Sorry this is kinda long, but here is the whole story of "the banfield 7"
Parts might be a little confusing because it was all cut and pasted and I had to remove some things (due to it being too personal and having other people's names in there). The only names mentioned in there are Banfield and Dr. Zagorsky. And, yes, I did get permission from Dr. Z and VIN to do this. 🙂
I was having a pretty good day until I got home today and got my mail. In the mail was a notification from the State Board that Banfield (7 doctors named) is filing a complaint against me. Hmmm.
Brief summary: 13 month old Am Staff male (previously owned by my lead technician and I was his vet until he moved), is seen at a Banfield facility on a Saturday in Mid-May. Dog recieves Distemper, hepatitis,parvo,corona,lyme, giardia, bordetella,rabies and Proheart, all at once. Dog returns the following Thursday to be neutered. Owner goes to pick up dog and on the receipt all of the vaccines are listed once again.
When owner questions the receptionist and tells her that the dog had just been vaccinated the previous Saturday, she disappears in back. The vaccination charges disappear from the bill. Within 48 hours the dog is vomiting, diarrhea, urinating blood and generally very sick. Owners go back to Banfield; labwork is done; owners are told that the dog is in renal failure. They are told that the dog needs to be hospitalized on IV's etc.etc and or course transferred all over hell and gone to emergency hospitals because they don't have 24 hour care. Owners call breeder (my tech), who calls me and we get the dog transferred to my hospital-over the Banfield Doctor's fervent objections. (It is now Sunday morning).
I see the dog. Run bloodwork, ERD, and complete urinalysis. Sure enough the dog is in renal failure. Treat the dog. Dog recovers and goes home in a few days. Owners ask me how this happened. Well, over the course of the dog's treatment I had conferred with 2 of my local colleagues and also called my old teacher and mentor (Head of Small Animal Medicine and Board Certified in Internal Medicine at my Alma Mater) and gave them the scoop and gave them my opinion. I suggested that this dog had an adverse reaction to all of the vaccinations that he had receive in the space of 5 days, add the stress of a major surgery and you have something akin to an immune mediated type of glomerulonephritis. I had read all kinds of journel articles about adverse vaccine reactions and had just finished a CE course on vaccination protocols, so this stuff was fresh in my mind.Of course without a biopsy of tissue that opinion cannot be proven 100%, but gee wiz, walks like a duck, talks like a duck.....
I have a really bad habit of being honest with my clients and tell them the truth about what I'm thinking and I told the owners what I thought about what happened to their dog. They, of course, were very unhappy with Banfield and in the course of trying to get some satisfaction (in the form of an apology), the owners tell me they got nothing but a big run around. I put the records away and thought nothing of it, "till now.
Let's see, the complaint alleges that I 1) failed to diagnose the dog properly (my diagnosis was the same as theirs). 2) That my diagnosis was made without proper diagnostics (I did everything their doctor did). 3) that my treatment plan was inappropriate ( I did treated the dog in the same manner in which they wanted to treat the dog---hospitalize, fluids etc.....The dog lived. How inappropriate could my plan have been...?) 4) that I told the owners that the Banfields vaccination protocol was inappropriate and the cause of the animals illness (you betch ya---believed it then and believe it now). 5) and that I refused to forward a copy of Mogli's medical records to them even though the client had given authorization. (Actually the client gave Banfield authorization for BANFIED to send medical records to ME, NOT visa versa. And I did send a case summary, not clinical notes (which is all I am required to do under the law) and copies of laboratory results to Banfield.
So here I am, trying to figure out what the complaint is all about. Probably retribution. Probably my big mouth got me in trouble again. (When I responded to some doctor who claimed to be a QA person for Banfiled, because she was "gravely concerned" over my treatment plan and my diagnositic abilities with this dog--I basically told her that she had no business questioning my doctoring skills and she needed to look and see what the doctor's in their hospital were doing to animals. And that she had no regulatory authority over me. That's what probably did it...you think?) As far as I know, Banfield was not sued over this dog, nor was a complaint filed against them with the board.(I haven't seen the owners in a while, but I haven't received any requests for information from any lawyer types).
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I don't understand how Banfield can legitimately file a complain against me. I saw a sick dog on my day off. I examined the dog, ran lab tests, treated the dog to the best of my ability and the dog went home. The owners were happy with me and we continue our relationship. The owners asked me to be honest and tell them what my OPINION was as to what happened to make this dog so sick, so quickly. I researched, spoke with 3 other doctor's, read journels and based on the best information available, I gave them my honest opinion. I did not state anything as in a legal deposition--I told them what I thought happened based on the information available. It is kinda scarey to me that I can face disciplinary action from the board because I have an OPINION that differs from someone elses.
Even though, chances are nothing will come of this (I HOPE!!!!), I still have to defend myself when I saved the dog's life. Banfield and I disagree as to the cause of the dog's renal failure. Perhaps I cannot prove my point 100%, but neither can they,(whatever their opinion is....no one seems to know). My clients respect me because they know I will be honest with them, and give them my best effort. I have a problem with not shying away from what I believe is the truth, even though it may be "politically incorrect." I can sleep at night. I've had other doctor's disagree with me in the past. Medicine is not black and white, and disagreements happen. Opinions are like a__holes... everybody has one.
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I am in the process of putting together the clinical notes, labwork,the copies of information
that I had sent to Banfield, statements from my lead tech that worked with me on the dog (and actually had a couple of conversations with Banfield staff), and letters from the 3 doctors that I had consulted with during this situation.The owners of the dog said that they would be more than happy to support me and address this complaint directly, themselves, with an independent letter, sent directly to the board. I hope to get it all put together in a profession, calm, organized, objective(????) fashion
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I spoke to **name*** up at the board this morning and yes this is a true complaint and not a hoax. I also learned some things from her. She said that the board is obligated to investigate any complaint regardless of their source, (be it pet owner or veterinarian). She also said that they receive many complaints from "veterinarians who were second opinions on cases" that turned in the first veterinarian for improper medical practices, and so on. So I then said that I was then very confused because I was the second opinion on this case, and that the owners were unhappy with their treatment from Banfield, who saw the dog first. I told her that I successfully treated the dog and sent it home and that I was absolutely flabergasted to get this complaint. *Her* tone in response changed, ever so slightly, when she replied "Oh, my."
Well, the light just went on. I wonder if Banfield, in their original complaint to the board stateded it in such a way as to make me appear to be the vet that saw the dog first and that I was refusing to cooperate with them as the second opinion vet......That makes more sense to me than Banfield filing a complaint against me when I had a successful outcome and sent the dog home with a happy owner.
Anyway *she* was helpful in telling how to address the allegations and how to answer the questions and told me that I could ask anyone that I like for help with my response. The plot thickens....
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According to the clinical notes that the owner demanded that they turn over to him before he left to bring the dog to me, the Giardia vaccine had been given again. It was my technician that found the notation in the file when she reviewed it after the dog was at our facility. The owners went a little nuts when we told them what we found because Banfield did not tell them that the dog had been revaccinated after the owners strict instruction to not revacccinate the dog.
When the dog was dropped off for surgery, the receptionist stated that the dog was being presented for neutering and vaccination and the owner told her right then that the dog had just received vaccines and to not give him anymore. The owner also requested that a specific veterinarian neuter their dog ( call him Smith) because the other vet (call him Jones was afraid of their dog and did not like the way he handled the dog). The owner was told that she would make certain to relay their request to whoever should know. When the owners picked up the dog, Jones had indeed neutered the dog. When asked why the other vet didn't neuter the dog at their specific request, the answer was "we didn't know that you wanted Smith and not Jones to perform the surgery. Smith went home early." Now, upon learning of the vaccination, their immediate thought, (without any prompting from me) was, "what else did they give the dog that they did not tell us about (and has possibly been excluded from the file.)"
Anywho, I am working my way through the questions and getting all my duckies in a row. As I review my notes and files, the complaint doesn't have a leg to stand on. If Banfield thinks I can be intimidated, they picked on the wrong person to try out their threat tactics. And as long as Krispy Kream keeps making donuts, I'll have enough sugar in me to get through it. You can even buy Kristy Kream at Albertsons now, so it saves me the drive into the next town. I'll probably weigh 400 pounds by the time this thing ends, but such is life.
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The owner of the dog is working on their response and sending directly to the board. If it is anything like their complaint to the board, it will be dynamite. The dog owners are 100% behind me and if it were possible, they are more upset about this than I am....but a chocolate covered glazed donut has a wonderful calming effect on me.
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finally got my attorney involve and I'm glad I did since she cleared up a big question. "How can Banfield have the right to file such a complaint?" The answer is, they don't.
I wish that I could remember the exact language that she used but it goes something like.."Since the Vet medical board is a governmental agency, set up by charter for the State of California to investigate complaints of "wrong-doing" (my phase), a person or entity cannot just file a complaint just because they want to. A person or entity must be "subject" to the complaint--ie the pet owner or the second vet that saw the pet and "fixed it" and is reporting misdeeds done to the pet by the first vet.(that was my language and how I understood the explanation).
Sooooooo, while I am gone (*on vacation*), my attorney is going to investigate further,and I am going to write the board today and formally ask for a xerox copy of Banfield original complaint and their language. When I get back, we are going to see if our assumption is correct,and if it is, do I have grounds for an action against Banfield for filing a frivolous or even false complaint against me? I guess attorneys can be helpful (plus mine is a real animal lover.)
This will be my last post for a while. I can assure you all that even though I may make donut jokes, this situation has really jolted me. I am extremely thankful for the support of my friends and family and overwhelmed by the support from the vet community. Your support gives me the energy and the spirit to "rock on" and still really love my job and MOST of the people that I come in contact with as a result. This is really bad news for our profession. If all the clients that had come to me after visiting my local Banfield office had filed complaints, Corporate up there, wherever they are, would be answering complaints for decades. I just fixed the pet, tried to say very little and moved on, always trying to do my very for the pet and the owner.
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As I reflect on this entire situation my gut feelings are of those of extreme sadness. It would seem that some members of the profession have reached a new low.
And here is the real kicker. After another conversation with my attorney, there really isn't anything that I can do to/about Banfield. Again, this is my interpretation of the legal language, but since the complaint was filed through a proper legal entity, which was set up specifically for the purpose of investigating complaints (the board), they can complain all they want, and I have to respond. Every single, solitary word of the complaint can be a lie and I still have to respond. It is the nature of the beast. And because of this, I do not really have good grounds for a civil complaint for...whatever. I have to say that the attorneys at Banfield have found a very effective way to harass and TRY to intimidate.
So, at the present time I am getting my paperwork in order. I have my supporting letters from my consultants. The owners have sent their letter of support to the board. I am going through and responding to each "alligation" in order, and am trying to be factual and professional as possible. I'll have it done by the weekend and mailed to the board to await my fate. On the face of it, it would appear that the complaint SHOULD be dismissed as groundless, but one never knows, do one? (for all those Archie McNally fans of the Lawrence Sanders novels).
One of the biggie lessons that I had learned many moons ago, was that poor communication was the number reason for a lawsuit. This case between the pet owners and Banfield is a case study in what not to do to a client and how to set yourself up for a lawsuit. This entire situation DID NOT have to happen. The clients became disenchanted with Banfield and came to me because of DISMAL/OR LACK OF COMMUNICATION on Banfields part.
First was the change in vaccine protocol for this dog (their other dog was not given all vaccines at once and was told by Banfield that it wasn't a good idea to do so).Second, the increase in the price quote for the surgery, and the owner is told basically too bad, so sad, I don't remember what I told you before, but the higher price stands. Third, in spite of the owners request to have a different doc neuter the dog, the doc they didn't want, does the surgery (the staff in back claims they didn't know about the request). Fourth, the dog is re-vaccinated for giardia the day of surgery in spite of the owner telling them on intake the dog was not to be vaccinated (let's now add insult to injury and NOT TELL THE OWNER OF THE ERROR!!!!!).And within hours of taking the dog home, he is getting sick (I did not have to tell these owners anything by the time they got to me---they had already put 2 and 2 together and were planning a board complaint. I just gave them the straight answers as best I knew).
The owners wanted someone at Banfield to say they were sorry that the dog got sick. Just to say they were sorry---not accept or admit to responsibility--just, we're sorry,"what can we do to make things better for you" would have gone miles to calm these folks down. Instead, for the next couple of weeks, they got nothing but the run around from all the corporate muckity mucks in spades. It is no wonder that the complaint was filed.
Due to the normal time delays for such things, plus the fact that they do have jobs and lives, the owners finally got the boards questions answered and sent back in mid-August. Because they are young, they don't have a lot of money. This entire process of filing with the board was quite emotionally upsetting for them so they were not planning on filing any civil action, if the board did not find in their favor.... until I told them of my problem. Holy, moly. Outraged doesn't do their response justice. Since I have discovered that my options are limited, I am going to wait until after my paperwork is filed and I have some time and talk with them again about reconsidered a civil action. My plan was to help with the lawyer and the legal fees. It would seem that they have the best case for action against Banfield. If it is too hard emotionally for them I'll drop the idea. I just hope beyond hope that the Board will find merit in their complaint, because these young folks had been through a lot with their pet and would be crushed to have their complaint dismissed.
No longer will I "cover" my the local Banfield vet when a pet owner comes in with yet another messed up case. In the past, I just shugged by shoulders and tried to avoid the question from the owner about why Banfield did what they did.....fixed the pet and moved on. Maybe some bad PR may be my only recourse---how does it go...do a good job and the client tells 3 people, do a bad job and they tell 13.
Under the category of worst case senerio, I can't imagine the board finding against me, BUT....... I am back at work. Being a little more careful with my note taking and client files. Get those quotes in writing and permission slips signed. This has to go under the heading of Monumental Lesson Learned. (Anyone who is curious, drop me a note and I'll tell you about the time a client wanted me arrested for child abuse.)
As soon as I know anything more, I'll put my findings on this board,no matter how things turn out. I am tryng to be optomistic. I thank all of you that are following this, for your words of support.I suppose it will be a long while until this situation is final, so all I can do is move on and be careful.
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I went back and reviewed the notes and looked at the complaint again. Only 2 of the doctors that have filed against me actually laid hands on the dog. A third doc, was a direct supervisor of the other two and we, (at my hospital) and the dog owners did have dealings directly with him. But all 7 are listing the Banfield San Diego address as theirs. I am pretty sure that the other 4 are up at corporate in Washington or Oregon or where ever. Now how can the 4 doc's that never saw the dog, never treated the dog etc., be a party to the complaint? Maybe they can, but I am definitely going to follow up on that train of thought. I would really like to address this issue in my response to the board, but I don't know if that would be the appropriate place to ask that question. Since I am almost done with my response, I think that I will bring that question up in another way, through a different avenue. Sherrie, according to your post the TBVMA initiated discussions with your attorney about prosecuting a false complaint. Dare I hope for that or should I start this investigation on my own?
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I wish to make a couple/three points perfectly clear. The owners of the dog in question are exceptionally bright, well educated young people.They asked me excellent questions and I gave them honest answers. I, in no way shape or form, suggested, encouraged, promoted or in any other way persuaded or influenced these young people to file a complaint with the board. After 20 years in practice the fear of "the board" still scares the wee wee out of me. No matter how I feel about any other vet, I would never wish it on them.
The owners of the dog were very upset with their treatment from the Banfield facility. When they arrived at my hospital that Saturday night, they were already very mad and already talking medical board. Since I did not know these people I was cringing. But I knew that I had to behave as I always have with my clients. They ask me questions, I answer them to the best of my ability and I let the client put 2 and 2 together.
The other point is this. After we got the dog settled in, my head tech read through the clinical notes that the owners got from Banfield before they left. In the notations on the day of surgery, it clearly states, "accidentally gave pet giardia, but he's not due till 3-20, did not bill/charge for." When I asked the owners if they were aware that the dog was re-vaccinated for giardia (against the owners express wishes), they said no. At this point the owners are now livid. The dog was re-vaccinated and the owners were not told of the accidental re-vaccination. Can someone from Banfield explain THAT please......?
The owners were pretty mad when they left my office. They found more information on the internet, than I was even aware of was available. I did not tell the owners much. They did research, they asked questions and I gave my best informed answers.
Final point for this evening. I did not speak to anyone on the phone myself for several good reasons. First, I was busier than a one-armed wallpaper hanger and simply did not have much time(when the dog was still in my hospital). Second, I was getting messages to call, but these messages were strongly insinuating my "lack of competence" in handling this case---so I was in no hurry to call and be insulted. And besides, I was NOT obligated to do so since the owners said in no uncertain terms was Banfield to ever have anything to do with their pets. And thirdly, I saw the "run around" that Banfield was giving the owners so I knew this would be a trickly situation Therefore, I chose to communicate with 2 doctors, in writing, only. That way, I had proof of exactly what I said and meant to say (and my words could not be twisted or mis-interpreted) and I had proof that I did respond for requests for records. About 3 or 4 days after the dog was discharged, I faxed a records summary, labwork to Banfield,in San Diego.
I still want to know why the owners were never told of the re-vaccination.................
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So here is what I wish to make clear.
1. Let us not forget who the real "victim"(for want of a much better word) is in this entire situation. It was the DOG/PATIENT. This entire situation started with a complaint to the board against BANFIELD from the OWNER of the dog. The owner of the dog alleges many, many, many misdeeds against BANFIELD in the treatment of their beloved pet. Not the least of which is re-vaccinating the dog, against the express wishes of the owner, not telling the owner of the error, and then the dog gets sick.
2. The owner endeavors to find a new vet because of a total lack or confidence in the Banfield staff (due in fact to the "mis-deeds" (not a good word) that they allege occurred.) Because of my relationship with the breeder of the dog, the dog winds up at my facility after hours on my day off. I had no idea who these people were, but I knew the dog, and I felt bad for the owner.
3. I fix the dog. The dog goes home. The owners are thrilled with me.The owners are still trying to get some sort of explanation from the powers that be at Banfield and for 2 solid weeks they are continually put off.
4. I followed the guidelines of the law by submitting a records summary and all accompanying labwork to the doctor in San Diego that requested it. ( Before I sent the material, he was already insinuating my incompetence and mis-diagnosis, so as I stated before, I did not really want to talk to him and be insulted, especially since I've been in clinical practice for 20 years and he graduated in '96.)
5. I spoke to the dog's owner when I received the records request, and told him what I was going to do. That all I was required to do by law was send a record summary and labwork. I also told the owner that they were many notations of private, priviledged conversations between me and them and me and other people in the notes, and that it would have been totally inappropriate to send the notes as written. The owner agreed and told me to send only the records summary.
6. Once the dog left the Banfield facility and the owners made their intentions known that they were seeking other care, THE DOG WAS NO LONGER A BANFIELD PATIENT, and Banfield had no legal rights to see or reviews any of my work. THIS DOG WAS MY PATIENT----HE WAS NOT A SHARED PATIENT, AS IF HE CAME TO ME ON REFERRAL.
7. My fellow VINner's....let's get back to the REAL issue. The real issue is the complaint that the owner filed against Banfield San Diego. The real issue is how the dog came to get sick in the first place and how the owners and the dog were treated. I could have said that the dog was invaded by green dogs from Mars, and used Voodoo and Jack Daniels in my treatment, and sent my notes in brail. All of that does not matter in the real scheme of things. The dog got better on my watch. The dog is home and playing with his litte sister and the clients are happy with me.
8. The focus of my concern is what happened to the dog BEFORE IT GOT TO ME. Banfields complaint is an attempt to distract and intimidate. Perhaps Banfield will answer the board, when they ask how the dog got re-vaccinated and the owner was not told...... among many, many other things that the owners have ask the board to investigate.
9. The two doctors that I wrote to were named on the complaint. I personally did not have any contact with the other five.
10. I finished my response to the board and sent it on it's way. I have no idea how long it will take to resolve this issue. As I reviewed my "book" (the response and supporting documents in 45 pages long) even I was surprized at the strength of my response. I had found notations and notes that I had long forgotten were there.
My present focus is on the dog's owners and their continued struggle for what they feel is some "justice". They are the type of client that we all wish for. They are intelligent, caring and passionate about their pets--but you can't just try to get something by them. They challenged me to be thorough, thank God, because much of my evidence for my position, I obtained on their behalf and desire to understand.
11. I love my job and am very passionate about the animals under my care. I may not be the sharpest knife in the drawer, but I have been told that I make up for it with my determination to learn and always do better. This complaint from Banfield has challenged me to do better. I'm a solo doc, so I get to own all of the mistakes that may occur in my shop, but I would not trade my job from any other. I will be okay with the board, but if by some freak of nature the board sees fit to discipline me, I'll take it and move on. I was in the Army for 11 years (3 on active duty) and nobody does an "ass-chewing" better than a military officer- so I've had my butt worked on by some of the best and still survived.
Thanks for listening. I guess I had a lot to get off my chest. Today is my day off and my dogs and I are going for a ride.
Again, thank you for all your support. It really means the world to me and since a few are close, physical neighbors, maybe we'll get a chance to get together at a meeting. Onward, Krispy Kream!
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sent the clinical summary BEFORE the owners filed their complaint. The second request for my exact clinical notations, came to me AFTER the owners filed with the board. In the e-mail that came from the Quality Assurance Medial Advisor,she stated,"I have grave concerns as to how you reached your diagnosis and I wanted to hear from you BEFORE REPORTING THIS CASE TO THE STATE BOARD."
Now here is my train of thought:the final line of that e-mail was obviously meant to intimidate me; the owners have filed a complaint; the powers that be at Banfield are mad; Banfield has absolutely no legal rights to any of the information in my file; this is going to be complicated and may wind up in court therefore I need to be very careful with what I say. So in that state of mind I responded to this person in writing. I was polite, probably a little emotional, and I relayed to her my diagnositic plan and whom I consulted with BUT also told her what I stated earlier today. That the big issue is not what I did or did not do, but rather, what had happened to the dog in San Diego BEFORE he came to me (and mentioned many of the complaints that the owners told me) and HOW he came to be sick in the first place.
I suggested that perhaps she should save her "grave concerns" for the doctors in San Diego and perhaps should focus her attention on them and not me since I fixed the dog.... or words to that effect. I spoke with my attorney then and have many conversations since and we both believe (knowing what we know and cannot share with you guys), that "communication" would not have stopped this complaint. It was coming my way regardless and is meant as a legal tactic. I hate to sound like I'm beating a dead horsey, but you can't complain to the board that you did not get clinical notes that you had absolutely no right to ask for in the first place!!! Again, knowing what I know about how the client was treated before and after coming to me, I believe that no amount of "professional communication" was going to help my cause. My attorney had also warned me that I was very likely, (she knows me well), to stick a verbal foot in my mouth and say something that could be twisted around and come back to haunt me in the future. That if I was compelled to reply, do it in writing.
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continued in next post....
