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Lady Gaga Snerd


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Lawsuit: Man says his penis was ruined thanks to his insurer
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Lawsuit: Man says his penis was ruined thanks to his insurer

By Newser Editors

Published January 22, 2015
Newser
Lawsuit: Man says his penis was ruined thanks to his insurer

 (AP Photo/Dario Lopez-Mills, File)

As far as lawsuits go, this line contained in one filed by Rupert Collins against his insurer has to rank among the most horrifying: "Rupert's penis and urethra is permanently eroded away." Courthouse News Service has the graphic details on Collins' suit, which he filed Dec. 30 against Kaiser Foundation Health Plan in Napa County Superior Court.

While a patient at Napa Valley Care Center (the complaint explains Kaiser was "contractually obligated" to provide physician services there), the elderly Collins began to experience issues with the Foley catheter that had been inserted into his penis.

 
 

Per the suit, a nurse faxed Kaiser on July 21, 2013, requesting permission to "have a trial of no Foley" to rest the area, which was "red and swollen and cut." Request denied and, per the suit, "his penis began to erode further and further each day." Nine days later, another nurse again faxed Kaiser with an identical request; it was again denied, according to the suit.

On July 31, Collins' daughter, "horrified" after seeing his penis "split completely in half from the tip of his penis all the way down to the scrotum sac," had a third nurse contact Kaiser.

She was allegedly told the erosion was "normal" and would eventually heal. The daughter managed to get a Kaiser urologist to examine Collins on Aug. 2.

His prognosis: The erosion was "complete." Not only would no healing occur, but as the suit states, "reconstructive surgery was not a viable option." It adds the doctor said earlier treatment would have saved the organ.

Collins is suing for elder abuse, negligence, and unfair business practices and seeks damages and attorneys' fees. (This man says he went to a hospital for a circumcision but got a penis amputation instead

 

http://www.foxnews.com/health/2015/01/22/lawsuit-man-says-his-penis-was-ruined-thanks-to-his-insurer/?intcmp=trending



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ed11563


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I think the HOSPITAL is guilty of gross negligence for failing to treat what THEY diagnosed as a critical problem.

The hospital should have taken care of the patient, then SUED THE INSURANCE COMPANY for the contract fee for everything that was done to protect and treat the patient.

 

We as a society need to have some big judgements against PROVIDERS like this for failure to treat their patients.

That's the only way to make them stand up to the tyranny of paper pushers at insurance companies when they deny claims for necessary care for covered patients. 

 



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Lady Gaga Snerd


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Where was the Attending Physician? When a nurse calls to report an observation and problem, the attending physician should have come in and done an exam.

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WYSIWYG


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Unfortunately insurance companies tell doctors what they can and can't do, now.

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ed11563


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Only because the doctors listen to them



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WYSIWYG


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"Only because the doctors listen to them" - ed11563

That's because, unfortunately, they are afraid of them. If they don't do what the insurance companies say, they will find their practices closed soon.

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aergia


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Each faxed request and rejection was accepted...Nonsense. Nurse A now goes to Supervisor B who escalates it. Gets Doctor C involved. Gets Medical Director of Hospital involved. MD to MD go toe to toe with Ins Company to Medical Director.........That catheter would not have lasted another day......It can be done. I have worked on both sides of this equation.

First do no harm. Do not let someone else do harm.

Take some responsibility people

2 thoughts:
in this type of situation, I do not understand how a foley did not just 'fall out' constructively.


Truth to tell, I grieved a very large settlement years ago, against the same company I now work for. Damn if we weren't $ucce$$ful.
It can be done folks......

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Southern_Belle


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Doctors are very good at finding the right terminology to get the insurance company to allow a claim. This man fell through the cracks.

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lilyofcourse


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Was this through private insurance or was it through Medicare or Medicaid?

Regular insurances underwrite those.

And they don't always put those patients high on their list of priority.



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Blankie


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lilyofcourse wrote:

Was this through private insurance or was it through Medicare or Medicaid?

Regular insurances underwrite those.

And they don't always put those patients high on their list of priority.

This was Kaiser, part of Kaiser Permanente, a private health insurer. I believe they are the largest managed care entity in the USA. 

Bigger is not better in health insurers, generally speaking.



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lilyofcourse


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So was he one of the "unimportant" ones?



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Blankie


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WYSIWYG wrote:

"Only because the doctors listen to them" - ed11563

That's because, unfortunately, they are afraid of them. If they don't do what the insurance companies say, they will find their practices closed soon.

Sometimes, in some cases. But quite a generalization.

Come to Massachusetts and witness the way Partners, a huge physician practice conglomerate, and one of the largest employers in Massachusetts,  bullies the insurance companies around here, and gets away with exorbitant rates.

Insurance insiders know that all insurance companies are not created equal. There are actually some reasonably good ones. Usually the regional not-for-profits and non-profits are better. The large national for-profits are worse. And that's a generalization also, which I readily admit.

 



-- Edited by Blankie on Saturday 24th of January 2015 04:54:08 PM

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Blankie


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The institution where he was treated was not a hospital. It was Napa Valley Care Center, a skilled nursing facility (nursing home).

He should have been brought by ambulance to a hospital. And nurses should not have been sending faxes to the insurance company (WTH? How about an emergency phone call?) The attending physician at the nursing home was largely at fault for not getting this guy to a hospital stat.

This article gives a little more.

 

http://www.dailymail.co.uk/news/article-2924065/Man-penis-split-two-eroded-sues-insurance-company-ignoring-infected-catheter.html



-- Edited by Blankie on Saturday 24th of January 2015 05:08:40 PM

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Tignanello


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Kaiser is impossible to deal with. I could NEVER get clients the care they needed under a Kaiser plan. The only advice I could ever give a Kaiser client who wanted advice in getting coverage was "get rid of Kaiser".

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flan327


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OMG!

Why did I click on this thread??

flan

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Blankie


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It is rather horrifying. I'm glad there are no pics.

It reminds me of when you boil hot dogs too long in water, and they split apart and curl.

That poor man.



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Lady Gaga Snerd


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Ugh! Thanks for the visual! No penis cloak allowed.

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