Crossroads Vet

All "treatment" records are kept as was Mr***'s'We are not required to retain consent formsThe consent forms were located the same day as their visit into the clinicI telephoned and left a message that same day that they would be mailed to the owner of the patient the next day, along with the treatment recordsThere was no indications that [redacted] was was suffering from any "mental capacity problems", at any point in timeMr [redacted] made his Dental appointment, showed up on time for drop off, was able to follow the pre-anesthetic directions, signed the consent to the dental with anesthesia forms, checked off "yes" to the pre-anesthetic blood work which we require for any patient going under anesthesia as stated on the form, as well as signed the approval for the charges of that visitAt the time of drop off Mr [redacted] did not indicated that he was "mentally incapable", and did not mention to call family members if there was any further questions or concernsMr [redacted] wrote his own number on the anesthetic consent form for him to be contacted with any questions or concerns about his procedureWith any procedure we go over charges and anesthetic consent formsIt was mentioned when the family came in to express concerns on 1/13/that Mr [redacted] did not remember signing the formsAs we have already forwarded to the family he did in fact sign and consent to all charges and procedures preformed on [redacted] ***No where on any paperwork the owners have filled out does it say to contact a specific person for questions or concerns regarding any treatments or proceduresAttached is the original new client paper work that says home number for ***, [redacted] is [redacted] and Cell Phone is [redacted] On the drop off anesthetic procedure consent for the phone number of [redacted] was giving to call if any questions or concerns arise with the patientThat same phone number [redacted] was called the next day to check and see how [redacted] the patient was doing after the anesthetic procedure, no concerns were brought up (Mrs.) at that number claimed patient was doing great that morning

Hi there,
We have already been contacted by the State Attorney General and our case has been closedHere are the supporting documents for our case showing the owner signed and consented to the following charges and the anesthetic procedureI have attached all documents.
Thank
you
See email to [email protected] for supporting documentsUnable to upload enough attachments on this page

Complaint: ***I am rejecting this response because:
As I explained in my last response, anyone who was paying attention should have been able to see that my father, who has some dementia since he's 93, was not understanding the procedures nor cost of services that were allegedly explained to himThey obviously didn't want to spend time asking questions to make sure he understood the procedures and the cost. When he came into pick up the dog that was the first time he noticed the exploitative charge of $since he had to pay it then. So this was definitely not INFORMED consent, in our opinion. Also when we asked to see the consent form which lists options for the treatment, the vet said they'd thrown it away. When we asked why, he was not able to give a reason. My father also did not get info about after care instructions, which are almost always given in written form according to my years of experience dealing with vets. The vet told us my father could have phoned them if he had a question. He was so upset about the dog's diarrhea that he called us instead and that's when we went in on the 12th, not on the 13th as the vet later entered into the record
According to Washington State Statue Section 246-933-"General Requirements For All Veterinary Medical Facilities(7) Records:(a) Every veterinarian shall keep daily written reports of the animals he or she treatsSeparate records for companionanimals shall be kept for each animalThe medical record for a litter may be recorded either on the dam's record oron a litter record until the individual animals are permanently placed or reach the age of three monthsRecords forfood and fibre producing animals and animals kept in herds or flocks, etc., may be maintained on a group or clientbasisAll records shall be legible, readily retrievable and shall be kept for a period of three years following the lasttreatment or examinationThe author of all medical record entries must be identified by code or employee number,or initialsThe records shall include, but not be limited to, the following:" I won't bother to list them all
We have filed a complaint with the Veterinary Board of Governors, overseen by the State Board of Health to investigate this violation of record keeping so that others don't have to go to the work we've done to investigate this caseWhen we objected to his outrageous charge for a teeth cleaning, $563, he replied that he hadn't lost a dog to a cleaning yet. But customers are concerned about being exploited as well. My vet in Walllingford in Seattle charges only $for the procedure because she knows that many people cannot afford such high charges. Apparently, DrS*** was more concerned about paying for his equipment which he said had cost him $5,recently than treating a senior citizen fairly according to Informed consent guidelines.. When we said we would file a complaint with the state vet association which is an industry association, he said "Go ahead I have a lot of friends there." Not exactly, an encouraging remark to reassure us that he hadn't taken advantage of my father. His inability to give us a copy of the informed consent form at the time of our request only deepened our suspicions. If he has not legally violated state laws, he has certainly ethically violated senior fraud protections. My father was a sitting duck
Sincerely, *** ***

All "treatment" records are kept as was Mr. [redacted]'s'. We are not required to retain consent forms. The consent forms were located the same day as their visit into the clinic. I telephoned and left a message that same day that they would be mailed to the owner of the patient the next day, along with the treatment records. There was no indications that [redacted] was was suffering from any "mental capacity problems", at any point in time. Mr. [redacted] made his Dental appointment, showed up on time for drop off, was able to follow the pre-anesthetic directions, signed the consent to the dental with anesthesia forms, checked off "yes" to the pre-anesthetic blood work which we require for any patient going under anesthesia as stated on the form, as well as signed the approval for the charges of that visit. At the time of drop off Mr. [redacted] did not indicated that he was "mentally incapable", and did not mention to call family members if there was any further questions or concerns. Mr. [redacted] wrote his own number on the anesthetic consent form for him to be contacted with any questions or concerns about his procedure. With any procedure we go over charges and anesthetic consent forms. It was mentioned when the family came in to express concerns on 1/13/17 that Mr. [redacted] did not remember signing the forms. As we have already forwarded to the family he did in fact sign and consent to all charges and procedures preformed on [redacted]. No where on any paperwork the owners have filled out does it say to contact a specific person for questions or concerns regarding any treatments or procedures. Attached is the original new client paper work that says home number for [redacted] is [redacted] and Cell Phone is [redacted]. On the drop off anesthetic procedure consent for the phone number of [redacted] was giving to call if any questions or concerns arise with the patient. That same phone number [redacted] was called the next day to check and see how [redacted] the patient was doing after the anesthetic procedure, no concerns were brought up (Mrs.) at that number claimed patient was doing great that morning.

Complaint: [redacted]I am rejecting this response because:According to Veterinary practice guidelines, my father's signature did not constitute "informed consent" because he did not understand exactly what he was signing.  The vet and/or his assistants made no effort that I can tell that he did understand the release form.  They had our phone numbers to call us if they had questions but they apparently did not.  They gave him no after treatment instructions which are also required. 
According to "Understanding the Legal Consent Doctrine and How To Achieve It" by [redacted] W[redacted], DVM, JD Priority Veterinary Management Consultants Yardley, PA (215) 321-9488 :
1 Veterinarians and their staff must do more than just present written consent forms to their clients to sign.
2 “Informed” means the clients acknowledge that they have been apprised of feasible alternatives and the possible adverse affects which might arise from the procedures being performed. Veterinarians may be held responsible for damages in cases where clients convince judges that they have signed consent forms without understanding their ramifications. 
Discussing the relative risks and benefits of additional or alternative diagnostic procedures or the implementation of specific treatments before they are pursued. Describing expected responses to treatment and how they will be assessed. Providing a reasonable prognosis for recovery, the likelihood of a recurrence or the possibility of little change in the outcome. Including information about feeding, exercise, aftercare, and return visits. ..........
Discussing reasonable cost estimates, payment plans, and protocols to follow if costs are likely to deviate materially from those agreed upon. ...... Courts also are reluctant to enforce consents signed by clients who are suffering from a mental “capacity” problem such as mental incompetence, duress, the influence of drugs or alcohol or under age. . . . Finally, consent forms that are drafted too broadly, allowing veterinarians to undertake any and all medical and surgical procedures or give permission for any and all treatments in the future, are usually unenforceable.
The following additional elements should be present in all written consent forms, including a statement acknowledging that clients have had an opportunity to ask questions and have received satisfactory responses."  The article suggests that after following seven steps to ensure the consent form was understood, they should imagine a judge and jury observing the transaction and asking them whether they think the client comprehended all of the risks, benefits, and costs, and provided a knowledgeable consent. If they cannot answer "yes"the standard of informed consent has not been reached.
Moreover , Dr. S[redacted] is in violation of Washington code WAC 246-933-320, which requires vets keep all treatment records for at least three years.  When we originally asked to see the consent form, he said he didn't keep them, which made us suspicious.  A week later, he said he found my father's form in the recycle and sent us a copy.  He should not be disposing of any records according to this  law.
 
 
Sincerely,[redacted]