I had no insurance and went to Sherman Oaks ER where I was told I would need 9,000 to sew the tissue/nailbed back on. I accepted loosing the nail and tissue. They sent me to Harbor County where I was told they would pack it and cast over it so it could heal.

Again the bone was intact and exposed. Instead they took me to the casting room and proceeded to do an orthopedic surgery by removing healthy bone from my finger. Now my finger is necrotic and has bad infection. I need to know why they would remove healthy bone from a soft tissue accident. Other than it is cheaper to amputate than to do the skin graft. Now I may loose the rest of the finger or even hand if the infection or necrosis gets worse.

I DO NOT have insurance and I do not qualify for Counties ORSA program as I have a business and Report all of my income honestly. Please any advice is helpful!!!  

(Sorry for the graffic photo)
Picture below shows the missing nail bed an a missing tissue. All bone is intact. This is also after sitting in their ER at Sherman Oaks for over 5hrs.

BTW: I have all exrays before and after what they did to me. My fingertip might have been worth 9,000. to them. But my hand health are priceless to me.

I felt treated less than a human being! On top of that now I can not work and have to jump ER's for IV Vancomyacin.

Again any advice would be helpful!!!

and I think it shows the heartless nature and incredible short sightedness of what is becoming of the health care industry.

Nevertheless, I think you might want to contact a medical malpractice attorney regarding the bad advice you were given in regards to the risks you had to take.  Contact the local bar association in your town for a referal.

I hope the situation turns out OK somehow.

(still not a lawyer)

You need to go to another doctor or hospital and get a second opinion or even third and someone needs to prescribe you some antibiotics to fight the infection.

Save all your x-rays, pictures etc and find a good malpractice lawyer with a history of winning cases to sue them.

Incidentally, the finger nail would have grown back slowly but surely based on the picture you provided. All someone had to do was give you an anti-infection shot; clean the finger up and stop the bleeding; stitch if necessary and dress it up with frequent re-dressings to allow it to heal and tissue to regenerate. Eventually the dressing comes off permanently to allow for faster healing.

Maybe minor surgery would be require to cut any exposed bone off but nothing over the top. The treatment procedure for what you describe would not be that much different from a burn victim. I highly doubt a skin graft would even be required.

You don't have insurance, so you were provided the worst care (the cheapest) - which is amputation. I guarantee that if you walked in with BC/BS they would have done everything possible to save the finger. This happens all the time - if some homeless person arrives with a problem in their leg, leg gets amputated. Insured person arrives in same hospital with same condition, all options are explored.

Remember your experience when the 2012 elections come around, and remember who is trying to look out for the uninsured, and who isn't.

LOOK at it now. (

It does seem that you did not get the best advise or care.  I crushed a finger in an industrial accident many years ago.  The ER doc was all for amputating back to the first knuckle.  They insisted in Xrays...  of course it was broke, the accodent was like being hit by a trip hammer!  Duhh!!
My Mother (God Rest Her Soul) got a neighbor who happened to be an Ortho Surgeon to take over the case.  He put a ton of stitches in, grafted tissue from inside my upper arm.  It was wrapped in guaze for several weeks, undisturbed. I was on antibiotics, of course.
Eventually, the day came to unwrap it...  the nurse dripped peroxide on it to loosed the stuck together bandaging as they cut...  but in the end some of the graft took.  The dead tissue was removed.  The nail grew out & fell off but a new one grew in.
Today, the finger is a little shorter than the other hand & longer than it's neighbors.  I have most of the nail but the soft tissue under the tip is less & a bit lumpy.
Yes, I had good insurance through my employer & I never saw a bill for copays or anything.  (When I went back to work, there was still a piece of my tissue on the equipment...  GROSS!)

It may be very hard to get a doctor to testify of a mistake and the treatment was within the range of possibilities.  V hard to prove it was "wrong" to treat it this way.  The question now should not be money but how to make the best outcome moving forward.      
skb

its best to go during the daytime because they get packed at night when all the regular doctors offices are closed.  no insurance, no appointment necessary, and they will not treat you like slime scum.

you will not wait 5 hours.
even at their most packed, wait time has never been more than 2 hours.
they have handled both me and my son for the past 15 years, insured and uninsured.

i've not had to consciously take myself or my son to the hospital because urgentcare has handled eeverything we brought to them.

they will discuss with you all the costs involved, which costs are necessary and which costs are merely options that you should consider.

the office visit is around 100-150 with no insurance and they will confirm you can pay that before seeing you. ...

Well I will continue going to the ER close to my house for IV Vancomyacin. As the wound care clinic wanted an extreme amount of money. Hope this picture does not gross anyone out.  Your input is apprechiated!

On top of all this some guy writes a bad review about me and as far as my records, I have never even met the guy! Not sure how to handle that either.

Wish I could simply find a Great Specialist here on TER!

Light & Love,
Dani

but I would still get a lawyer's opinion on the matter for the $100 or so he/she might charge for a short consultation.

First, it was too late before I could edit my post and to remove the reference to getting an infection fighting antibiotic.

Second, you notice they prescribed the Vancomyacin after they chopped off half her finger and the infection had already developed and spread.

You think it might have been a better idea to give her an antibiotic to fight infection at the onset. Perhaps a cheaper, money saving option before more drastic, expensive steps have to be taken to save her limb.

The cheapest option is not always the best regardless if one has insurance or not and cutting corners does not always work.

modified to eliminate rudeness, please do not post in this manner in the future  LB

-- Modified on 11/16/2010 3:24:33 PM

As another comment stated, amputation is in the realm of acceptable treatment. No one's going to find that doctor liable for malpractice.

The problem is we all watch too many medical dramas on TV, and think that everyone gets "heroic measures" when they go to a hospital. Please...

The quality of treatment you receive depends on the hospital (the sleepy community hospital will not have the same care as the large university hospital), it depends on the specific doctor that sees you (you might be seen by a 3rd year resident, or an experienced ER doctor - luck of the draw), it depends on which specialist is on-call when you happen to come in (if the best specialist happens to be skiing in Aspen when you come in, YOU LOSE), it depends on what (if any) insurance you carry (no insurance? no heroic measures AT ALL), it depends on what the doctor thinks and knows about you (if I tell him I am a concert pianist, he will try harder to save my finger than if I say I am a garbageman).

Something else, in her website she states that she is a surgical assistant and technologist, level I & II trauma, she ought to then know the risks of not attending to her injury.

I think chromerider69 is right, even the most rudimentary medical classes will teach you that if an infection goes far enough, it can kill you.

OP, I don't care to see any more ghastly pictures. I want to see you get with the program and get this taken care of. Your life can very well depend on it.

Go to social services if you have to. That is what it is there for.

I found an Urgent Care by my house. I will go today!

All the advice and support is Great! Mainly just focusing now on healing. Even if I had a case for malpractice I would not waste my energy and time.

Light & Love for the Board!

It happens to be among the most powerful broad spectrum antibiotics in the U.S. Pharmacopoeia. Specifically used for M.R.S.A. (flesh eating bacteria) and other very nasty infections. Very expensive, can only be given via IV at this time. Pay attention before shooting off your dim witted comments!

modified to eliminate rudeness, please do not post in this manner in the future LB

-- Modified on 11/16/2010 3:26:22 PM

first off, minor tissue damage does not turn into the wound in the picture over night. you had been treating it yourself for some time, thus infection has set in. 9k for finger sounds right...maybe those with insurance will stop whining about their rates. at harbor, they probably did tissue debridement as well as some bone removal in order to create a flap for closure. based on the 2nd picture, again you are not doing as told as the wound has become infected again. yes iv vanc is one of strongest out there, but generally its a 10 day course of treatment, up to 6 weeks if a systemic infection. when you left the er's  you were probably given an rx for oral abx, my guess would be clindamycin. just having the paper doesnt work...get the rx filled and take the meds as prescribed and do the dressing changes as directed. stop partying, stop working, get the finger healed. or lose it, it's your choice.

There was absolutely NO reason for you to attack the other lady.  I mean WTF?!  The only Jackwad I see here is you.  She was trying to help.  So what if she goofed on the info a little!  You need to take a chill pill!  Your attack on her was unprovoked, undeserved, and unnecessary.  Nice touch that you hid behind an alias to attack her for trying to be nice and helpful to someone in need.  Coward.  I am using one to stay off of your attack list.  Geesh!  Maybe FFP will do us all a favor and show us who you are. Considering your poor behavior I would like to know just to stay the hell away from you.  Lighten up!

Why would you assume she is doing any of these things??  Do you really think she likes looking at her finger the way that it is??  I highly doubt it.

"stop partying, stop working, get the finger healed. or lose it, it's your choice."  

You sound like a pompous judgmental ass who likes to assume he knows how people live instead of actually asking.  

ORAL- If an ER doc hasn't written you an RX for an antibiotic I would without a doubt look into a lawsuit.  They don't have to do much but writing an RX cost them nothing and is part of being an ER doctor.  

I also agree with the lady who spoke about Urgent care.  They usually are better than the local ER's since they are generally geared for the less fortunate without insurance.  Might be something to consider.  

In the mean time, I would be soaking my hand in bottles of peroxide which you can get at the dollar store in bulk for cheap.  I know your cash is limited because you said you haven't been working, but maybe asking a friend to loan you a couple hundred isn't a bad idea and get yourself into an Urgent Care immediately before it turns into a full body infection.  

i make these "assumptions" based on 1. the pictures, 2. her descriptions of the events and 3. many years as a wound care nurse. this is a very common wound progression for addicts, i see it every day. i know how the system works and i know what the er's are going to do for people w/o insurance. i do admit i dont know anything about urgent care or patient care.
and btw, peroxide will only help to a small extent. it will not remove necrotic tissue, it will not prevent infection from going systemic. it will also "eat away" the new tissue as it grows. betadine dressings, changed twice daily after good thorough cleaning will do more to help the wound heal, but again, will do nothing for the infection.

1... How did you do this.. Was it a dirty, contaminated injury( rust, dirt, etc)
2. if all the tissue around the bone is gone, destroyed etc.. they have to remove some of the bone to
being able to fold the tissue over and close it..

3,, Infection.. Sometimes no matter how careful you are. Things get infected. you have done trauma to your body..

4. I can 100% gaurentee you that the surgeon does not usually have any idea of what if any insurance you have. The hospital still pays him..  That is between you and the business office.. This whole notion that doctors treat patients based upon their insurance pisses me off.. It's not true.... They give you their nights, weekends, holidays, kids and wives to go into that ER or OR to take care of you . with little or no thanks at all...

Here is a thought for you...

Ask the Doctor, why they did what they did.. His name is on your ER paperwork and he has an office
you will need to follow up with a physician anyway.. what happened to you sucks and I am sorry. Dude you are looking in the wrong place for anwears......

Thank you all again for the input and support.

Things are turning around so quickly, and partially because of an OZONE Machine.

There is a link to what it is and look how much healthier my finger is after only two treatments!

Light & Love,
Dani

1. About 15 years ago I went to urgent care regarding a foot problem. The doctor asked me if I had insurance before he sent me for x-rays. I can only guess that if I did not have insurance, he would have declined on the x-rays. I did have insurance but I was upset regardless.

This is a clinic affiliated with the renowned Mayo Health System. To counter your point, doctors do treat patients based on their health insurance status.

2. We have two major hospitals in town. The doctors are employees of the hospital at the one affiliated with the Mayo Health System. I wanted an expensive procedure done that was not covered by my insurance and wanted to know the cost.

He gave me his best guess and told me he had no bone in the procedure because he got paid the same every month by the hospital regardless if he performed one on thirty surgeries a month.

This hospital is still my favorite because their service is still lights out.

2. The second hospital, the doctors are considered private contractors and bill separately for their service. The hospital bills separately for their service as well. Not unusual to read about this hospital in the paper about their service including ER service. They actually were stripped of their Medicare and Medicaid compensation once.

The service of this hospital leaves plenty to be desired I tell you. You can see how a patients insurance status can effect how a doctor treats a patient at this hospital. If he thinks he will get paid, he might do all he can otherwise maybe not.

Given the under staffing in emergency rooms and high uninsured rates these days, many emergency rooms are taking a tougher stand on what actually constitutes an emergency. If you are insured you will get treated, if not and it seems like you are not going to die in all likely hood you might get referred to another clinic.

I am not blaming doctors for such decisions, many times it is the hospital boards that set such policies to maintain profitability.

I agree with you that many times doctors give their all and sacrifice plenty to help their patients in return for no thanks at all but it is not a perfect world like you seem to indicate.

BTW - It is a provider who started this thread, not a dude.

That is quite a pile of assumptions and generalization all ending with the oversimplified political statement.  And the way you used/exploited her situation to make that statement is rather unseemly.  Everybody probably feels for the OP, but you can't pretend like anyone is trying any harder than anyone else to "look out for her."  

Besides, she said she isn't covered by ORSA coverage because she "report[s] [her] income honestly."  That program covers 100% of expenses for people making less than about $15000/yr, and progressively less for higher incomes.  So if she wasn't covered *at all*, she had a plenty high enough income for independent insurance.  She's the kind of person who those very people who are "trying to look out for the uninsured" want fined for failing to purchase insurance.

Thank you all for your input! I thankfully have beat this terrible infection and my finger continues to heal nicely .

BTW-
Now feeling much better, the need to address a few opinions or should I say assumptions from chromerider69 & RoseMallowe have come to fruition. Of course I am in no way offended by anyone's opinions, I believe clarification was in order.

I chose the legal corner discussion board for the purposes of Legal Information concerning the Medical Treatment I received. With my extensive work in the Operation Room I know my treatment WAS NOT MORAL ETHICAL TREATMENT of a Human Being. In my 12yrs. in the OR as a Surgical Tech/Asst. MY primary concern was ASEPSIS! At the moment that they started a surgical procedure on me in the CASTING Room. With NO REAL STERILE set-up, no mask or even a clean setting. As the room was cluttered with plaster DUST everywhere! I KNEW I would need antibiotics, If for nothing else then for prophylactic treatment (preventive treatment). As when the sterile field has been compromised it is common practice to Prescribe Antibiotics. When I asks the resident if he was intending on prescribing me antibiotics, he responded. " NO, that they do little amputations all the time in the casting room like this and have a low infection rate."  I WAS FLOORED, "Microbiology101" folks! Then within 24hrs, I had acquired a very progressive and serious SSI (surgical site infection) which I went back to my Local ER by my house to be diagnosed and treated for. This was the evening of 11/10/2010.

I gratefully am NOT an addict and thankfully, I am healing VERY nicely thanks to a Healthy Diet, Exercise, Positive Thinking, Ozone Treatments, and a Strict Antibiotic Regimen. I am a Compliant Patient that did what any PRUDENT person would have done at the moment of injury. I called 911, was subsequently taken to the closest Emergency Room and was there for about 6 hours. With nothing but a sterile cup of 1% Sterile Topical Lidocaine (in a cup to dip the finger in) before being transferred to the county facility. Furthermore, I DID NOT continue to work throughout this time. NOT just for my own safety and well-being but for everyone else's. I go to to school and run a business outside of the "Hobby". I admit I fall into an Income Bracket that can afford and should acquire Health Insurance. Unfortunately, I have a few pre-existing conditions that render me uninsurable according to the Companies I have looked into.

So I wanted to know from the Legal Corner if;

A.) Is a physician liable for removing healthy bone when ONLY the tissue surrounding it has been damaged?
-which PittPanther answered for me, Thank You PittPanther!

B.) If a physician does a surgical procedure with poor sterile technique, in a room that is not a surgery suite of some sort. Is the physician be liable when the patient develops an SSI (surgical site infection)?
-this question has not been answered as of yet. However, it is the first time I have actually point blank asks it.

I have been cleared to go back to my regular activities. Although quite self-conscious, I will do so very soon.

I am VERY Grateful for ALL of the continued support from my TER community.

Light & Love,
Dani