Northshore Veterinary Hospital

[redacted] Revdex.com PO Box DuPont, WA Dear [redacted] , This letter is in response to claim ID [redacted] made by [redacted] after his first visit to Northshore Veterinary Hospital We have been in business in Whatcom County since April of This is our first complaint we have had at the Revdex.com We strive to provide excellent medical care to our patients and the best customer care to their owners, our clients Here is what I can surmise happened with [redacted] , a year old spayed female Golden Retriever Mix who is owned by [redacted] , and I believe, [redacted] June 3, 2015, [redacted] suffered a cm laceration while she was at the beach This wound was wrapped by someone at [redacted] in Sehome Village, Bellingham Washington The owner was not charged for this visit [redacted] was later seen at [redacted] , an after hours emergency hospital in Bellingham Washington I am assuming options were presented to the owner for wound care and that an Elizabethan collar was dispensed Northshore Veterinary Hospital did not receive the records from [redacted] so I do not know what was discussed or offered On the morning of June 4, 2015, DrKimberly J [redacted] of Northshore Veterinary Hospital saw [redacted] when she was brought in by [redacted] At that time, DrJ [redacted] discussed wound closure under sedation or bandaging [redacted] elected to just have the wound bandaged At that time, the cm full thickness wound (now at least hours old) was bandaged and Tramadol mg was dispensed to control pain and Cephalexin, (an antibiotic) mg was dispensed to control infection There were verbal instructions to keep the e collar on and to schedule a recheck for Monday, June 8, On that date, [redacted] returned with [redacted] who had taken her bandage off multiple times over the weekend The wound was actively and acutely bleeding Surgical debridement and repair was recommended and agreed to by [redacted] after discussion with DrKimberly J*** DrJ [redacted] debrided (removed dead, infected and/or damaged tissue) and sutured the laceration closed under sedationThe foot was not bandaged because DrJ [redacted] feared self trauma by [redacted] as she attempted to remove the bandage over the repaired laceration At the time of discharge, Katie S, a veterinary technician gave instructions to [redacted] to have [redacted] wear the e collar at all times and to continue the medications as directed On June 9,2015, [redacted] arrived at am, without calling us and without an appointment According to multiple staff members who interacted with ***, he was very agitated and confrontational [redacted] stated that [redacted] had removed all the sutures from her laceration He demanded that all services be performed at no charge and that he was not responsible in any way for the sutures coming out of the laceration DrC [redacted] agreed to see [redacted] on top of an already busy schedule rather than have her return for an available doctor later in the day Here is her account of what happened copied from the medical record: 8:15am: Directions to leave the E.collar on at all times until suture removal were not followed, and [redacted] opened the wound againMr [redacted] requested to speak with a veterinarian I introduced myself to him and received a very firm handshakeHe then had this series of questions for me before he dropped [redacted] off for a third time for wound repair: (1) why wasn't a bandage put on? my answer: to allow airflow to the older wound, but that this requires that the E.collar stay on at all times (2) why is the wound now bigger than what it was when she first got it? my answer: closure of wounds older than hours old generally require debriding and the creation of fresh margins to have success in healing (3) why didn't we inform them to leave the E.collar on at all times? my answer: KS did speak with [redacted] yesterday upon discharge of patient, emphasizing the importance that Ecollar be left on at all times (4) if wounds should be closed within a short period of time after happening, then why did the emergency clinic suggest that they wait until the morning to save money? my answer: I don't know, but if the staff was given the impression that there were financial concerns, then they may have offered that as an option He said that they said nothing about $ concerns After answering all of his questions, it seemed that my answers hadn't satisfied him, giving me the impression that he wanted me to accept responsibility for the fact that [redacted] was back for wound repair againI let him know that I had other patients to see this morning and that we would notify him when we finished with wound repair Apparently he remained in the exam room after we brought his dog to the back, and unfortunately overheard me venting to Katie Sabout my frustrations with him wanting to focus on blaming us instead of accepting any responsibilityHe then opened the door and said that he had heard everythingI told him that I was OK with him knowing how I feltI let him know that it was clear to me that there is a lack of trust, which is not the kind of working relationship that is needed with clientsHe wanted to argue some more, so I asked him if he would rather take his dog to another clinicHe did not, so I said that we will resolve this problem and then we would arrange for him to find another veterinary clinic to work with in the future He still wanted to argue, so I told him that I had things to do and that I was done with the conversationHe said he wanted an apology, so I apologizedHe then went out to the parking lot where he paced while talking on his phoneKS and Janna went out to diffuse the situation and to let him know that it is still an option to take [redacted] elsewhere for care if it would help him feel more comfortable CEC: 06-09-at 9:56a: Two staff members attended to [redacted] for about minutes in the parking lot as he paced and spoke on his phone, quite agitated He informed them that he was calling lawyers in town and threatened to bring a lawsuit against Northshore Veterinary Hospital After speaking with him, they were able to admit [redacted] (still in our hospital) for evaluation and treatment Costs were not discussed other than ***'s demand that any treatment would be done at no charge as he was not at fault because he was never told that the e collar should be kept on at all times [redacted] , evidently, did not relay this information to him which is an unfortunate lapse in communication between the two of them I believe [redacted] is ***'s fiance, according to staff members Later that same day, I evaluated [redacted] , who is a lovely dog and a wonderful patient She is probably a little naughty about her bandages but she had left her sutures alone, as far as they were still all present at the time I evaluated her The laceration repair looks great with only a small amount of dried discharge at the cranial aspect of the incision I placed one suture in the laceration because there was a mm space between sutures but no gap in the wound to remove all doubt as to the fortitude of the repair Non of us wanted a repeat if this morning's experience with [redacted] so I wanted to make sure he was satisfied I bandaged the foot because the lack of a bandage appeared to be an issue for [redacted] and again, I wanted him to be satisfied I did not charge for any of my services or materials as none of us wished to have another volatile incidence at our clinic I did dispense some inexpensive antibiotics to prevent infection as the previous antibiotics that were dispensed were due to finish in the next hours The charge for these was around $ The antibiotics were declined by [redacted] as were the bandage changes and evaluations that I had scheduled at no charge to him over the next week I do not feel that [redacted] 's care was hindered or delayed on our part at all I think her medical care was aligned with proper standard of care for our profession I do think that the difficult communications that DrC [redacted] had with [redacted] impacted the customer service that [redacted] received The unfortunate part in all this was that the sutures were never missing or licked out by [redacted] and that if the staff had evaluated her at the time of presentation, this whole situation might have been avoided I think the inflammatory mood and confrontational behavior of [redacted] unfortunately impacted and delayed the evaluation of [redacted] Had the staff examined the laceration repair, they would have seen that all the sutures were still in, this, of course, does not necessarily mean that [redacted] would have been satisfied with our care I do not think a full refund is in order here I think [redacted] 's care, on our part, was at the very least, on par with industry standards I agree that the customer care could have been better, but I also cannot tolerate abuse of the staff There was an incidence of a dissatisfied client at another hospital here in Bellingham that happened a few months ago The client ended up stabbing the veterinarian and then leaving to walk into another veterinary hospital, whereupon he was dissatisfied again and stabbed the veterinarian and a receptionist All veterinary clinics in Bellingham were ordered by the police to lock their doors until the man was apprehended He was detained within a few hours and we were all allowed to open our clinics again but it was a very traumatic incident for the veterinary community in Bellingham I have worked with DrColleen C [redacted] since January of She has never had a complaint written against her and I have never seen her react in the manner described to a client The entire staff has attended meetings to discuss this particular incidence and ways the conflict might have been avoided We take conflict management very seriously and hopefully, this type of incident can be avoided in the future I had a conversation with [redacted] later in the week and I was happy to hear that [redacted] was doing well and was receiving treatment at [redacted] I apologized for his experience at Northshore, for which I am truly sorry I think we could have handled that better and I am grateful for the opportunity to improve the conflict resolution skills of the entire staff at Northshore Veterinary Hospital Thank you for your concern Please let me know if you need medical records as well Sincerely, Kimberly B [redacted] DVM

[redacted]
Revdex.com
PO Box 1000
DuPont, WA 98327
 
Dear [redacted],
 
This letter is in response to claim ID [redacted] made by [redacted] after his first visit to Northshore Veterinary Hospital.  We have been in business in Whatcom County since April...

of 1997.  This is our first complaint we have had at the Revdex.com.  We strive to provide excellent medical care to our patients and the best customer care to their owners, our clients. 
 
Here is what I can surmise happened with [redacted], a 5 year old spayed female Golden Retriever Mix who is owned by [redacted], and I believe, [redacted].
 
June 3, 2015, [redacted] suffered a 0.5 cm laceration while she was at the beach.  This wound was wrapped by someone at [redacted] in Sehome Village, Bellingham Washington.   The owner was not charged for this visit. [redacted] was later seen at [redacted] , an after hours emergency hospital in Bellingham Washington.  I am assuming options were presented to the owner for wound care and that an Elizabethan collar was dispensed..   Northshore Veterinary Hospital did not receive the records from [redacted] so I do not know what was discussed or offered.   On the morning of June 4, 2015,  Dr. Kimberly J[redacted] of Northshore Veterinary Hospital saw [redacted] when she was brought in by [redacted].  At that time, Dr. J[redacted] discussed wound closure under sedation or bandaging.  [redacted] elected to just have the wound bandaged.  At that time,  the 0.5 cm full thickness wound (now at least 18 hours old) was bandaged and Tramadol  50 mg was dispensed to control pain and Cephalexin, (an antibiotic) 500 mg was dispensed to control infection.  There were verbal instructions to keep the e collar on and to schedule a recheck for Monday, June 8, 2015.  On that date, [redacted] returned with [redacted] who had taken her bandage off multiple times over the weekend.  The wound was actively and acutely bleeding.  Surgical debridement and repair was recommended and agreed to by [redacted] after discussion with Dr. Kimberly J[redacted].  Dr. J[redacted] debrided (removed dead, infected and/or damaged tissue) and sutured the laceration closed under sedation. The foot was not bandaged because Dr. J[redacted] feared self trauma by [redacted] as she attempted to remove the bandage over the repaired laceration.  At the time of discharge, Katie S, a veterinary technician gave instructions to [redacted] to have [redacted] wear the e collar at all times and to continue the medications as directed.  On June 9,2015, [redacted] arrived at 8 am, without calling us and without an appointment.  According to multiple staff members who interacted with [redacted], he was very agitated and confrontational.  [redacted] stated that [redacted] had removed all the sutures from her laceration.  He demanded that all services be performed at no charge and that he was not responsible in any way for the sutures coming out of the laceration.  Dr. C[redacted] agreed to see [redacted] on top of an already busy schedule rather than have her return for an available doctor later in the day.  Here is her account of what happened copied from the medical record:
  
8:15am:  Directions to leave the E.collar on at all times until suture removal were not followed, and [redacted] opened the wound again. Mr. [redacted] requested to speak with a veterinarian.  I introduced myself to him and received a very firm handshake. He then had this series of questions for me before he dropped [redacted] off for a third time for wound repair:
(1) why wasn't a bandage put on?
my answer:  to allow airflow to the older wound, but that this requires that the E.collar stay on at all times
(2) why is the wound now bigger than what it was when she first got it?
my answer:  closure of wounds older than 6 hours old generally require debriding and the creation of fresh margins to have success in healing.
(3) why didn't we inform them to leave the E.collar on at all times?
my answer:  KS did speak with [redacted] yesterday upon discharge of patient, emphasizing the importance that E. collar be left on at all times.
(4) if wounds should be closed within a short period of time after happening, then why did the emergency clinic suggest that they wait until the morning to save money?
my answer: I don't know, but if the staff was given the impression that there were financial concerns, then they may have offered that as an option.  He said that they said nothing about $ concerns. 
After answering all of his questions, it seemed that my answers hadn't satisfied him, giving me the impression that he wanted me to accept responsibility for the fact that [redacted] was back for wound repair again. I let him know that I had other patients to see this morning and that we would notify him when we finished with wound repair.  Apparently he remained in the exam room after we brought his dog to the back, and unfortunately overheard me venting to Katie S. about my frustrations with him wanting to focus on blaming us instead of accepting any responsibility. He then opened the door and said that he had heard everything. I told him that I was OK with him knowing how I felt. I let him know that it was clear to me that there is a lack of trust, which is not the kind of working relationship that is needed with clients. He wanted to argue some more, so I asked him if he would rather take his dog to another clinic. He did not, so I said that we will resolve this problem and then we would arrange for him to find another veterinary clinic to work with in the future.   He still wanted to argue, so I told him that I had things to do and that I was done with the conversation. He said he wanted an apology, so I apologized. He then went out to the parking lot where he paced while talking on his phone. KS and Janna went out to diffuse the situation and to let him know that it is still an option to take [redacted] elsewhere for care if it would help him feel more comfortable.
CEC: 06-09-15 at 9:56a:
 
 
Two staff members attended to [redacted] for about 45 minutes in the parking lot as he paced and spoke on his phone, quite agitated.  He informed them that he was calling 5 lawyers in town and threatened to bring a lawsuit against Northshore Veterinary Hospital.  After speaking with him, they were able to admit [redacted] (still in our hospital)  for evaluation and treatment.  Costs were not discussed other than [redacted]'s demand that any treatment would be done at no charge as he was not at fault because he was never told that the e collar should be kept on at all times.  [redacted], evidently, did not relay this information to him which is an unfortunate lapse in communication between the two of them.   I believe [redacted] is [redacted]'s fiance, according to staff members. 
 
Later that same day, I evaluated [redacted], who is a lovely dog and a wonderful patient.  She is probably a little naughty about her bandages but she had left her sutures alone, as far as they were still all present at the time I evaluated her.  The laceration repair looks great with only a small amount of dried discharge at the cranial aspect of the incision.  I placed one suture in the laceration because there was a 1 mm space between sutures but no gap in the wound to remove all doubt as to the fortitude of the repair.  Non of us wanted a repeat if this morning's experience with [redacted] so I wanted to make sure he was satisfied.  I bandaged the foot because the lack of a bandage appeared to be an issue for [redacted] and again, I wanted him to be satisfied.   I did not charge for any of my services or materials as none of us wished to have another volatile incidence at our clinic.  I did dispense some inexpensive antibiotics to prevent infection as the previous antibiotics that were dispensed were due to finish in the next 36 hours.    The charge for these was around $14.  The antibiotics were declined by [redacted] as were the bandage changes and evaluations that I had scheduled at no charge to him over the next week.  I do not feel that [redacted]'s care was hindered or delayed on our part at all.   I think her medical care was aligned with proper standard of care for our profession.  I do think that the difficult communications that Dr. C[redacted] had with [redacted] impacted the customer service that [redacted] received.  The unfortunate part in all this was that the sutures were never missing or licked out by [redacted] and that if the staff had evaluated her at the time of presentation, this whole situation might have been avoided.  I think the inflammatory mood and confrontational behavior of [redacted] unfortunately impacted and delayed the evaluation of [redacted].   Had the staff examined the laceration repair, they would have seen that all the sutures were still in, this, of course, does not necessarily mean that [redacted] would have been satisfied with our care.  I do not think a full refund is in order here.  I think [redacted]'s care, on our part, was at the very least, on par with industry standards.  I agree that the customer care could have been better, but I also cannot tolerate abuse of the staff.  There was an incidence of a dissatisfied client at another hospital here in Bellingham that happened a few months ago.  The client ended up stabbing the veterinarian and then leaving to walk into another veterinary hospital, whereupon he was dissatisfied again and stabbed the veterinarian and a receptionist.  All veterinary clinics in Bellingham were ordered by the police to lock their doors until the  man was apprehended.  He was detained within a few hours and we were all allowed to open our clinics again but it was a very traumatic incident for the veterinary community in Bellingham. 
 
I have worked with Dr. Colleen C[redacted] since January of 2000.  She has never had a complaint written against her and I have never seen her react in the manner described to a client.  The entire staff has attended meetings to discuss this particular incidence and ways the conflict might have been avoided.  We take conflict management very seriously and hopefully, this type of incident can be avoided in the future. 
 
I had a conversation with [redacted] later in the week and I was happy to hear that [redacted] was doing well  and was receiving treatment at [redacted].  I apologized for his experience at Northshore, for which I am truly sorry.  I think we could have handled that better and I am grateful for the opportunity to improve the conflict resolution skills of the entire staff at Northshore Veterinary Hospital. 
 
Thank you for your concern.  Please let me know if you need medical records as well. 
 
Sincerely,
 
 
 
Kimberly B[redacted] DVM