What do you think? Did I deserve to be crippled for life over this letter?
This is a picture of me in the air ambulance on my way to the Baptist.
This is the text of the first letter of complaint I sent in about being abused at the Baptist. I had a hard time compressing what happened into two pages, and was trying to concentrate on my being ejected from the hospital without the surgery I needed. At the time, we were not aware of the extent of Dr. Basilicos involvement in what happened to me....
December 16, 1998
Dear Dr. Robbins:
I am writing to you in order to make a formal charge of unethical conduct by one of the physicians who practices at your hospital, Dr. James Karlson.
On August 28, 1998, I was admitted as a patient at the Baptist. I was flown here by medical jet, at my own expense ($10,000), from the ICU at the Idaho Falls Regional Medical Center because I desired so strongly to be treated at the Baptist. I had suffered multiple trauma as a result of a horseback riding accident, including a C2 neck fracture, a closed head injury and, most relevantly, a shattered left elbow. I met the man who was assigned to be my attending physician for the first time in an X-ray room in the basement of the hospital. On that occasion, Dr. Karlson was abusive and unpleasant to me, which was in sharp contrast to how I had been treated by the other doctors and staffers at your hospital. I resolved at the time to ignore this behavior, since I knew that even good doctors are sometimes not very nice people.
However, over the remainder of the weekend it became clear to both my husband and myself that Dr. Karlson did not have my best interests as a patient at heart. On Sunday evening, we asked for a meeting with the patient advocate, and asked to have Dr. Karlson exchanged for another physician.
At no time during this interview did we disparage Dr. Karlson, simply stating that I would prefer to have my treatment overseen by another physician. When we were told that we could not replace him without a reason, we related to her * the mildest of the incidents I had experienced.
Monday morning rolled around, I was assigned a different attending physician and everything seemed to be fine. Monday was the day that all the doctors would be coming back to work, and I would have a chance to secure a surgeon to reconstruct my elbow. Only, something had gone wrong.
Suddenly, no one was available to do my surgery. Here I was, in the best orthopedic hospital on the East Coast, with a generous private insurance policy, and yet no one was available to repair my elbow. Some surgeons "didn't have time"; others "didn't feel comfortable" ; yet others simply didn't return our calls. At first, we were astonished, then, eventually, desperate. After a while, we became suspicious.
On advice of a friend, I consulted with Dr. Larsen, the hospital's chaplain. We asked him to ask around and find out why I couldn't find a surgeon. In less than half a day. Dr. Larson returned to us with the answer: No one wanted to do my surgery because, "You were scheduled for surgery with Dr. Karlson at 9 AM on Sunday morning, and you stood him up." When we protested to Dr. Larson that I had never been scheduled for surgery with Dr. Karlson at all, he simply stared at us, obviously not believing us, then walked out.
At first, we were mortified at the idea of a bunch of people left waiting by us in an O.R. Then we were appalled by the idea that I had somehow missed my only opportunity to have my elbow fixed. But soon, reason reasserted itself: Dr. Karlson had never spoken to us about this "surgery." I had not signed any forms authorizing any procedures. No anesthesiologists had visited me on Saturday. No one had restricted my diet. And when, a few hours later, we asked the nurses to check my patient file and see if I had been scheduled for surgery over the weekend, they came back and said they saw no evidence of it. What Dr. Larson had been told, and then passed along to us as fact, was simply not true.
Evidently, Dr. Karlson spread this story around the surgical staff in order to poison the waters at the Baptist and make it impossible for me to get my elbow surgery there. It is hardly conceivable to me that having him replaced as my attending physician was a great enough crime in his eyes to warrant this kind of vengance, but apparently this was so....
Clearly, it was Dr. Karlson's intention to harm me; he certainly succeeded. By the time I was able to find another surgeon at a different hospital to reconstruct my elbow, 15 days had elapsed since my accident. It turns out that my elbow was not in quite as terrible a condition as my X- rays seemed to show. For example, my triceps did not need to be advanced after all. According to several other doctors I have consulted, if I had received a timely reconstruction, it might have been possible for me to regain full range of motion at the elbow. ** The 15-day delay in my surgery made that impossible. The best I can hope for now is "functional range" -- as a personal trainer, that's hardly likely to suffice.
Perhaps the patient handbook at the Baptist should be amended to read as follows: "You have the right to exchange the attending physician you were assigned for another one, sweetly and politely. Keep in mind, however, that this action gives your former attending physician the right to retaliate against you in any way he sees fit, short of murdering you in your bed."
That's how the system at your hospital worked for me. Is that really O.K. with you? Dr. Karlson's unethical and unprofessional conduct has left me with a permanent disability that might have been avoided. I request your personal attention to this matter. In fact, I would like a face-to-face meeting with you to discuss Dr. Karlson's and the Baptist's responsibility for this incident and its subsequent consequences to myself, my family, and my ability to earn a living.
I am not a litigious woman, but if I do not receive some satisfaction in this matter, I will certainly retain counsel to assist me in exploring my legal options for redress.
* We called the woman who came to my room the Patient Advocate in this complaint as a kind of shorthand to conserve space -- we had no idea who she really was, only that she was just as good as talking to the Patient Advocate.
** We were later to learn that this was not as black-and-white as we had been told. In fact, part of the times that doctors would tell me over and over that I was definitely going to be crippled for life may have been part of the campaign of abuse and terrorization at the Baptist, rather than a medical fact.
This is the letter I sent to the Joint Commission on Accreditation of Healthcare Organizations, the JCAHO. They screened and then accepted my complaint.
On August 24th, 1998, I was thrown from a horse in Grand Teton National Park and sustained multiple trauma, including a broken neck at C2, a broken back at T5, a shattered left elbow, broken leg, and severe head and facial injuries. Given the severity of my injuries, I wanted to get treatment at the best orthopedic hospital I knew of, the New England Baptist Hospital of Boston, which was also near my home. After I was stabilized for four days at an ICU in Idaho, the Baptist agreed to accept me, and my private insurance company agreed as well -- so much so that they eventually paid for the bulk of the cost of an air ambulance.
At the Baptist, I was assigned an attending physician, Dr. James Karlson, whom I had never met. In our initial encounter, in an X-Ray room at the Baptist, he was physically abusive, ripping off my neck brace and manhandling me on an unpadded x-ray table. He had apparently not read my records, since every doctor I had spoken to up until then had emphasized to me the importance of keeping my neck brace on and taking special care with my neck to prevent the spinal cord injury I had somehow escaped during the accident.
After that incident, I learned that Dr. Karlson was also scheduled to perform the reconstruction on my left elbow. Given his thoughtless and abusive behavior, I refused to allow him to operate on me, as is my right. At that point, Dr. Karlson retaliated by ordering my bladder catheter removed -- I could not even sit up unassisted at that point, and a fall on the way to the bathroom could easily have left me paralyzed or brain damaged. Dr. Karlson also apparently put the word out at the Baptist through the gossip network that I was not to be treated by other doctors -- every other member of the orthopedic staff of the Baptist I contacted was for some reason unavailable. Our belief about this was confirmed by the hospital's chaplain, Dr. Kenneth Larsen, who reported to us that "No one wants to do your surgery, because you were scheduled for surgery with Dr. Karlson... and you stood him up."
When I requested to see a hospital administrator to try and solve some of my problems and get a surgeon, I was shunted to the "patient advocate" department, whose only response was to assign me a new attending physician. Over my objections, Dr. Basilico was assigned to me.
During the four days I was Dr. Basilico's patient, he was verbally abusive to me, screaming at me while I was bedridden, threatening to withhold medical care from me, and using his authority as my attending physician to prevent me from transferring to another hospital for my surgery. Dr. Basilico provided me no help at all in finding another surgeon, nor did he provide me with any medical care himself. He reduced by half the amount of pain medication I was receiving, I believe, as a punishment for turning down Dr. Karlson. He also verbally abused my husband. The case management staff, as well as the "patient advocate," knew about this, and did nothing to help me.
When I found a possible surgeon at another hospital by frantically networking by phone from my bed, this triggered an apparent effort to drive me from the hospital before I could finalize arrangements with this surgeon. Once the hospital staff had made it impossible for me to get care from this surgeon, they began trying to discharge me to a nursing home without rehab facilities. The sum total of help I received from the case management department in finding an appropriate rehab facility was to hand me a thick booklet that contained an alphabetical listing of nursing homes in the Boston area.
In this context of neglect and abuse, I finally was able to arrange for a bed at the Spaulding Rehabilitation Hospital. Upon reviewing my case, Spaulding agreed to take me, but the Baptist failed to execute their part of the three-way negotiations between the two hospitals and my insurance company. Even while I was arranging a transfer to Spaulding, Baptist staffers were insisting that I take steps to move immediately to some other facility because I, "couldn't stay here," any longer. Finally, I guaranteed my stay at Spaulding by advancing cash, which was later reimbursed by my insurance company. I paid a heavy price, indeed, for refusing to let an abusive doctor operate on me. After the long delay in obtaining the elbow reconstruction I needed, I never regained full range of motion at the elbow. As a personal trainer, this constitutes a significant disability. In addition, I was severely traumatized by the abuse I experienced.
This is a list of the people at the Baptist who knew I was being discharged from the hospital without surgery, as a result of refusing to let Dr. Karlson operate on me, and who made no efforts at all to see to it that I got appropriate medical care: Dr. Frederick Basilico, the second abusive attending physician; Dr. Lampros Minos, * one of Dr. Karlson's assistant surgeons; the case manager; the "patient advocate" and her staff; Dr. Kenneth Larsen, the hospital's chaplain; the nursing staff. If we had been allowed to speak to the hospital administrator when we asked to, he would have known about it, too.
Once I became persona non grata at the Baptist, no punishment, from withholding my pain medication, my X-rays, a consultation with my EENT, and finally, my elbow surgery, was too horrible to be inflicted on me. Once I had angered the physicians at the Baptist, it was open season on me; no person or system protected me. And I know from research that I have done that I am not the first person to whom this has happened. The above persons, and the Baptist as an institution, were perfectly willing to see me discharged without the elbow reconstruction I had come to the Baptist to get, sent to a nursing home with no rehab facilities, and left with a permanent disability; they seemed utterly unconcerned that it is the hospital's legal responsibility to see to it that I received the surgery I needed, or to arrange a transfer to another appropriate facility where I could receive that surgery.
The doctors and staffers at the Baptist seemed to be under the impression that if they abused me and ignored my medical needs for long enough, I would dry up and blow away like a tumbleweed, leaving them free to return to their remarkably profitable business of providing elective joint replacements to patients with private insurance.
But no matter how it's actually run, the Baptist isn't a private clinic: it's a hospital. It's chartered by the state as a hospital, taxed as a hospital, and accredited as a hospital, and the staff are required to address the medical needs of the patients they agree to accept. I did not survive being thrown from a running horse, sustain a broken neck and a head injury so severe that part of my scalp was torn off and six of my teeth were broken, so that I could be physically and verbally abused, denied adequate pain medication, kept from seeing my own doctors, and ultimately discharged without the orthopedic surgery I so desperately needed.
In conclusion, I have tried to be as compact as possible in relating these incidents. I'll be happy to provide the Department with details if you feel they would be helpful. I have submitted three complaints to the management of the Baptist since I was discharged, and have received only a form letter and a referral to the same patient advocate department that failed me when I was a inpatient. I have submitted formal complaints against the doctors and staffers who were involved with the appropriate Massachusetts boards of registration. Thank you.
*We were still under the impression at this time that Lampros Minos was a doctor....
Basilico and Larsen complaints
This is the text of the letter I sent to Dr. Basilico at the same time I wrote to the hospital, December of 1998. If you were the attending physician of a patient who had been discharged without emergency surgery, would you, as Dr. Basilico did, have ignored this letter?
December 16, 1998
Dear Dr. Basilico:
As part of wrapping up the acute phase of my recovery from multiple trauma, and as part of leaving your cardiology practice, I feel compelled to acquaint you with some facts concerning the brief period when you were my attending physician at the New England Baptist Hospital. As you may recall, you became so outraged at the disruption and inconvenience you experienced as my attending physician that you came to my hospital room and chewed me out.
Are you aware, Dr. Basilico, that you were chosen to be my attending physician after we had to fire Dr. Karlson not by me, but by my case manager? * I feel compelled to state to you now, as I was not given the opportunity to do so at the time, that the assignment of you as my attending physician was one forced upon myself and my husband, over my most strenuous objections. It would, in fact, not be an exaggeration to state that I begged her not to select you. I knew that you were much too busy and much too little attached to me as a patient to take on a case of that complexity. But I was not given a choice.
I feel further compelled to remind you that none of the telephone calls related to those potential transfers that you found so trying were initiated by me, or authorized by me. In fact, I was completely unaware of them until that evening. They were, once again, initiated by the case manager, without my authorization or knowledge. I was not trying to transfer out of the Baptist: the case manager was acting entirely on her own **, for reasons that are still unclear to me.
Of all the painful memories I have from the hideous meltdown that my stay at the Baptist became, the one of you standing over me in my bed and dressing me down for a host of sins I never committed is surely one of the most bitter. Would it really have been too much trouble for you to check and see who was genuinely responsible for those "outrages" before you blamed me? Many things about my stay at the Baptist were not what they seemed.
I noticed today that one of the physicians at the Baptist who is following up with me for my broken neck has been sending updates to your office. As usual, I have no idea why. I will put a stop to this as soon as I can.
* At this time, we were so uninformed about how hospitals work that we thought the case manager was in charge of the abusive treatment I received.
**As we later learned, this was impossible: case managers operate under the direction of the attending physician, and attending physicians are responsible for their acts.
These are the copies of the police report and petition for a criminal assault and battery complaint against Dr. Karlson.
If you ever have to do this, be sure to get advice from a domestic violence resource center or an attorney who is familiar with domestic violence issues. In my visits to police stations to find the correct precinct to give the incident report, I discovered that when I said that the perpetrator was a physician, I was always directed initially to the officer who handles sexual assault cases. Go figure. If you have been medically abused or assaulted, you need to speak to the officer in charge of domestic violence or regular assault and battery cases.
This is a picture of the front page of my medical malpractive lawsuit.
This is a copy of the No-Contact restraining order that the judge put the defendants under as my lawsuit progressed.
Isn't this interesting? Even though I was able to sign my departure paperwork from Idaho Falls, apparently I was "unable" to be interviewed to sign this consent form when I arrived. And check out the stamp in the upper-right corner. Even though I was Dr. Karlson's patient on that day, and didn't become Dr. Basilico's patient until Sunday evening, Basilico's name is on the stamp on this form. What I, my husband, and everyone else to whom I have ever shown this form gathered from this is simple: this consent form was tricked up retrospectively by someone who panicked when they reviewed my medical records and discovered that no one had obtained my consent when I arrived.