Veterinary Emergency Clinic

Dear Ms [redacted] :I am responding to a complaint from the client of our hospital, assigned ID # [redacted] , made against the Veterinary Emergency Clinic, Inc(VEC), one of the businesses operating under the hospital name of Pittsburgh Veterinary Specialty and Emergency Center (PVSEC)I am the medical director of this facility and also an owner of Pittsburgh Veterinary Surgery, P.C., the business entity that operates the surgical services for this hospitalVEC provides the emergency services for PVSEC.The client claims that she was not properly informed regarding the nature of the testing that was done on her dog, and that she subsequently agreed to a surgery based on that testing that was not successful in saving her dogShe claims that she might have made a different decision if she had been informed more thoroughlyShe wants restitution for the costs of the surgery, because she might not have agreed to it if otherwise informedThere are a number of other complaints from her regarding the activities that happened that night at the hospital surrounding the care of her dog.I would like to respond to this complaint point by point:First of all, we at the hospital are very sorry that we could not resolve her pet's condition and that he had to be euthanized for disseminated cancerWe deal with a large number of very sick pets and understand the loss that their families feel when their beloved companions die or are euthanizedWe are pet owners ourselves and have suffered similar losses and felt the same painThis client's pet was presented for evaluation of weakness, and enlarged belly full of fresh blood and severe anemiaTheir family veterinarian suspected a tumor on the spleenThe emergency doctor who saw this pet discussed with the owners that additional testing would be needed to see where the blood was coming from in the abdomenAn ultrasound exam was recommended for that purpose to evaluate the liver, spleen and other organs for massesX-rays of the chest were recommended to see if there was any evidence that a cancer had spread to the lungsThe client agree to this plan and the costs associated with itThe chest was noted to be cleanThe ultrasound exam showed a mass in the spleen that was bleedingThe emergency veterinarian discussed that this mass was one of two possible causes, two thirds likely that it was a cancer called hemangiosarcoma, andthe other 1/that it was a hematoma (blood clot)She informed the that the ultrasound did not identify other masses outside the spleenThis led to a conclusion that their dog could have an exploratory surgery to remove the spleen and to evaluate the abdomen thoroughly visuallyOur surgical resident then had a thorough discussion again, reiterating the same things.The surgical resident indicates to me that she informed the owner that she would like to have her available by phone in the event that something was found at surgery that was not seen on ultrasoundShe further states that when asked why this would be necessary, she explained with an example that there could be masses that are hidden where they could not be seen or that are too small to be seen on ultrasoundIn other words, the client was informed that sometimes, cancer is seen at surgery that was not expected based on the testing doneThere was no questioning at that time from the client about this and she authorized the surgeryAt no time was there any intent to deceive or otherwise not fully disclose what was found or what was being doneDuring surgery, performed by a board certified surgeon, multiple small masses were found throughout the abdomen that apparently were smaller than could be resolved on the ultrasound exam, and they were also bleeding.This confirmed that the spleen mass was indeed cancerous and had spread.The owner was indeed called during the surgery and informed that there was cancer spread widely and that their dog could not survive thisThe surgical resident informed me that she called the client and made the comment that "this was one of the worst cases of spread that she had seen", to the owner, because she was trying to make sure she understood how serious this was and because it was a little surprising given the ultrasound exam did not show itA senior, board certified surgeon had already confirmed the findingsThe client's claim that we did not give her enough information regarding the ultrasound exam specifications is unfoundedWe do not expect our clients to understand all of the specific details of a technical piece of equipmentWe do try to explain the limitations of tests and that is why the surgeon informed her that she should be available by phone in the event that a phone call needed to be made regarding additional findingsThis is very common with bleeding tumors in the abdomenClient complains that we are misleading her regarding the presence of surgeons on site that nightIn fact, we have a surgeon and resident on call every night of the year for emergency surgeryThey are not "on duty", they are on call and come in after hours for emergenciesIn fact, that night, four patients with bleeding tumors in the abdomen were operated after-hours.These surgeons had in fact been there the day before for regular appointments and surgery, and were now coming in to operate these four dogs on an on-call basisClient complains that she did not get a call the next day to discuss how the remains were to be handledShe indicates that she called in at around pmthat dayI apologize if we mislead her about when she would be call usually our policy to try to resolve these details promptlyI do believe we did resolve them when she called in that day at pmClient complains about the "lost collar"The CSR that handled the call should have indicated that they would find it, instead of stating that she did not know where it wasHowever, as is usually the case, it was promptly found and has been mailed to herClient claims that we denied her access to her invoicesThat is absolutely not consistent with any practice at our hospitalShe might have been told that charges were not completed and entered in the computer, but never that we would not send it to herIn fact, shortly thereafter, all materials regarding her pet's care were emailed to her as requestedClient claims that Medical director was argumentative with her regarding the decisions made based on ultrasoundAt no time was I argumentativeMy discussion was focused on trying to understand what else she wanted to hear about the testing done the night before in order to try to understand what decisions she would have made with more detailsI was not trying to make her answer in a particular wayI was simply trying to understand what would have changed the chain of events of the night beforeI have tried to go through the decision making tree and clarify that her dog's condition that night was critical and required a difficult decision from the owner to take him to surgery, or that he was going to bleed to deathClient further makes a wrong statement that I did not know the blood count of her dog that night.There is a 1% difference in what she remembers being told and what she claims that I saidSuffice it to say that whether the number was 24% or 25%, it represents severe anemia in a dogThe chart shows a recorded blood count of 24%, which is what I quoted her.In summary:Client's pet was presented to our facility at 6:41pm with severe bleeding in the abdomen, a common presenting complaint at our emergency and specialty hospital.We are staffed 24/7/with ER doctors and have specialists in disciplines available for consultations on varied conditionsOur surgeons are available 24/7/365, on call for emergency surgery and we responded as such that night for her pet as well as others in similar conditions that required emergency surgeryAll owners are informed as to the possibility that in spite of high tech equipment and well trained ultrasonographers, that sometimes it is not possible to see metastatic "spots" in the abdomen prior to seeing them in surgery with the abdomen open.Those that are seen on ultrasound prior to surgery, are so advised and we do not operate themIn this dog's case, nothing that was clearly cancerous, was seen on the ultrasound exam.This pet was stabilized and received a blood transfusion prior to anesthesia, and was taken to the operating room at 10:pm.The charges that were incurred are routine and consistent with the costs as with this level of emergency staffing and medical care at a top specialty a emergency center.I do not believe that this client was misinformed at any time during the briefhospitalization of her petIt is always unfortunate when we cannot correct a pet s condition and have to make a decision to euthanize while under anesthesia.However, this does not change the fact that significant costs were incurred in pursuing the option to treat this client's pet.Based on a careful review of the medical record and conversations with all of the medical personnel involved in this dog's care, there was no deviation from the high standards of care that we pride ourselves in providingTherefore, we are going to respectfully decline to refund the costs incurred in the care of her pet.Sincerely,Anthony DP [redacted] MS, DVMDiplomate, American College of Veterinary Surgeons Medical DirectorPittsburgh Veterinary Specialty and Emergency Center [redacted]

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me Regards, [redacted]

DrMs [redacted] : I am responding to a complaint from a client of our hospital, assigned ID # [redacted] , made against the Veterinary Emergency Clinic, Inc(VEC), one of the businesses operating under the hospital name of Pittsburgh Veterinary Specialty and Emergency Center (PVSEC)As requested, the client [redacted] was refunded for $by check on November We ask at this time that the claim be withdraw Thank you, Lauren F [redacted] Executive Assistance Office: ###-###-#### Tell us why here