers sounds like a good idea, though.

[ScientiaOmnisEst]

Originally Posted by atisketatasket

I think leejosepho has pointed out the basic questions that would arise - and presumably your mother consented to this treatment and signed forms to that effect - which ought to include statements like she'd been warned of side-effects, etc. I was on lithium briefly and told to stop or contact her at the first sign of x y z, did he not do that?

Because the onset was so fast - just a matter of days, and we thought it was something benign. We had no idea it was lithium until the ER doctor told me they found elevated levels.

Also, my mom was doing some reading about lithium poisoning, and apparently there are a number of tests that are supposed to be conducted before prescribing - my mother underwent none of them, not even with her history of poor reactions to medication.

[ruh roh]

I would definitely seek legal advice on this. Just because it happens a lot doesn't mean it's not malpractice.

These people get away with far too much. My kidneys were failing and my pdoc hadn't even noticed the blood levels. I had to call her attention to it. She was in the process of leaving her practice and I think she wasn't really into details at that point.

Interesting, I just happen to be going through early intervention of lithium toxicity. However, in my case I had an on the ball psychiatrist.

Your mother's psychiatrist ought to have had her undergo regular blood testing (no more than three months between). He should have been including in those tests, screening of kidney function, calcium levels, and thyroid/parathyroids levels. These tests should be graphed in such a way as to show how these results are trending.

In my case, my psychiatrist saw my kidney function as trending down and concerning trends regarding my calcium and para/thyroid hormone levels. I was immediately referred to specialists for screening. Thank goodness my kidneys checked out fine but my medication treatment will be changed anyway. Had my psychiatrist not been monitoring my blood tests, I could now be in the hospital with irrepairable damage.

To repeat. The psychiatrist is responsible to order and monitor regular blood testing and react accordingly.

[leejosepho]

Any other doctor would have likely done essentially the same.

I had meant to be speculating that a different doctor taking over the case would likely have just moved on along, but yes, I would suspect doctors are told by their liability providers to say nothing at all in relation to "Oopsies" since "Anything you say can be used (by a patient) against you in a court of law."

Example: Following an otherwise-successful eye surgery where a doctor had added an impromptu extra at the end that could have easily been done later in his office, I now have only one eye that can read. If I had been given an opportunity to say something at that moment, I definitely would have said "No!" while speculating in relation to possible complications. That doctor and several others since have never once even batted an eye and have just moved right on along every time following my detailed report of that incident showing a high probability that a grievous error had been made. In my own mind, their silence proves my suspicion they realize what happened and are intentionally remaining completely silent even when I mention my suspicion they are instructed to do that.

For the record: I do not claim to know the strength or weakness of whatever kind of case you might have, and my questions and comments here are certainly not coming from insensitivity.

If this quote refers to what i said, i came back to clarify.

I think that it happens often is a tragedy, to express my concern about psychiatric care. i didnt i say that happens often = not a malpractice case.

Just because it happens a lot doesn't mean it's not malpractice.

The reason i posted the clinical guidelines is because the OP mentioned misdiagnosis. Lithium is prescribed for depression, psychosis, and other things, and a lot of people think medications are prescribed according to diagnosis, which is not often not the case, so i wanted to provide that information for reference. OP didnt clarify the misdiagnosis.

My psychiatrist i mentioned earlier told me lithium toxicity happens despite the proper testing too. The reason he told me was that the metabolim of lithium is affected by other medications and health problems that the standatd tests miss.

Since they dont monitor blood levels every day, the adverse event can happen in between, but i cant recall all the details.

Originally Posted by justafriend306

Interesting, I just happen to be going through early intervention of lithium toxicity. However, in my case I had an on the ball psychiatrist.

Your mother's psychiatrist ought to have had her undergo regular blood testing (no more than three months between). He should have been including in those tests, screening of kidney function, calcium levels, and thyroid/parathyroids levels. These tests should be graphed in such a way as to show how these results are trending.

In my case, my psychiatrist saw my kidney function as trending down and concerning trends regarding my calcium and para/thyroid hormone levels. I was immediately referred to specialists for screening. Thank goodness my kidneys checked out fine but my medication treatment will be changed anyway. Had my psychiatrist not been monitoring my blood tests, I could now be in the hospital with irrepairable damage.

To repeat. The psychiatrist is responsible to order and monitor regular blood testing and react accordingly.

[still_crazy]

Its hard to successfully sue shrinks. I"m not trying to discouarge you--in fact, as a "mental patient," I strongly encourage you to pursue this, please please please--but I do want you to be aware that you're up against an industry that routinely destroys people with no repercussions, whatsoever.

[atisketatasket]

Originally Posted by Skies

My psychiatrist i mentioned earlier told me lithium toxicity happens despite the proper testing too. The reason he told me was that the metabolim of lithium is affected by other medications and health problems that the standatd tests miss.

Since they dont monitor blood levels every day, the adverse event can happen in between, but i cant recall all the details.

Yeah - mine said I would need a blood test every six months or so. But six months is a really long time.

[Ocean Swimmer]

Usually when you start seeing any Dr these days they have you sign a bunch of forms no one reads. One is an arbitration clause.
They may not even have given you a copy.
Check with the office or hospital to see what she may have signed.

[precaryous]

I have sued a psychiatrist but I'm not a professional of any kind.

I just want to add to what others have said- a psychiatrist can be disciplined criminally, civilly, and through their medical licensing board.

In my case I also reported him to my insurance companies, Medicare and Medi-cal. They revoked his ability to accept Medicare and Medi-cal patients.

Once the medical licensing board revoked his license I reported him to the other states where he held a license and they revoked his medical license, as well.
My understanding is that state medical licensing boards do not/did not share disciplinary issues with other states- so it was necessary for me to inform the other state medical boards myself. You may or may not want to pursue this if the psychiatrist/M.D. in your case has his license revoked in your state.

It was a very unpleasant experience. The medical licensing board case resolved first within a year or two. The civil case lasted two or three years. The criminal system refused to indict him in my case even though he had been arrested for a similar crime with another patient. I was told I did not have sufficient evidence.

What I learned: success does not depend on whether you are in the right and he is in the wrong. Success depends on what you can prove.