Animal Medical Center Blog Costs Lisa Collier Cool Patients pet health costs pet surgery veterinarian

A $9,000 surgery, and her dog died: A different take on health costs, this time for pets

My good friend Lisa Collier Cool had a young dog who died a couple of months ago after surgery at the Animal Medical Middle in Manhattan. She was charged $9,000, and was irate. Cool, an writer and journalist, wrote this letter. Her website online is right here.

Why am I’m posting here? We hear rather a lot about individuals arguing over medical bills, and we’re asked incessantly if we plan to collect and show prices for veterinary medical procedures. (The answer is not any, at the very least not proper now.) Yet this specific story touched me. Additionally, Lisa’s a positive, meticulous journalist, and I feel her story is value telling. She put this on Facebook, and I asked if I might publish it over here, and she granted permission.

By Lisa Collier Cool

Almost 5 months to the day after disastrous post-surgical “care” at the The Animal Medical Middle within the NYC killed my beloved 5-year-old Border terrier, Angus, for reasons that no one there has ever been capable of satisfactorily clarify–however unbiased specialists attribute to gross mismanagement of his IV fluids resulting in extreme weight reduction and dehydration–I’ve resolved my ongoing dispute over their bill of $9,080 for this fatal remedy, despatched with a cheery message reading, “Thank you for visiting the AMC!”

We settled upon a reduction since I don’t have it in me to proceed this emotionally wrenching struggle. Under is the letter I sent that particulars the state of affairs, which I hope can be helpful to anybody who has comparable points with the AMC or any veterinary hospital and may serve as a cautionary story to these considering having their pets handled at the AMC to allow them to avoid an analogous tragedy. We now have a new Border terrier, Ollie, who’s a relative of Angus and in wonderful health, to console us.

Lisa’s e mail to the Animal Medical Middle

Re: Demise of Angus Cool, patient #1017685

To: Pamela Schwartz, DVM
Crystal Sunlight, DVM
Dennis Slade, DVM
Billing Department
Ms. Kathryn Coyne, CEO
Ms. Carol Dinsmore, COO
Ms. Liana Everaert, Government Director of Shopper Relations
Mr. Robert Liberman, Chair, Board of Trustees
Mrs. Kenneth Langone, Vice Chair
Ms. Katharine Johnson Rayner, Vice Chair
Mr. Neil M. McCarthy, Vice Chair

As an award-winning medical journalist who has written for the New York Day by day News, The Wall Road Journal, Yahoo! and many different main nationwide media retailers, I all the time attempt to get top-quality healthcare for my household, including our pets. When our beforehand wholesome five-year-old Border terrier, Angus, developed a number of minor signs on account of a liver shunt, my husband and I turned to the AMC, trusting that that Angus can be in wonderful arms for the ameroid ring process that Dr. Pamela Schwartz beneficial.

That turned out to not be the case—48 hours after the December 31, 2018 surgery, we have been devastated and heartbroken to be advised that Angus was brain lifeless and had repeatedly gone into respiratory and cardiac arrest for causes that nobody on the AMC has ever satisfactorily explained. I had two unbiased veterinarians, one in every of whom works for the FDA and the opposite who critiques instances as an professional for the state veterinary board, evaluation Angus’ medical data. Both have concluded that the reason for demise was extreme dehydration as a consequence of mismanagement of his IV fluids. Given this catastrophic mistake, we search a refund of the $5,409.73 paid to the AMC and request that the additional bill we acquired for $three,671.33 (with a cheery word studying, “Thank you for visiting the AMC”) be waived. These specialists have recognized multiple points together with his care, that are described under.

Excessive dehydration, 9% weight reduction in 24 hours and malfunctioning IV gear. On 12/31/18, once we brought Angus to the AMC for the surgery, he was vibrant, vigorous and alert, weighing 6.three kg, in line with the AMC’s data. The subsequent day, his weight had dropped to 5.75 kg., a 9% lower. That may equate to a 150-pound individual dropping 13.5 pounds in 24 hours!

Raging thirst and a malfunctioning IV

Once we visited him within the morning of 1/1/19, after being advised that the surgery had “gone well” and that Angus was “stable overnight,” he was dazed, did not acknowledge us and had such a raging thirst that in our 10-minute go to, he shortly drank two huge bowls of water and seemed around for more. We additionally noticed that his IV was malfunctioning and its alarm went off 3 times throughout our go to. Every time, the vet tech turned off the alarm, only to have it go off again. We reported Angus’ extreme thirst to the vet tech in the course of the visit and requested him to let the docs know. I used to be so concerned about Angus’ hydration that I referred to as the ICU later that day, saying I was nervous that he wasn’t getting enough water.

AMC’s data repeatedly talk about dehydration and present that not only did he not regain the load misplaced within the first 24 hours, but his weight dropped within the subsequent 12 hours to five.64 kg (a total loss of 10.5% of his body weight in 36 hours). One veterinarian we consulted states that the data point out someone calculated how a lot fluid can be wanted to switch what had been lost, but ordered it to be given over 24 hours, as an alternative of “running the line wide open,” as she states would have been the usual of care for such severe dehydration. She also states that all the symptoms that the AMC has been unable to elucidate—profound electrolyte abnormalities, excessive fever, mind damage, and mouth twitching—are recognized results of dehydration that ought to have been recognized and immediately treated by the ICU workforce. Subsequently, our dog was heavily sedated and unable to drink on his own, but nonetheless didn’t get sufficient IV fluids to restore his weight. It was repeatedly noted in the data that he was urinating incessantly and profusely, making it even more obvious that he was dropping fluid rapidly.

Medical report errors and unauthorized spleen removing and expenses. After the surgical procedure, we have been advised that Angus’ spleen had been removed, at a price of $1,114.33, regardless that we were not contacted about this sudden surgery beforehand nor did we ever authorize this expense. The medical data variously describe a benign nodule on the spleen as both being 0.8 mm or 2×2 cm (a 250% discrepancy in measurement). Our marketing consultant finds it odd that this problem was not detected on the CAT scan for which we paid $1,600. She also points out that no one apparently observed that Angus had giant kidney stones and questions how rigorously the scan was reviewed and interpreted pre-surgically.

Other medical document errors: We acquired a invoice saying that the surgery had been carried out by Emily Kennedy, who doesn’t maintain any sort of veterinary license in NY, which is contradicted by one other report saying the surgeons have been Drs. Daylight and Schwartz. One medical document says he “ate well in the afternoon.” Elsewhere it says he ate nothing on that or some other day.

Was he secure, or did he have a seizure?

Chaotic, uncompassionate care. On the day Angus died, 1/2/19, we received a call in the morning from the ICU saying that Angus had had a grand mal seizure in the course of the night time. 5 minutes later, we acquired a call from Dr. Daylight stating that Angus had been secure overnight with no problems. I requested her if the other individual was mistaken to say there had been a seizure. She referred to as again somewhat later to verify that a seizure had occurred. Apparently she hadn’t checked the medical report before the primary name. Later that day, she said that he had “profound electrolyte abnormalities” and wanted a barely longer ICU stay, but she “felt sure” he would “go home on Friday.” Lower than two hours later, she referred to as again to say we should always rush to the AMC to say our last goodbyes because Angus was dying.

To this day, we never acquired any rationalization of Angus’ dying, condolences or apology from Dr. Schwartz, who had informed us in a presurgical consultation that he was “an excellent candidate” for this surgery, that she had carried out it “numerous times” with a price of “about 5%” of great problems, while the opposite 95% of instances have been totally successful. She also said that in a current research, canine that have been pre-treated with an anti-seizure drug had a 0% price of probably the most critical complication (seizures). She prescribed that drug and we administered it as suggested.

Once I rushed to the AMC in tears after being advised our dog was dying, Dr. Schwartz by no means came out to talk to us, nor has she EVER been in contact. Dr. Slade stated our beloved dog was “brain dead” and he didn’t know why, however suggested a necropsy to seek out out. We have been also suggested to get euthanasia (described on the invoice as $69.13 for “patient services”), but once we noticed Angus earlier than the injection, he seemed to be already lifeless—he wasn’t respiration, had no obvious heartbeat, glazed eyes and his body felt chilly.

Close to-perfect health pre-surgically

We obtained a card with the ghastly “rainbow bridge” poem, which drastically upset me. I needed to contact the AMC quite a few occasions for months before getting the necropsy results, which discusses the seizure but makes no point out of fluid administration points that induced our dog’s drastic weight loss and in the view of the unbiased specialists, killed him. Nor does it record any particular reason for dying or clarify why he developed aspiration pneumonia, mind swelling and a number of different hospital-acquired circumstances when he was in near-perfect health pre-surgically. In the long run, we are left as we started with the AMC, with no passable rationalization of why he died less than 48 hours after a supposedly low-risk surgical procedure. The authorization type doesn’t listing demise as a danger.

Suspected procedural damage. Our professional also observed that when Angus was catheterized for urinalysis a number of days earlier than the surgical procedure, he might have been injured as a result of recent purple blood was discovered within the urine.

Given this multitude of problems and the fatal “care” the AMC offered, I hope you will do the appropriate thing, refund the 5,409.73 we already paid and waive the $3,671.33 bill. Not only did we lose our younger, pedigreed dog and endure large emotional misery, but we also spent $300 on cremation and will probably be spending $1,800 in April to buy a Border terrier puppy of the identical championship bloodline as Angus. I also hope this letter will immediate your surgical and ICU employees to enhance its IV fluid protocols and examine for malfunctioning IV gear so that nobody else suffers an identical tragedy sooner or later. We’d wish to resolve this quietly and attempt to transfer on.

Sincerely yours,
Lisa Collier Cool

What the Animal Medical Middle stated

I requested her what the AMC replied, and she added: “I reviewed the letter they despatched and under is a quote that sums up their position.

“We have conducted a thorough medical review of Angus’s case and the care and treatment he received while at the Animal Medical Center. The medical review concluded that Angus died from complications of portosystemic shunt attenuation surgery, specifically seizures…one of the known risk factors that was discussed with you.” The letter additionally states that, “all pre and post-operative care was deemed medical appropriate” in their evaluation of their very own work.

“The letter from the Animal Medical Center is dated April 4, 2019 and signed by ‘Dr. Queensberry, Chief Medical Officer’ and ‘Liana Everaert, Executive Director of Client Relations.’”