My fiance had back surgery in April, went to a skilled nursing facilty for 17 days and was getting in and out of bed and walking with a walker to the bathroom and doing fine. She came home and 2 days after getting home her legs buckled on her when she was getting up and she fell. Her legs stopped supporting her and she could no longer stand or walk. She was taken back to the hospital and was inpatient for 2 weeks. They tried to to get an MRI 4 times but were unsuccessful. She has had numerous MRIs and never had a problem before including the one just before surgery. The first couple of attempts she could not hold her legs still because she didn't have full control over them. The next 2 attempts would go OK to a point of reaching her shoulderblade area and then she says the pain becomes unbearable like someone sticking a hot poker into her and she had to make them stop. The MRI techs said she'd have to have it done under anesthesia to get the full scan. The doctor on duty said they didn't do that there as an inpatient. This is one of the largest hospitals in the state of Arkansas (UAMS) and discharged my fiance. She had to be taken home by ambulance and placed in bed by the paramedics. After about a week we were finally able to get her back in a skilled nursing facility for rehab again. She can move her legs and has gained strength in them but still can't control them to stand or walk. We have been trying to get someone to listen that she needs an MRI to see if they can figure out what's wrong. No one is. The discharge papers from the hospital even said she needs an MRI under anesthesia. We are a little worried about this as well that it might do more damage to her if there is something wrong causing the pain during the MRI. Anyway, the skilled nursing facility is discharging her next Monday and we are wondering what we are going to do. She has no lift, no hospital bed etc and still needs the MRI to see if anything can be done to help her walk again. Does anyone have any suggestions? We've considered talking to a lawyer because we can't seem to get anywhere otherwise. She does have a "telemed" followup with the surgeon's office at the end of August (28th). Not sure what good that's going to do. Oh, and she was her surgeons last surgery as he moved to another state and is no longer with the hospital she had the surgery at.
As far as equipment needed for home, the rehab facility discharge planner should be ordering those items, to have in place and delivered to the home upon DC
ROBOTIC LATERAL LUMBAR INTERBODY FUSION (LLIF)// L1-2 with extension of fusion to T9;
It should not be an insurance issue. She is disabled and has medicare and did have United Healthcare insurance. Since going into the rehab the second time and at the suggestion of the facility she applied for medicaid and was approved so they could get the rehab covered when before it was going to to be over $203 a day copay with United Healthcare.
Her pain is better, the pain in the shoulders wasn't bad until they tried doing the MRI's and only then when it would get to a certain point. She's been able to move her legs but they seem to be stronger because of the rehab. She can lift and move them around but can't control her feet when she tries to stand, they try to slide out from under her.
We have been trying to get anyone to help us with getting another MRI so we can see what's going on. We have contacted the surgeon's office but not getting anywhere. Like I said her surgeon has moved to another hospital out of state and I believe they are just letting her fall thru the cracks but why I don't know. She could not make the followup appointment with the surgeon's office because she was in the hospital after falling. The same hospital the surgeon's office is located in. They were made aware of this. A surgeon never came by to see about her the whole 2 weeks she was in the hospital, only interns from his office. They could see she could move her legs some and seemed to be fine with that. We explained she couldn't stand or walk but nothing was ever done by them. The attending Dr did order the other MRIs she attempted but after the 4th attempt discharged her. She had to be taken home by ambulance and placed in bed by paramedics.
I'm terribly sorry you're being given the bums rush here, and that your fiance is suffering so. Make a big stink about this. Good luck.
Was the prior surgeon an ortho or neuro or general?
It may be an issue that perhaps now she doesn't have a "primary" doctor. If an MRI under sedation was a recommendation, it should be in her medical records.
Also, are you her Medical Representative? This is a HIPAA form she would have been given or requested where she wrote in your name as MR and signed it, then given it back to the staff. It's my understanding (in my state of MN) that this form is required by every doctor your see. If you are making calls on her behalf, and are not her MR, this may be one reason they don't respond to you alone. The HIPAA form allows her medical team to legally discuss her private medical information with the MR without the patient's consent or presence.
I am unsure if I am listed as a representative but am listed as her contact and have access to her information at her request to them.
MRI under sedation was on the discharge papers and suggested by the person administering the last MRI she attempted.
The discharge paper says MRI as a future need but she was discharged as no longer having acute care hospital needs. I have the feeling that the fall caused some new damage.
The post rehab after 22 day changed charges of $203 each day is usual and customary even if she is on Medicare. That is a bargain compared to other Medicare plans. That charge lasts up to 100 days when she would then be considered as custodial nursing care going up to $350 per day. What you need is a medical care advocate to assist you in accelerating the process of getting an MRI. It might cost $200 per hour for this person. Remember also that after the MRI will be a follow up appointment.
I do not see any medical malpractice. However I see long waits and muscles will deteriorate, unfortunately. Even after she gets a video visit, an MRI with anesthesia will have to be scheduled in a hospital setting pending whatever insurance she has. All this will have to be done through Medicaid. When you say unsafe discharge, she can be admitted to a Medicaid facility depending on where an open bed is available which might be close by or far away..depends on the state where you live.