Dedham Veterinary Associates

Revdex.com: I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # [redacted] Regards, [redacted]

11/22/2016 response for complaint #[redacted] Mrs. [redacted] came in as a new client for a third opinion regarding her cat Prince's mouth on 7/8/2016.  During that exam it was noted that Prince has some mouth sensitivity and inflammation around his molars and pre-molars (also noted in...

previous medical record by multiple veterinarians as far as 3 months prior to her visit on 7/8/2016) and a dental cleaning with possible extractions was recommended.  During the 7/8/16 exam, Mrs. [redacted] scheduled a dental for 7/19/16 and was given an estimate with a high end of $1218.00 for a dental cleaning with possible tooth extractions.  Prince came to our hospital on 7/19/2016 for his scheduled dental procedure.  During the dental procedure it was noted that Prince had heavy tarter and calculus build up and there was gum recession and greater than 50% bone attachment loss involving his mandibular premolar 3 and molar 1 and right maxillary premolar 3 and 4.  All of Princes teeth were digitally radiographed to confirm the stability and structure of his entire mouth.  The above mentioned affected teeth were removed due to their condition.  All other teeth were in good condition, there was no sensitivity or irritation noted at that time.  The total invoice for this dental procedure was $942.18.Prince was discharged later that evening with specific discharge instructions to closely monitor Prince over the next 14 days and to contact the clinic immediately if there was questions in Princes healing.  Mrs. [redacted] initialed and signed that she fully understood all of the discharge instructions-including communicating with the clinic as soon as the owner was able to.  On 7/20/16 our surgical technician called Mrs. [redacted] multiple times to see how Prince was doing after his dental procedure.  We did not hear from Mrs [redacted] for 11 days, even after many attempts to connect about Prince.  On 8/1/2016, Mrs. [redacted] called and spoke with our receptionist stating that Prince's mouth was bothering him, but she was unsure of any fine details (how long has his mouth been bothering him, is he eating and drinking, is he lethargic).  Owners response was that she did not know these answers as she has 6 cats and did not actually look at Prince's mouth.  She just saw him paw at his mouth once or twice a few days prior.  The receptionist spoke to the manager, who booked Prince the next morning with a Doctor.  On 8/2/2016 recheck exam the owner had minor details regarding how Prince was doing at home. On physical exam it was noted that there was some minor irritation/redness at the surgical site, but the rest of the gums were healthy.  This irritation can be common as the suture material is a slower dissolving material and can cause a local inflammatory reaction from the body breaking down the material.  Prince was given injectable antibiotic and pain management with STRICT instruction that we MUST speak to the owner every day over the next few days to make sure Prince is healing correctly.  The hospital staff and attending Doctor called Mrs. [redacted] multiple times over the next few days, leaving voice mails to please call back and let us know how Prince is doing.  We did not hear back from Mrs. [redacted] until 8/13/2016, where she mentioned that Prince's gums were still red and now it seemed to be effecting his other teeth.  Mrs. [redacted] was scheduled for an appointment with in the hour to be seen by a veterinarian.  During the 8/13/2016 recheck exam it was noted and documented with pictures that prince did have redness and inflammation involving most of his teeth, but did not seem overly painful as the Doctor was able to fully exam his entire mouth.  Prince was scheduled for another dental procedure the next day were the remaining teeth were removed.   Prince was scheduled for a dental the next day, 8/30/2016. At this time there has been zero charges inured by the owner regarding follow-up care, medications even with her lack of communication.  On 8/30/2016 it was agreed that Mrs. [redacted] would only be financially responsible for the cost of removing the additional teeth (which she would have been responsible for if of his teeth were removed during 7/8/2016 dental procedure.)At the time of the 8/30/2016 dental it was noted that Prince did have progressive redness and inflammation that was not present at the original dental procedure (7/19/2016) the remaining teeth were removed and further diagnostic work up was recommended, this would indicate that a possible auto-immune disease was progressing.  Prince was discharged to Mrs. [redacted] that evening, again with stressed emphasis that we must hear form her the next day regardless of how Prince is doing and as soon as possible if any concerns, questions or issues arise.  This was stressed by the attending Doctor, surgical technician and Hospital manager.  Mrs. [redacted] also initialed and signed that she fully understand the discharge instruction.  The hospital staff, attending doctor and hospital manager tried to contact Mrs. [redacted] multiple times.  Hospital Manager verbally connected with Mrs. [redacted] on 9/3/2016, at that time Prince was doing great.  He was eating and drinking normally and was not lethargic, he was healing well.  The hospital staff continued to call and leave message for Mrs. [redacted] regarding the progression of princes healing (10 attempts over the next 5 days)  Mrs. [redacted] finally called back on 9/6/2016, she informed the receptionist that Prince was doing great, no concerns.  On 9/24/2016, Mrs. [redacted] called the office and mentioned that Prince had pawed at his mouth a few times.  When Mrs. [redacted] was asked if there was any redness, swelling, foul odor she did not know.  She also did not know exactly how much he was eating or drinking normally. Prince was scheduled for an appointment   on 9/28/2016, it was noted that Prince mouth was fully healed except for one spot at his maxillary canine area and he did have some inflammation of his gums. This inflammation after the teeth have been removed is another indication that there is a possible underlining auto-immune disease.  It was recommended that if the inflammation is still present once mouth is 100% fully healed that a detailed medical work-up for possible auto-immune disease, retroviral and bartonella virus.  Mrs. [redacted], declined further medical work up at this time but agreed to keep a close eye on the healing over the new few weeks and that she would call the hospital if there was no change or as soon as possible if symptoms worsened. The hospital staff again tried to reach out via phone calls with Mrs. [redacted].  To date we have never herd back from Mrs. [redacted] regarding Prince's healing.  At the time of the original third opinion exam on 7/8/2016 Mrs. [redacted] was given an estimate for a dental cleaning with possible extractions that had a high end amount of $1218.00.   At the time of the 8/30/2016 dental, Mrs. [redacted] was invoiced for the remaining tooth extractions and suture material to close the surgical sites, total of $290.50.   Mrs. [redacted] claimed to have zero money at time of discharge, even though this was verbally agreed apon with the manager and Mr.s [redacted] on 8/29/2016.  Mrs. [redacted] informed the manager at the time of Princes discharge that she only had $100.00 to pay, which she did.  It was agreed that Mrs. [redacted] would make payments on the remaining balance of $190.50.At the completion of both dental procedures with full mouth extractions Mrs [redacted] was financially responsible for a total of $1232.00.  Which is well with in the standard guidelines of an estimate. There is still a balance on her account for the remaining agreed upon amount of $190.50. Mrs. [redacted]'s original estimate was for possible few extractions as full mouth extractions were not expected. With in the veterinary industry dental cleaning with full mouth extractions range $2000.00-$2500.00 for general practice and $3000.00 plus for board certified dentists.Thank you again for your time with handling this complaint,[redacted]

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # [redacted]. 
 
Regards,
[redacted]