Bumrungrad Hospital Ordered To Pay Bt12 Million To Mother Of Disabled Son

[BSJ]

Hmmm, I thought in the event of something untoward happening whilst in Pattaya I would be gasping "Get me to Bumrungrad Hospital". But now I think I will be gasping "Get me a medivac flite to Singapore....and hurry"!

With a bit of luck the Sawang Boriboon crew will understand me!

[Sherlocke]

"I suggest all the bashers read "What am I doing here?" by Bruce Chatwin, in which one of the articles tells of a Spanish woman who was told by her English doctors that her unborn daughter had no arms and legs, and should be aborted. She chose to have the baby, which was born with the full complement of limbs. Food for thought."

Your getting your arguments confused here - this only supports the basic procedures that are so often ignored or not carried out in Thailand

THe doctors in this case TOLD the patient what they thought the situation was - this is NORMAL practice! - This did NOT happen in THailand

THe patient is then in a position to make a decision.

Now the information they GAVE (not done in THailand) was incorrect so this is a completely different problem - and as you have demonstrated it was discovered and publicized - this is very unlikely to happen in Thailand.

[Sherlocke]

I went to Bumrungrad hospital 8 months ago and I thought I had a back ache. It was my good luck that the doctor had enough insight to ask for an x-ray. After the x-ray was finished they asked for another one. Ten minutes later they brought in a wheel chair and wheeled me out to a surgeon. He, with a penetrating look said to me, "Mr. Certified you are not having back spasms, your problem is much more serious. There is a main valve running into your heart and it is called an Aorta, this valve has burst and you are internally bleeding. If we don't operate on you, 100% you will die, all people do. Do I have your permission to save your life, and can I get the surgical team together now?" I said yes, signed some papers and they wheeled me quickly in for a cat scan. After the cat scan I was put on a stretcher and 4 or 5 nurses were running with me down the hallway to the operating room. In the operating room I was handed the phone and it was my Mom on the other end. The surgeon took the time to call her and explain everything. I said what all sons would say to their mother, and she said what all mothers would say to their sons. I gave them back the phone and they assured me I was going to be ok. I didn't know then I had a 4% chance to survive. Then the mask was put on my face and they operated all night for 13 hours. The next morning a little before noon I came to in the emergency room. There at my bedside was the surgeon and 4 other nurses. They saved my life. They gave it their all and they pulled me through. I lost a lot of blood and the odds were against me but through their efforts and skill, and desire to save me they did almost the impossible. Today when I think about what happened to me I have so many mixed emotions that I've never had before. I feel such gratitude and thankfulness yet also feel an inability to express these feeling to a team of professionalls that gave me another chance to live and experience life. These people are my heroes and I will always be indebted to them for the wonderful job they did for me. This includes everyone from the surgeon, to the follow up doctor who I still see, to the intensive care nurse who stayed by my side day after day, to the physical therapists who helped in the early days, the regular nurses who were always cheerful and professional,to the food therapist who interviewed me several times, and of course to my friends that came and visited me to cheer me on. Its easy to complain about minor things such as an alledged attitude or whatever you might perceive as being not up to your professional standards whatever they might be. But I went through a life changing experience at this hospital and from what I experienced everything they did was to the best of their ability with very high standards. And the cost was about 1/4 it would have been back home, maybe less than that.

you had a close shave - how do you know everything was to the "highest standards?"

[ballpoint]

"I suggest all the bashers read "What am I doing here?" by Bruce Chatwin, in which one of the articles tells of a Spanish woman who was told by her English doctors that her unborn daughter had no arms and legs, and should be aborted. She chose to have the baby, which was born with the full complement of limbs. Food for thought."

Your getting your arguments confused here - this only supports the basic procedures that are so often ignored or not carried out in Thailand

THe doctors in this case TOLD the patient what they thought the situation was - this is NORMAL practice! - This did NOT happen in THailand

THe patient is then in a position to make a decision.

Now the information they GAVE (not done in THailand) was incorrect so this is a completely different problem - and as you have demonstrated it was discovered and publicized - this is very unlikely to happen in Thailand.

As I've already said, I was giving my thoughts on the case, putting myself in the childs shoes, and not passing any judgement. However, I DO think that telling a mother her unborn child is deformed and should be aborted, when it isn't and shouldn't, is far greater negligence than what has occurred here. No doubt if I had said it was a Thai doctor giving the advice I'd have a lot more people agreeing with me.

[whatchamacallit]

However, I DO think that telling a mother her unborn child is deformed and should be aborted, when it isn't and shouldn't, is far greater negligence than what has occurred here. No doubt if I had said it was a Thai doctor giving the advice I'd have a lot more people agreeing with me.

How about the doctor telling the mother that her unborn child is deformed - PERIOD!!!! It is up to her and her husband what step they should take next!!!

I'm sure the Ultrasound performed on her was not because she wanted a picture of her unborn child for her family album!!

Edited December 26, 2009 by whatchamacallit

[ballpoint]

However, I DO think that telling a mother her unborn child is deformed and should be aborted, when it isn't and shouldn't, is far greater negligence than what has occurred here. No doubt if I had said it was a Thai doctor giving the advice I'd have a lot more people agreeing with me.

How about the doctor telling the mother that her unborn child is deformed - PERIOD!!!! It is up to her and her husband what step they should take next!!!

Maybe you're right, but the case we're commenting on is that the child has been born, and will have to live with this court case in his mind for the rest of his life. The parents have more or less admitted that they would have aborted him had they known he would turn out as he is, why else the huge original claim they made? I'm not saying that abortion would have been right or wrong had they have found out, but the child is now a living, intelligent human being, who will eventually find out that he wouldn't have been wanted had his condition been known.

The other obvious response is, where does it say in the OP that the doctor did know the child was deformed and chose not to tell the parents?

[Sherlocke]

They either failed to do the right tests, failed to notice or chose not to tell the parents - any way it is negligence and I believe far ore common than most people would like to believe.

[whatchamacallit]

The other obvious response is, where does it say in the OP that the doctor did know the child was deformed and chose not to tell the parents?

I don't know if you're aware that medical world in the past couple of decades has advanced by leaps and bounds - believe it or not they can actually determine the sex of your unborn child from day 1 :-).... For a doctor not to be able to see (from the result of the ultrasound) that you have a deformed unborn child at 18 weeks is shocking!!!!!!!!!!

[PeaceBlondie]

You can ask questions. They should give real answers. My doctors in Chiang Mai do. The wiser doctor in Hua Hin said he had to tell me he didn't know. The specialists at Samitivej weren't so honest. So I avoid BKK.

[Sherlocke]

"Following the ultrasound test, she was told that her baby was fine." - As I have claimed before there is a culture in Thai medical industry of keeping the patient in the dark - I have come across one or two serious incidents of this myself and would find this to be just about the most likely reason for this mess.

whether termination is right or wrong in this case is irrelevant - the patient was either not informed or information was deliberately withheld.

In the case of a "geriatric" birth - (over 28 yrs) there are plenty of tests and observations carried out as routine which will give you pretty much anything you want to know about the developing baby.

It is clear that there has been negligence here and not just a "slip-up" this is a failure to carry out absolutely basic procedures. In fact the mind boggles to think how a fully trained doctor and team could possibly overlook these procedures.

many pelople are too in awe or confused in hospitals to ask questions - it is the duty of a doctor to offer information to help the patient make their own informed decisions.

One mistake in another hospital or country in no way justiffies or ameliorates the situation here in THai hospitals and it really needs to be looked at more closely by it's potential customers. (us!)

Edited December 26, 2009 by Sherlocke

[ballpoint]

Yes, it's shocking, and there's far too much of it going on today, especially in Thailand, but you just can't get the staff, can you? Not that you'd know about it, there's some big conspiracy to keep us all in the dark. I mean, you'd find out about it in a normal country, but never in Thailand. Oh, apart from this case of course. Anyway, why trust a doctor? If they say your baby's healthy I suggest you abort it, if they say it's deformed then keep it. After all, who cares about this poor kid who has to put up with a physical deformity and this mental trauma? What's more important is making sure those doctors get what's coming to them isn't it?

Carry on your bashing and blaming, I'm signing off on this thread.

[Johpa]

First, understand that the practice of medicine combines both science and application of the medical arts. Second, after nearly 30 years of interactions with Thai medical personnel, I find them equal to any here stateside or in Europe. Those who expect 100% perfection should simply kill themselves and let their God sort out their myriad afflictions. As for me, I am happy to continue to seek medical advice from Thai medical practitioners although always being aware of the need to follow the dictum of caveat emptor.

[Dakhar]

<snip>

It is also unfortunate that many westerners seem to judge a hospital by it's furniture and equipment rather than the nature of the people who work there.

<snip>

Include me out of that statement.

I went to Phuket International hospital (AKA Sirirod hospital) last year to see the doctor that had removed my ear wax previously. I was told I had to go to the new, recently built wing to the ENT doctor there. I said I wanted to see the doctor in the old building but these people were worse than the flower sellers, tailor touts and tuk-tuk drivers. They were so insistent that I went with them into this futuristic building with comfortable looking armchairs, wide screen TVs hanging from the ceiling and lots of pretty smiling nurses.

I knew I wouldn't stay but realised I had to go through this procedure to convince them that I wasn't interested. So I saw a senior nurse and explained I wanted my ears syringed out. "Oh, we don't do that. We use new equipment that painlessly sucks out the wax".

If anyone has had this done they will know that it isn't painless at all especially if the nurse/doctor doesn't have a steady hand and rams the end of the probe against your ear drum.

So I said I didn't want it but she insisted that she get the doctor to speak to me. I went through the same series of questions with him. He eventually gave up trying to convince me to let him use this vacuum equipment so I went back downstairs to the old building, sat on the old plastic chairs and waited to see the doctor who quickly, painlessly and relatively cheaply syringed out the ears just like my old doctor in the UK used to do.

This Thai doctor's name is Dr. Toranit, in case anyone else wants to see him. I hope he's still there. If anyone knows if he has his own clinic, I'd like to know where it is.

As an Audiologist I am licensed and trained to do "cerumen removal" and I used to do this procedure every day for 3 hrs a day....

I can tell you from experience, that the vacumm method is in my opinion, a much better way of doing things. I have worked with ENTs that also use the pressure hose, "irrigation" and I have seen a lot of ruptured ear drums caused by those "irrigators" that you so fondly promoted.

[Dakhar]

"Following the ultrasound test, she was told that her baby was fine." - As I have claimed before there is a culture in Thai medical industry of keeping the patient in the dark - I have come across one or two serious incidents of this myself and would find this to be just about the most likely reason for this mess.

whether termination is right or wrong in this case is irrelevant - the patient was either not informed or information was deliberately withheld.

In the case of a "geriatric" birth - (over 28 yrs) there are plenty of tests and observations carried out as routine which will give you pretty much anything you want to know about the developing baby.

It is clear that there has been negligence here and not just a "slip-up" this is a failure to carry out absolutely basic procedures. In fact the mind boggles to think how a fully trained doctor and team could possibly overlook these procedures.

many pelople are too in awe or confused in hospitals to ask questions - it is the duty of a doctor to offer information to help the patient make their own informed decisions.

One mistake in another hospital or country in no way justiffies or ameliorates the situation here in THai hospitals and it really needs to be looked at more closely by it's potential customers. (us!)

Not to shift blame, but you would think that a "Hi So" person would request 4 D imaging... We did this for both our kids, we had a CD burned for "keep sake" etc. Even a janitor could tell you if the child was deformed with 4D imaging.

[Dakhar]

You can ask questions. They should give real answers. My doctors in Chiang Mai do. The wiser doctor in Hua Hin said he had to tell me he didn't know. The specialists at Samitivej weren't so honest. So I avoid BKK.

I give HUGE props to the Doctors that use Googel right in front of me. I use one in Vichayut that does that, and he even "spins" the monitor around so I can watch him look up things.

I have seen the good, the bad and the ugly here. I was in the OR of a botched surgery about 3 weeks back. I sure did not sleep much that night.... the next day, I saw another surgeon work his art at a different hospital. It was a "tricky" case and he made it look like "childs play." When he got finished he spun around and said... "That was easy" and the truth is it was a difficult case, and that was his first time to do this "version" of a procedure.

[Sherlocke]

Why should they "request" any service - they are lay-people - patients

any hospital worth their salt would have offered any service they have to hand and helped the patient choose - but as is so often the case the high-handed doctors in Thailand like to dictate treatment to their patients.

[Sherlocke]

Without a doubt thailand has competent even great doctors - but the problem is not the smattering of good doctors it is the "top-down" culture that exists in Thai hospitals - the hero-whorship even of doctors a belief in their infallibility that pervades the whole system that is so very disturbing; this coupled with a non-existant system of checks and balances is a dangerous combination.

[wasabi]

I have had bad medical care in the US and Thailand but in the US it tends to be more that the doctor doesn't know and isn't interested in finding out what is wrong with me. In Thailand the doctor thinks I always want a response and some antibiotics and even if they don't know what is wrong they act is if they know precisely what is wrong and give me a sack of pills to bring home the point. I have had some really good treatment in Thailand before but I would say the cultural differences run counter to practicing good medicine. This neonatal screening is a blaring example of the gross negligence that can result. Either it is severe incompetence to not notice the child's deformities or cultural that the parents were not informed. I suspect the doctor did see the deformities since they seem so obvious but simply hoped everything would be alright rather than dealing with the confrontation that would ensue from informing the patients.

I do feel Thai doctors have access to good sterile equipment and often are skilled surgeons but are poor in diagnostic abilities. Because of this and the high pollution I chose to leave Thailand and return to the USA earlier this year. I would like to retire in Thailand but before I do so I will make sure I am in a position where I may return to a more developed country so that I can receive what I consider the highest quality treatment available.

[whatchamacallit]

Yes, it's shocking, and there's far too much of it going on today, especially in Thailand, but you just can't get the staff, can you? Not that you'd know about it, there's some big conspiracy to keep us all in the dark. I mean, you'd find out about it in a normal country, but never in Thailand. Oh, apart from this case of course. Anyway, why trust a doctor? If they say your baby's healthy I suggest you abort it, if they say it's deformed then keep it. After all, who cares about this poor kid who has to put up with a physical deformity and this mental trauma? What's more important is making sure those doctors get what's coming to them isn't it?

Carry on your bashing and blaming, I'm signing off on this thread.

The only person who mentioned the word ABORTION in this whole thread is you!! Stop looking at the world thru rose colored glasses!! What would you do if a hospital was grossly negligent and you suffered serious consequences due to this? You don't know a thing about raising a child who is totally dependent on you for the rest of his/her life!!! As the child will need care for the rest of his life and will likely out live the parents - maybe this is why they're asking for monetary compensation. What mental trauma rubbish you're talking about!!! He should be proud of his parents for fighting for his right!!!

[Dakhar]

Why should they "request" any service - they are lay-people - patients

any hospital worth their salt would have offered any service they have to hand and helped the patient choose - but as is so often the case the high-handed doctors in Thailand like to dictate treatment to their patients.

4D at this point in time is considered a "luxury" service over reg. scans. The burn a CD of the results and even acompany "music" on the cd.

Kind of nutty, but my wife had it done.... by request....

[BlueSmurf]

The second dept I went to was the skin section. Had some bright red spots as well as some greyish brown ones of a diff texture on various places -- back, neck, arms and even on head. I swear I wasn't in his office 3 minutes, total damage 900 baht. All he did is say you can take your shirt off, he stayed seated at his desk and glanced at me from afar and said, "oh that? that's melasma. anything else, or will that be all for today?" He didn't walk over to have a close look, he didn't try to look me over other than just ask me what "spot" I was concerned about. What if there was a real cancer on my back?

You might want to get those spots looked at. I get annual skin cancer checks at home by a specialist, as I spent way too much time in the sun as a kid.

The doctor needs to do a close up inspection in order to check the shape, colour, edges of the spot etc. He can’t do it from behind his desk and he needs training so he knows what he’s looking for. You’re obviously concerned about it or you wouldn’t have gone to this muppet. Hopefully someone can put you in touch with a trustworthy doctor here.

I’ve had 2 cut out, I needed a few stitches, but all’s been fine since. Don’t worry yourself too much because most turn out to be nothing, or easily remedied, but don’t ignore them – get them checked out by a decent doctor early on.

Good advice.

[Sherlocke]

I've had a similar experience.

skin cancer is very common in fair-skinned Westerners - even those who tan easily - it seems that only Australia has an effective public education program o this.

THe UK now actually has a larger number of cases than Oz - OK bigger population but cool climate - it is folks travelling abroad to hot climes who are at risk.

Thai hospitals concentrate largely on making shin white - through highly dubious methods - and keeping it smooth - i.e. their only real concern is cosmetic. You have todo your groundwork thoroughly to get a doctor who understands skin cancers

[moe666]

Too all of the bashers here good luck getting a straight answer from a western DR.as well. You get the old in and out with them, maybe 2 or 3 min. if lucky. If you think only Thailands medical system is in it for the money, try a hospital in the US they charge you for the paper cup they give you the pills in.

[jeb]

Heh, I have a friend who works in BKK Hospital. His line said some weeks ago was 'I feel bad when I know we are scamming the patients...they are so overcharged' and then he mentioned some medicine and procedures. And told me how much the new helicopter pad costs...(iirc that one was built on BKK Hospital and not one of the sister hospital the same people own, not that it matter. They will never be able to recoup the cost for it through normal fee's.)

And the attitude that goes with it.

Some time back I fell and injured my back which had serious effects. A local orthopedist recommended I see a doctor named Prakit in Bangkok who worked at Bangkok Hospital. After seeing me and going over the intake documents, X-rays, etc., he told me I needed spinal fusion. After L3-4-5 fusion he was surprised at my having problems during in-hospital rehab. Instead of being up and around within 3-4 days, I was still having difficulties after 2 weeks when I came home and was bedridden for months after.

After I was mobile again and went back for post-op visit I was casually told that the intake X-rays showed an L1 fracture. Oddly enough the neurological symptoms of vertebral fracture are pretty much the same as what I experienced both before and after the surgery.

The treatment for a fractured vertebrae is back support and immobility while the bone fuses. On the other hand I paid 560,000+ baht for what they did to me. Adding insult to injury, an extra-cost pain specialist spent hours treating the same symptoms after the operation that I had had before.

Part of the Hippocratic Oath is, First do no harm. However, as far as my experience with Prakit and Bangkok Hospital is concerned that seems to run a poor second to revenue generation. They both seem to aim toward soaking farangs as much as the traffic will bear.

The wasted money is bad enough; the infuriating aspect is the markedly reduced physical capabilities resulting from the operation.

jeb

[fiercesnake]

Many will site the scandals in Western hospitals – but these scandals can only occur when there is and EFFECTIVE CHECKING system in place that will reveal such problems – in Thailand this does not happen.

Good point! True no system is perfect but because this country is still developing it fails to take into account the need for effective checks and balances in all major areas. By this I mean across the board not just the medical industry. I find training of general workers here extremely poor in general. Yes the girls all look very beautiful and they wear immaculate clothing and makeup but ask them something pertinent about the company they work for and the response is often just a lovely smile and a run away to get someone else who also doesn't know anything about the product or service their company provides.

But this whole culture of not looking into a problem head on is the major issue. Who knows what the ultrasound operator was thinking (thinking???) when doing the scan. Was she scared to tell this important rich lady her fetus was a complete reject!? Maybe just smile and pray to Buddha all will be OK??? Many a time I find Thais know that something is very wrong but are just so scared to even mention it so as to avoid conflict and/or negative feelings. They don't call this place Land of Smiles for nothing! Though this aspect of the culture is certainly nice in minor day to day issues avoiding the regular contentions I see in farang society, it is simply taken to an extreme as (possibly) seen in this example.

If Thais can balance the idea of when not to confront a problem and when to directly confront a big issue the whole country will improve. Now there is child with extreme deformities that has little chance of a "normal" life and parents rightly grieving for action. Unfortunately another poster was correct by saying be careful for what you wish for as ultimately the costs are just passed on to you the customer; certainly the rich folk there are not taking the compensation out of their own personal bank accounts , it will come from the company bank holdings and the beancounters will want to recoup the loss.

Unfortunately what the real tragedy is here is that there will be no real improvement by having, as Sherlocke above suggested, an improved system of checks and balances here. The only time this is likely to occur is if someone in real power has something similar happen to them. It is a grave shame for the child and family that this has come to this point!

[jackh]

It all boils down to one basic fact. It is 100% your own responsibility to be proactive with your healthcare. No doctor or hospital in the world will be able to help you more than you help yourself. Learn about your own problem and ask your doctor specific questions and treatments. Manage your own care.

My attitude is that the doctor works for me. He can justify my treatment options clearly and answer my questions, or I go someplace else. Do not be intimidated by their "God" complex. They are just mechanics.

[PuaSai]

I don't understand how this could have been missed...I mean, I was counting toes on my son when we did the ultrasound...surely one would notice if it was missing both legs and an arm? Or the staff was hoping they where just misreading it and that everything would be 'ok', as to not upset the hi-so customer?

I bet you are right about not wanting to upset the "hi-so" customer. I guess they forgot that the woman would indeed eventually find out the real diagnosis when she gave birth. As you said, you can see detail in the ultrasound, especially limbs.

[twix38]

I am pleased to hear that the Bumrungrad has been successfully called to account for this example of gross incompetance at least.

I saw an ENT specialist 2 years ago and told all clear and given anxiety pills to take, though not told what pills were for at the time, so assumed medication to treat condition. I looked them up on internet when I got home and threw them away.

A couple of months later I returned to UK and under the NHS I had a Gastroscopy and was found to have Barratt's Epithelium at LGD. The Thai Doctor at Bumrungrad would not have seen this as he only did a check of my upper throat, but importantly he fobbed me off with what turned out to be anxiety pills and told me not to worry and all okay.

He should have not been in such a rush and he should have recommended further checks (like a gastroscopy). It was only that I knew there was something that I persisted (but not with him anymore) and had it checked back in UK shortly after, as I was returning home.

Now I am on regular check ups and daily medication to ensure it does not progress onto Cancer of the Oesophagus.

I blasted the Bumrungrad and threatened to sue, but I don't have the means or determination to follow it through.

This Doctor found nothing and therefore treated my problems as all in my mind and due in part to anxiety, thus giving this as my diagnosis and telling me all clear instead of recommending further tests. He could very well have given me a death sentence had I not ignored him and gone elsewhere.

I got the usual cover up, deniability and buck passing when I complained.

I do hope they begin to learn their lesson and pay more attention to good medical treatment including adequate prevenatative and diagnostic follow through to ensure they get it right rather than let too many cock ups get through.

It's nice to have a grand piano and violin playing, but as for medical treatment, I will NEVER return.

Edited December 27, 2009 by twix38

[goatfarmer]

It all boils down to one basic fact. It is 100% your own responsibility to be proactive with your healthcare. No doctor or hospital in the world will be able to help you more than you help yourself. Learn about your own problem and ask your doctor specific questions and treatments. Manage your own care.

My attitude is that the doctor works for me. He can justify my treatment options clearly and answer my questions, or I go someplace else. Do not be intimidated by their "God" complex. They are just mechanics.

Agreed.

[toptuan]

I have found generally this is the Thai style of doctoring. Keeping a great physical distance from the patient. Being offended by questions. It is bizarre when you encounter it for the first time as a westerner.

My very personable upcountry doctor acts totally unhurried, nods and sympathizes at all the appropriate places in my description of my ailments, looks directly in my eyes, and holds my hand and arm the whole time during each consultation. But then again, I think he's gay.

Upcountry medical care is not exactly world-class, but at least I feel psychologically better when I pay my 150B fee.

Edited December 27, 2009 by toptuan