Akron Veterinary Referral and Emergency Center

(Revdex.com Copied from original document.)Dear Ms [redacted] ,The following is in response to your letter dated 12/23/and received on 1/3/concerning the experience Ms [redacted] expressed in bringing her cat to our facility on 7/8/To date, I have no been involved in this particular incidentI do not know the details other than her cat was severely injured requiring extensive surgeryThat said, it is obvious Ms [redacted] cares deeply for the well-being of her cat and is understandably upset given the experience she has articulatedWhile I cannot make any specific promises at this juncture, I can say I intend to assist in seeing this incident through to a resolutionI am aware Ms [redacted] sent a letter to DrF [redacted] , an owner of the hospitalUnfortunately, he has been out since early December for medical reasons and is not scheduled to be back in our hospital until the first of FebruaryI realize it has been some time for Ms [redacted] , but if she will allow me to sit down with DrF [redacted] as soon as he is back to review all the records and details of the case, I will make certain we follow through on our promise to attempt to reasonably resolve this expressed issue.Ms [redacted] , it is important to us we get to the bottom of any incident of dissatisfaction expressed to usWe take the business of emergency and specialized veterinary medicine very seriouslyWe absolutely recognize the intrinsic value pets have on our lives and work diligently, regardless of how critically sick or injured a patient presented to us may be, to satisfy our clients by meeting or exceeding their expectationsTherefore, please know we will be in contact with Ms [redacted] as soon as reasonably possible upon DrF [redacted] 's return to work.Thank you for your attention and understanding regarding this matter, Ms [redacted] .Respectfully Submitted,Shaun M [redacted]

I am rejecting this response because:
Hello Ms. [redacted],Thank you for helping me resolve my issue with Akron Veterinary Emergency Clinic.  I am rejecting this response at this time, until I get an actual offer of resolution from the hospital. I can appreciate and respect Mr. M[redacted]' response and completely understand that the delays are, in part due to Dr. F[redacted] being out for medical reasons.  However, I sent my letter to them in mid-November asking for a written response within 30 days.  I find it very unprofessional that they left my letter ignored.  If the Dr. knew he was going to be out, or even if it was unexpected, he or Mr. M[redacted] should have written me to tell me that and ask for more time to get this resolved.  Instead, they decided to ignore me, leaving me doubtful that they will actually follow up or offer any type of acceptable resolution.  I would appreciate if you assisted me until they follow through on their promise to contact me. For your records, I have attached the letter I wrote to them.  It was sent certified through the USPS on 11/17/16. Thanks very much for your help. [redacted]

(Revdex.com Copied from original document.)Dear Ms. [redacted],The following is in response to your letter dated 12/23/2016 and received on 1/3/2017 concerning the experience Ms. [redacted] expressed in bringing her cat to our facility on 7/8/2016. To date, I have no been involved in this particular incident. I...

do not know the details other than her cat was severely injured requiring extensive surgery. That said, it is obvious Ms. [redacted] cares deeply for the well-being of her cat and is understandably upset given the experience she has articulated. While I cannot make any specific promises at this juncture, I can say I intend to assist in seeing this incident through to a resolution. I am aware Ms. [redacted] sent a letter to Dr. F[redacted], an owner of the hospital. Unfortunately, he has been out since early December for medical reasons and is not scheduled to be back in our hospital until the first of February. I realize it has been some time for Ms. [redacted], but if she will allow me to sit down with Dr. F[redacted] as soon as he is back to review all the records and details of the case, I will make certain we follow through on our promise to attempt to reasonably resolve this expressed issue.Ms. [redacted], it is important to us we get to the bottom of any incident of dissatisfaction expressed to us. We take the business of emergency and specialized veterinary medicine very seriously. We absolutely recognize the intrinsic value pets have on our lives and work diligently, regardless of how critically sick or injured a patient presented to us may be, to satisfy our clients by meeting or exceeding their expectations. Therefore, please know we will be in contact with Ms. [redacted] as soon as reasonably possible upon Dr. F[redacted]'s return to work.Thank you for your attention and understanding regarding this matter, Ms. [redacted].Respectfully Submitted,Shaun M[redacted]

Initial Business Response /* (1000, 5, 2015/10/29) */
Dear Ms. [redacted]
we are in receipt of your letter regarding Mrs. [redacted]'s issuing a formal complaint expressing her concern for the care of Jezabelle received here at Akron Veterinary Referral & Emergency Center (AVREC)and in her words,...

"negligence that lead to the death of her dog". First of all, we are very sorry for her loss. While our desired goal is to heal and save the lives of our patients, we, unfortunately, do not have ultimate control over life or death. Again, may I express our sympathy for her loss. With all due respect to Mrs. [redacted], the scenario she is projecting in her written complaint does not totally bear out in fact. Yes, Jezabelle had a severely herniated disk and the medical records show a review of anesthetic and surgical risks including the possibility of never being able to walk again or ever having bowel or bladder control and the very real possibility of anesthetic death was discussed with the owner. Mrs. [redacted] signed the presented consent to treat paperwork including the fee estimate.
With regard to the notion Jezabelle had meningitis, although the topic of meningitis may have been brought up at some point, it is not clear to us why she is insisting she was told by the surgeon Jezabelle had meningitis. Via myelogram, the CSF (cerebrospinal fluid) results were consistent with a herniated disk and this was communicated to Mrs. [redacted]. Why, over the course of multiple discussions between the doctor and Mrs. [redacted] to the contrary, she still insists her dog died from meningitis is not clear to us, but it is our contention she was effectively communicated with in regard to the clinical findings. That said, there were subsequent discussions between Mrs. [redacted] and our office manager once again expressing meningitis was not indicated. Sadly, we do not know why Jezabelle died and to date, if an autopsy was ordered by Mrs. [redacted] and performed, we have not been privy to the results. Again, we are at a loss as to why she is adamant Jezabelle had meningitis. At the risk of belaboring the issue, the amount of prednisone did not play a role in Jezabelle's passing. For the record, Predisone was continued because it was an option for treatment and her regular veterinarian already had her on prednisone. The surgeon did reduce the dosage when he was told Jezabelle was not eating, as steroids can result in gastrointestinal upset and since the spinal cord was decompressed, through surgery, the higher dose of steroids was not imperative.
We take our responsibility to our clients and patients very seriously. The care and treatment of Jezabelle received was clinically appropriate, well within veterinary standards and administered by very competent doctors and staff. We wish we had a definitive answer for what may have caused her death post discharge and during recovery. Again, it is not clear to us why Mrs. [redacted] is insisting Jezabelle has meningitis. We do not have any clinical information that would support such a finding. Likewise, for her to use the phrase, "negligence that lead to the death of her dog" was simply not warranted. We respectfully, see no reason to reimburse Mrs. [redacted] for the fees incurred and which happened to be below her signed estimated cost to treat.
Ms.[redacted], as a veterinary specialty and 24-hour emergency hospital we see some very sick and injured dogs and cats. With each and every patient, we do our very best to meet or exceed our clients' expectations. We are truly sorry Mrs. [redacted] does not have Jezabelle with her at home, but in no way are we responsible for her passing.
Ms. [redacted], thank you for your time and attention.
Most Respectfully Submitted,
Shaun W. M[redacted]
Initial Consumer Rebuttal /* (3000, 7, 2015/11/02) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I stand by the statement that Dr. C[redacted] said Jezabelle passed away from meningitis. As a simple pet owner, not a doctor, I can only go off the word of Jezabelle's doctor that she died from meningitis. As I stated in my initial letter, Dr. C[redacted]'s exact response to my question, "How could this have happened?" was "Five minutes after you called about Jezabelle's passing, her lab results came in". "Jezabelle passed away from meningitis." I of course took his statement as fact. Moving forward with that information I questioned when Jezabelle's labs came in. They had been sent to AVREC on August 18, 2015 at 3:11pm not on August 19, 2015 around 12om as Dr. C[redacted] had stated. Naturally, this made me feel uneasy. Could that window of time been enough time to get her treatment? Her lab results were never explained to me nor were they addressed in the AVREC's rebuttal. I cannot draw an educated conclusion about her lab results, but the comment section does state that, "This pattern of pleocytosis has been associated with infectious and noninfectious CNS disease." Where did Dr. C[redacted] find enough evidence of meningitis to feel confident enough to give as an answer to Jezabelle's cause of death to me? Is Dr. C[redacted] denying he said Jezabelle died from Meningitis? Meningitis was never brought up by anyone during Jezabelle's care until Dr. C[redacted] said she died from it. The meningitis statement did not just come out of thin air.

AVREC stated they gave Jezabelle Prednisone as an option for treatment because her regular doctor already had her on it. I called Jezabelle's regular veterinarian, Dr. [redacted] of [redacted], and asked the last time she was on Prednisone. Dr. Raina's assistant told me there was no notation of Jezabelle ever being prescribed Prednisone. The last time she was seen was May of 2013. She was prescribed Cephalexin. I firmly believe that if the AVREC prescribed Jezabelle, Prednisone, she should at least be on the appropriate dosage. She was prescribed a dose appropriate for a dog one third her weight. Why would they prescribe a medicine if it didn't serve a purpose? If it did serve a purpose, why wasn't she on the correct dose?

The care and treatment may have been clinically appropriate while she was at the hospital, but as soon as we carried her out their doors, she was just an afterthought. They were kept updated on her quickly ailing health, but there was no concern or sense of urgency for how sick and weak she got in such a quick period of time. I explained she couldn't eat and was so depleted she could only drink water from a syringe, had been heavily panting for 20 hours, she was so weak she couldn't hold her own head up. I asked if I could bring her back because I was scared for her. AVREC told me I would have to wait about eight hours (9am-5pm) hours before being seen. In the time we waited so we could go back, Jezabelle passed away.
We believe the AVREC was negligent because of their lackadaisical after care. We still don't know when her labs were actually reviewed. By the sequence of events we know they were received Tuesday, but never reviewed until Wednesday after her death based on Dr. C[redacted]'s statements. Why did Dr. C[redacted] lie about when the labs were received? Could Jezabelle have received treatment in time? Were the labs still not reviewed when I called at 9am on Wednesday morning in my desperate plea for help? Would a full dose of Prednisone have helped her battle her affliction? If they had allowed me to come to the AVREC when I called could that have been enough? We believe that the AVREC had multiple opportunities to help Jezabelle, but failed to do so. We believe attentive care from the AVREC could have changed the path that led to Jezabelle's death.
Final Business Response /* (4000, 9, 2015/11/13) */
May I again say, we here at AVREC are very sorry for Mrs. [redacted]'s loss. We truly understand how it feels to lose not just a pet, but a cherished member of the family. And wanting definitive answers and reasons why that, unfortunately, can never be empirically determined only adds to the strong feelings of loss.
With all due respect to Mrs. [redacted], we stand by the initial response to her complaint we submitted to Revdex.com on 10/27/15. We understand the term meningitis was talked about with regard to "check for", "rule out", etc. However, we contend Mrs. [redacted] was never told Jezabelle died from meningitis. We are still at a loss for the confusion and misinterpretation. Jezabelle did not have meningitis, but a severely herniated disk. In reviewing the details of this case, the results of the CSF (cerebrospinal fluid) were reviewed by three additional board certified surgeons and all agreed that the results did not indicate meningitis, but were consistent with the identified herniated disk. The attending surgeon did not tell Mrs. [redacted] Jezabelle died from meningitis and we are sorry there continues to be confusion regarding this. I will clarify one point and apologize for misspeaking in our initial response. Her regular veterinarian did not put Jezabelle on prednisone, it was the veterinarian at the ER where she first took Jezabelle before coming to AVREC. Again, our apologies for that error.
Lastly, we would be more than happy to have Mrs. [redacted] come in and sit down with me, the surgeon involved and the hospital owner to discuss in detail the clinical findings bearing out the fact Jezabelle had a herniated disk and was medically treated appropriately. We affirm our position the doctors and staff of AVREC are not responsible for causing Jezabelle's death.
Respectfully Submitted,
Shaun W. M[redacted]
Chief Executive Officer
Akron Veterinary Referral & Emergency Center

Final Consumer Response /* (4200, 11, 2015/11/25) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The AVREC may claim there was "confusion" about the Meningitis discussion, but the conversation with Dr. C[redacted] was crystal clear. When a doctor is responding to why my dog died my ears are wide open and my full attention is given. There are absolutely no blurred lines about Dr. C[redacted]'s statement to me. He may have been lying at the time to offer sympathy, but I took his statement as the truth. There was no confusion.
The fact still remains that in my desperate call for help, AVREC's first available to be seen was eight hours later after my first call of how grim she appeared. We still contend Jezabelle was never on a proper dose of her steroid. If not a factor, as AVREC states, why bother prescribing? Her lab results were not reviewed almost 24 HOURS after they were received. They were never mentioned in multiple phone calls, until Dr. C[redacted] claimed they had come in five minutes after I called.
If this case revolved around a child, rather than a dog, this would be absolutely unacceptable and given a heightened sense of resolution and ownership. In a parents call for help would they have been told to wait eight hours to been seen at an EMERENGY clinic? Would the medicine not be given in an adequate dose? After passing, would we be given a lie to console us? Would a parent be confused over a doctor's response for death? Jezabelle was our child.
Jezabelle deserved proper treatment and after care. She was neglected and given lackadaisical care. The AVREC did not fulfill their duties as her doctors and she died as a result of their failures.