Boy, 4, given emergency surgery at private hospital without an xray, say parents - it wasn't a ruptured appendix after all

[webfact]

Picture: Siam Rath

 

Siam Rath said they were contacted by the parents of a child and the four year old boy's grandmother after they were unhappy with the service at a private hospital in Rangsit, north of the Thai capital Bangkok. The hospital was not named.

 

Yollada, 29, Natthapong, 25, and gran Janthakarn, 51, had taken "Thee" to the hospital suffering from a fever. His urine and feces were checked and he had a problem with his blood values.

 

A doctor came to press his abdomen and on this alone determined that the boy had a ruptured appendix and needed immediate life saving surgery.

 

The doctor was 100% sure.

 

The parents had no time to seek a cheaper hospital and quickly a consent form and costs of 160 - 180,000 baht had to be signed.

 

In the urgency of the situation the parents agreed but five minutes later the mother was called into the theater and told that it was not a ruptured appendix.

 

Picture: Siam Rath

 

Her son had already been opened up. It was a blocked intestine. The doctor whipped out another form to sign for 250,000 baht and would leave a 5 cm scar.

 

But after the operation the doctor emerged and spoke to the grandmother saying it was a twisted intestine that had circled around the appendix. It was not a blocked intestine but the operation had been a success.

 

The appendix had to be cut even though it had not ruptured.

 

The mother ran up to confront the doctor about all the chopping and changing of the diagnosis.

 

Picture: Siam Rath

 

If they had been properly apprised of the situation they could have gone elsewhere (to a cheaper hospital) as it was not the emergency first thought.

 

The family further claimed that when a relative argued that the scar was not 5 cms but much bigger the doctor had said ok it's 7 cms, okay it's twelve...then had turned around and left the room.

 

It was 15 cms.

 

After six days the boy showed improvement.

 

But the family planned to change hospitals as they were thoroughly dissatisfied.

 

They have racked up 95,000 baht in costs so far and been made to sign guarantees for 100,000 baht more.

 

They are furious about the changing diagnosis and claim that only hands were laid on their son - an xray was not performed that could have meant they could have gone elsewhere.

 

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[Foxx]

"without an xray"

 

Standard X-rays are useless for diagnosing appendicitis, so it's not surprising one wasn't done.  X-rays show hard tissues such as bones - not soft, squidgy bits like intestines.  A CT scan is helpful, but is expensive, and not every hospital has the necessary equipment.

[emanphoto]

¯\_(ツ)_/¯

https://www.mayoclinic.org/diseases-conditions/appendicitis/diagnosis-treatment/drc-20369549

[hotchilli]

2 hours ago, webfact said:

The parents had no time to seek a cheaper hospital and quickly a consent form and costs of 160 - 180,000 baht had to be signed.

 

2 hours ago, webfact said:

Her son had already been opened up. It was a blocked intestine. The doctor whipped out another form to sign for 250,000 baht and would leave a 5 cm scar.

Nice to see the hospital getting it's priorities right.

[swm59nj]

Sounds like in this case the true cause of the issue had to be made via exploratory surgery. 
It is not unusual for a surgical diagnosis to be given.  Then when the patient is opened up, a different or additional issue is found.  The other form was probably a release for the doctor to proceed with the new issue.  Especially since the patient is a minor.  And as for the additional cost.  Different types of surgery have different costs.  
From the initial diagnosis.  It sounds to me the doctor prevented a potential life threatening situation. Even though something else was found during surgery.  Which was also a serious medical issue. 
And if the doctor did initially say it was a twisted or ruptured intestine.  That’s not the time to spend time shopping around for a less expensive facility to correct the issue. 
 

Edited February 17, 2023 by swm59nj

[Ralf001]

49 minutes ago, hotchilli said:

 

Nice to see the hospital getting it's priorities right.

Why is the doctor "whipping out forms to sign" ?

 

story smells a bit off to me.

[Burma Bill]

3 hours ago, webfact said:

all the chopping and changing

Sadly, the young lad appears to have suffered this during surgery! Get well soon.

[Ralf001]

7 minutes ago, swm59nj said:

And if the doctor did initially say it was a twisted or ruptured intestine.  That’s not the time to spend time shopping around for a less expensive facility to correct the issue. 

Yep, I was complaining of abdominal pain to the nurses in ICU that was getting worse by the hour.

Wheeled out  for a CT scan........ Perforated lower intestine.

Within 3 hours (had to get blood delivered from BKK) I was under the knife. 

[BritManToo]

Same thing happened to my son when he was 5yo.

Diagnosed at a government hospital as needing emergency appendectomy.

I didn't agree, pain was in the wrong place for appendix, and took him to another government hospital who diagnosed him with constipation. Treatment was a squirt of something in the bum to loosen it all up. Cured in 10 minutes.

No forms or signatures required from me at any time (mom wasn't around).

 

Some Thai doctors aren't all that good.

Edited February 17, 2023 by BritManToo

[BritManToo]

23 minutes ago, swm59nj said:

It sounds to me the doctor prevented a potential life threatening situation.

Sounds to me like the doctor was incompetent.

Wonder why the parents took him to a private hospital, as Thai kids are treated free of charge in any government hospital (no need to be registered at that particular hospital unlike adults).

Edited February 17, 2023 by BritManToo

[JackGats]

If I'm not mistaken medical deontology dictates proactive surgery in case of suspected appendicitis, even if some uncertainty remains. Not operating asap in case of appendicitis is a risk doctors should not be willing to take. I remember reading that the symtoms of appendicitis can be deceitful, with pain even materialising at the wrong side of the abdomen.

Edited February 17, 2023 by JackGats

[BritManToo]

2 minutes ago, JackGats said:

If I'm not mistaken medical deontology dictates proactive surgery in case of suspected appendicitis, even if some uncertainty remains. Not operating asap in case of appendicitis is a risk doctors should not be willing to take. I remember reading that the symtoms of appendicitis can be deceitful, with pain even materialising at the wrong side of the abdomen.

Can't be that urgent as poster @Ralf001 just claimed it took them 3hrs to get him to the operating table.

[KhunLA]

13 minutes ago, JackGats said:

If I'm not mistaken medical deontology dictates proactive surgery in case of suspected appendicitis, even if some uncertainty remains. Not operating asap in case of appendicitis is a risk doctors should not be willing to take. I remember reading that the symtoms of appendicitis can be deceitful, with pain even materialising at the wrong side of the abdomen.

A simple ultrasound would have given the proper, better diagnosis in matter of minutes.   

 

Reads more like a money grab or extreme incompetence.

Edited February 17, 2023 by KhunLA

[ukrules]

3 hours ago, webfact said:

The doctor was 100% sure.

I've rearely met an idiot who isn't 100% convinced of one kind of nonsense or another which is completely wrong but they stick to their guns.

 

34 minutes ago, swm59nj said:

It sounds to me the doctor prevented a potential life threatening situation.

It sounds to me like the Doctor prevented a potential career ending situation, who knows what, if anything was really wrong with the kid?

[brianthainess]

Doctors here always seem to act on the worst case scenario, then after ''good luck you not have bowel cancer only infected intestine;;       

[Dazkkk]

Had same problem here in UK 15 years ago. Terrible pain in right abdomen, doc pressed on area and caused a lot more pain, so declared it was apendix which needed to come out ASAP. 

Came too and was told appendix was fine, but they took it out anyway. Turned out it was an inflamed kidney, which they treated with drugs and stuck a antibiotic suppository up my ass during the operation, which I was allergic too. 
In hospital for 3 weeks. ????

Apparently kidney paid can show same symptoms as appendicitis.