Carolina Veterinary Specialists

I am rejecting this response because: the vet left out a crucial part of the evening; even with all the over priced diagnostic tests, she admitted Brie was too sick and weak to perform any life saving surgery; the diagnosis would be for my peace of mind She said in her response the test would be done for the "good intentions toward the wellbeing of Brie" but that is simply a lie Collecting data and money, at the expense of my last moments with Brie for no real purpose is criminal She was not empathetic or responsive to my wishesHer intentions were to milk the situation for all it was worth Holding my dog hostage while "Stabilizing and triaging" with oxygen and fluids was pointless Everyone knew Brie was dying that night, it was just how much money they would make before she did When a group of people are permitted such atrocities, the entire community suffers, not just Brie High standards keep a society striving This group should be reprimanded for their total lack of compassion and ethics they showed that night

Revdex.com Response in regard to case ID [redacted] 4/15/17   This is an explanation of events regarding an ER visit with a critical patient and the owner’s complaint against CVS for unethical conduct.  When the patient arrived at CVS, at no point upon first entering the...

facility did the owner address a technician and tell the staff that the sole purpose of the dog being here was for euthanasia. Due to the critical state of the patient, Brie received immediate assessment in the treatment area by Dr. A[redacted] and as with all critical patients to afford immediate life-saving procedures a critical care deposit was requested so that Brie could be triaged appropriately and with the proper standards of care that is provided at CVS.  The owner has misidentified the doctor on the case as Dr. P[redacted], who was never present.  The doctor in question is Dr. A[redacted].  I repeated my name several times to the owner to identify myself as the doctor on the case.   The owner’s first dispute is that the critical care deposit was unnecessary. However, the medical record reflects that Brie was in critical condition, in shock, with such a low blood pressure that a value was not able to be obtained  on presentation, and had free fluid present within her abdomen. Brie’s exam, coupled with the free abdominal fluid and history of anemia made a hemoabdomen a likely possibility for her rapid decline in status and collapse episode prior to arrival.  Due to this initial triage exam, a critical care deposit would have been used to have obtain bloodwork, ultrasound her abdomen and obtain free abdominal fluid for analysis, and place an intravenous catheter to stabilize Brie with fluid therapy while we worked toward a diagnosis.  The owner reported that no advanced diagnostics had been performed for Brie so this deposit would have been used with good intentions toward the wellbeing of Brie. This is the standard of care that any critical patient is offered at CVS when the animal is too unstable for the doctor to leave the patient’s side.   During the triage exam, the owner entered the back of the hospital unauthorized where other patients are currently receiving care and was refusing to leave her. The owner was distressed and irritated when speaking with her.  I told the owner that I had not left Brie alone and that I was trying to stabilize her prior to talking with her, in the interest of Brie.  The owner continued to not leave the back of the treatment area and was escorted by a male doctor to an exam room with Brie. At no point during this discussion with the owner did she announce her sole purpose was for euthanasia. The owner did exclaim that her dog was dying and that we were separating Brie from her. I reiterated to the owner that I was attempting to have Brie more stable before I talked with the owner and that this was not an issue of separating both of them, but a matter of care.  The owner argued that she could be present in the back because her veterinarian allowed her to be in the back of the hospital there. I told the owner due to other animals like her dog receiving critical care this could not be allowed as a matter of policy at CVS.               Once Brie was placed in an exam room with the owner, her husband, and my technician, I repeated my concerns about Brie’s  serious condition and again asked for a critical care deposit for diagnostics to be performed. The owner wished to discuss what I would do with that information. After discussing the options for testing and Brie’s history of not having a thorough work-up for anemia, the owner exclaimed, “She’s obviously dying, what would we do with more information?”  The owner at this point expressed wishes for euthanasia, which I respected and said I would perform. I empathized with the owner and told her I was sorry for the situation. The owner contemplated her tough decision to euthanize her pet and within the room had further questions regarding what would occur if we moved forward with testing. I told the owner that if we confirmed my suspicions about the hemoabdomen, we would attempt to stabilize Brie and if an area of bleeding was identified, then an emergency surgery may be recommended to stop the bleeding.  I told the owner my first goal would be to stabilize Brie to a point where surgery may even be considered. I told the owner I could not give a long-term prognosis at this time.  The owner at this point asked how much an emergency surgery would be. I explained to the owner that the cost estimate for this surgery would be estimated to cost $3,500-4,000 on an ER basis.   The owner, with this information, elected for me to euthanize Brie. I told the owner that I respected her wishes and that I again was very sorry. I understood and empathized with the owner’s decision from a standpoint of Brie being in advanced age, in critical condition, and cost concerns.               The owners second complaint is that I used my position, her guilt, and a suspected  “commission” based salary to abuse her in a situation of obvious distress. I am on a fixed-salary and as an ethical professional do not exploit people during a critical time to generate salary dollars. I am extremely passionate about my patients, but at the same time, I respect owners’ wishes as well. When the owner requested euthanasia, I did not judge her, but instead comforted her in her difficult decision.   I did not charge the owner an exam, an IV catheter, quick ultrasound assessment, or for the blood pressure monitoring in respect to the owners distress and suffering for the loss of her pet.  The placement of the IV catheter was to facilitate euthanasia and would have been placed for any euthanasia in which an owner were to be present.  Brie received oxygen and supportive therapies until the owner could come to a euthanasia decision.   I am sorry that the owner interpreted the events of that night in such a negative way. I am deeply saddened that she feels that our interaction was financially based, when this is not the case.  I feel any case in which there is dissatisfaction is a reflection on the type of care I have provided and I do take that personally and wish to resolve this issue.  I respect the owner grieving the loss of her pet, as I do any owner who has lost a loved friend.  I give my condolences to the owner. I hope that once reading this letter she can see my actions in a more positive and professional light and that a resolution may be obtained.

I am rejecting this response because: the vet left out a crucial part of the evening; even with all the over priced diagnostic tests, she admitted Brie was too sick and weak to perform any life saving surgery; the diagnosis would be for my peace of mind.  She said in her response the test would be done for the "good intentions toward the wellbeing of Brie" but that is simply a lie.  Collecting data and money, at the expense of my last moments with Brie for no real purpose is criminal.  She was not empathetic or responsive to my wishes. Her intentions were to milk the situation for all it was worth.  Holding my dog hostage while "Stabilizing and triaging" with oxygen and fluids was pointless.  Everyone knew Brie was dying that night, it was just how much money they would make before she did.  When a group of people are permitted such atrocities, the entire community suffers, not just Brie.  High standards keep a society striving.  This group should be reprimanded for their total lack of compassion and ethics they showed that night.