Day 3 of our San Diego healthcare nightmare

by Stephen Cobb on June 9, 2012

The sad saga of an epic #fail in healthcare continued today. Chey Cobb, the disabled 50-something IT professional, former Senior Technical Security Officer at the NRO and author of Network Security for Dummies, is now home and resting after being placed in a psych ward for 3 days. Her pain is still not managed. She has still not received adequate care. She has not been given any follow-up program, process, plan. Nobody medical has committed to call or help, except one very kind nurse whose powers are limited.

Epic failBefore I get to the day’s updates I want to thank all of those in the legal community who took my calls on Friday and the many friends who have reached out via phone, social media, and the inter-tubes.

If there is anyone whose call I have not returned, my apologies. I also want to thank the patient advocate from Jewish Family Services, San Diego, who did his best to kick things up a notch, even though the net result from Sharp HealthCare so far has been “we’re sorry we can’t do anything for you.” So please allow me to recap the facts. This will help me document what went down and add some clarity to the previous posts (Day One is here and Day Two is here).

  • Monday, May 28: Chey calls Sharp Rees-Stealy Medical Center to speak to her primary care doctor (PCD) about increased levels of pain she is experiencing, a matter she had previously discussed with her PCD. The PCD is out for the week. Despite several requests, no replacement or locum calls Chey back.
  • Monday, June 4: Chey is out of pain meds and her PCD refuses to prescribe any more, effectively imposing a cold turkey detox from an 80mg per day oxycodone regimen that had been in effect for about a year, established after extensive tests and consultations in New York, before we moved to San Diego (all fully documented in an envelope full of medical records that Chey handed to her PCD in person).
  • Wednesday, June 6, AM: Chey is finally able to see her PCD who confirms that she is not going to prescribe any more pain medication, despite knowing that Chey has been out of said medication for several days and it will take days if not weeks to switch to a different PCD (who will then refer Chey to a pain specialist for a pain assessment and medication).
  • Wednesday, June 6, PM: Chey’s psychiatrist is sympathetic and says he can arrange a pain assessment but only if Chey voluntarily admits herself to the psych ward at Sharp Grossmont Hospital. That proves to be a grueling, humiliating, and physically painful experience for Chey who does not get into a bed in the psych ward until around 4AM (we arrived there at 7:30PM). She receives no medication other than Ativan/lorazepam to help/make her sleep.
  • Thursday, June 7, AM: Chey receives no pain consultation and no pain medication all day. Spends a lot of the day sobbing at the way in which her efforts to live with incurable chronic pain have been crushed. As far as I can tell she is not examined by a doctor (they have her dopey on Ativan).
  • Thursday, June 7, AM: When I visit in the evening she gets 5mg oxycodone. I ask if she can leave, since she is not getting the treatment she was told she would receive, is very unhappy and uncomfortable, and she is there voluntarily. I am told that if she attempts to leave she will be put on a 5150, that’s a 72 hour hold that is reported to the federal government and results in the automatic revocation of certain civil rights like firearm ownership and/or possession. I test the doors and yes, they are locked all the time so you can’t get out and trying to get out sets off a very loud alarm. Chey agrees to stay another day based on the promise of medical treatment.
  • Friday, June 8, AM: Chey has been without adequate pain relief for going on 5 days and yet the nurses are annoyed that she won’t sit up and participate in group. (This is not a medical ward, this is a locked psych ward and some of the people there are pretty scary). Chey hurts too much to sit up, much less go anywhere (there’s a reason she’s in a wheelchair, walking hurts too much at this point).
  • Based on the advice to patients handed out by the hospital, to “tell your caregivers if you are in pain,” Chey tries to tell her caregivers she is in pain. No doctor comes, despite the fact that the right to prompt and medical care and treatment is spelled out deep within the version of the California code that they hand to patients. The promised social worker has not shown up (although we’re not sure what the social worker is supposed to do for chronic pain). A nurse tells Chey: “We have called your husband to tell him to make you stop bothering us.”
  • Friday, June 8, PM: I get news of this about 1PM. I start calling around for patient advocate lawyers. I go over to Sharp Grossmont in evening and have a phone conversation with Chey’s psychiatrist who says Chey is free to leave, but he is still hoping to get a pain consultation for Chey. I get the sense he is dumbfounded by the difficulty of moving the process forward and had no idea Chey would be treated in this way when he extended the offer to help her. Chey and I have a long conversation with the deeply apologetic and very sympathetic head nurse on duty. Chey is given some more oxycodone but nowhere near enough to control her pain. I leave her there for the night in the hope of a pain consultation in the morning.
  • Saturday, June 9: I arrive at Grossmont with Chey’s wheelchair about 10:30AM. I find a doctor just leaving, apologizing that he cannot refer Chey to a pain specialist but willing to write a prescription for a low dose of oxycodone. The social worker shows up. Still not sure why since she can’t actually do anything to help. It takes about 2 hours to process Chey out of there. Her personal possessions are returned to her from the safe. During the entire time she was there, no doctor touched my wife to see if she was in pain.

There will be more tomorrow. I will explain what a pain contract is and why you, dear reader had better pray you are never presented with one (hint: it is not a contract, you get nothing from it except grief). I will also explain how you can be abused and neglected by medical professionals even when your employer provides you with excellent health benefits.

In closing: There is an organization in San Diego called Sharp Healthcare. It’s slogan is: San Diego’s Healthcare Leader. The title of the Sharp website home page is “Top San Diego Doctors and Hospitals – Sharp HealthCare.” Then there is Sharp Rees-Stealy, a collection of medical centers. The nature of the connection between these Sharp entities seems hard to fathom, for patients and employees alike. Frankly, if that is healthcare leadership, we are all in trouble. If a 50-something professional couple with good health insurance can be kicked to the curb like this, it can happen to anyone.

Our experiences this week have shattered all hopes we harbored that San Diego would be a better place to get healthcare. My wife is faced with living out her days in constant and excruciating pain from which she can get no relief. The events of the past week leave us with no hope of that ever changing.

{ 3 comments… read them below or add one }

Aimee June 10, 2012 at 6:47 pm

I am so very sorry that we, as a community of HH and pain sufferers, have to go through things like this to get any help at all. Moreover, I am disheartened that the medical community continues to ignore our disease as a whole. I am thankful you were able to contact patient advocate lawyers, yet sorry at the same time. Thinking of your family and hoping that your wife gets the help she deserves.

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Pamela Hamilton June 11, 2012 at 9:24 pm

What an awful experience….it certainly needs to be exposed…you are both courageous to do so. Has Chey tried acupuncture?

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Donna Duke June 13, 2012 at 6:06 pm

The hospital administrators need to be aware of these issues! Contact the JCAHO and that’ll scare the administration! Report it to the Joint Commision for the Accreditation Hospitals, to Medicare or other state health & human services official. Hospitals are audited by the “Joint Commission” & they can pull the plug on hospitals & nursing homes when deficits are found. Hospitals take these visits VERY seriously!! The administrators, nursing administrators, and all the directors/managers & the staff of all the departments are dotting their I’s & crossing their T’s. Then they pray they pass! Does your insurance require a PCP referral or can you make an apointment for a pain management physician of your own choosing? Good Luck with this horrible situation in getting proper care.

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