When vets make mistakes, pets pay the price - Pet health- msnbc.com
Owners outraged over botched surgeries, medication errors, misdiagnoses
By JoNel Aleccia
updated 5:20 a.m. PT, Wed., Feb. 10, 2010
Jared Genser was a day away from euthanizing his family dog, Finnegan, when the Washington, D.C. lawyer discovered that the lab’s diagnosis of a painful and deadly bone cancer was wrong.
Jenn Diederich of Riverton, Utah, sent her dog, Ted, for surgery to repair a torn ligament in a right rear leg, only to find that the veterinarian had operated on the left leg instead.
And Stefani Olsen of Silver Spring, Md., returned from a weekend business trip to discover that the clinic where she’d boarded her elderly diabetic cat, Toonces, had overdosed him with 10 times the amount of insulin he needed, leaving the animal blind, wracked with seizures and suffering from severe brain damage that lasted until his death.
“It goes beyond heartbreak,” said Olsen, a 45-year-old health information technician who’d had the 15-year-old cat since he was a kitten.
If any of these mistakes had occurred in human patients, they’d be classified as medical errors worthy of investigation, public reporting and professional discipline, including dismissal.
Wrong-site surgery and medication overdoses, for instance, are among the so-called “never events” regarded as inexcusable in a human health care setting.
But because the errors occurred in animals, owners and advocates say they were ignored, minimized or outright denied by a system that devalues the bond between pets and their owners and fails to hold veterinarians sufficiently accountable when they make mistakes.
“When someone’s companion animal is injured by a veterinarian, their choices are between slim and none,” said Joyce Tischler, founder and general counselor for the Animal Legal Defense Fund, a Cotati, Calif., group that fields several calls a month about pet medical errors.
“Action against veterinarians is woefully inadequate,” she added.
Owners of injured animals say they’re stunned to discover state veterinary boards that dismiss up to 80 percent of the complaints filed against their members, and a legal system that regards pets as mere property, with no way to recover damages for emotional loss.
Laws vary, but in most state courts animals are worth their market value, plus perhaps any economic value they generate for their owners, Tischler said. That could be a considerable amount of money for a high-value show dog or a racehorse, for instance, but for most household pets, it's not.
“If you have a 10-year-old mixed-breed dog, the value of that dog is generally considered to be under $100,” Tischler said. “It's a sad situation, it's an unfair situation for people who care about their animals and are quite shocked to find when their animal is killed or injured they cannot sue.”
But industry advocates and vets themselves say that such rhetoric overstates the problem. They contend that mistakes occur only in a tiny fraction of the nearly 190 million for veterinary visits for dogs, cats, birds and horses each year, and that there is adequate monitoring and discipline when they do happen.
“I guess I don’t agree that there is a lot of malpractice out there,” said Adrian Hochstadt, assistant director of state legislative and regulatory affairs for the American Veterinary Medical Association, which represents about 80,000 vets.
“If there are negligent doctors — and there are probably a few in every system — if it’s a big problem, it would have been addressed by legislation," he added.
No tracking of vet errors
It’s difficult to know how often medical errors occur in pets. The AVMA collects no statistics on veterinary malpractice suits, Hochstadt said, and the group’s associated Professional Liability Insurance Trust, or PLIT, which offers malpractice insurance for vets, refused to release numbers or outcomes of such cases.
One small study of veterinary errors, a 2004 paper published in the journal Veterinary Record, found that 78 percent of recent veterinary graduates surveyed in Scotland and England admitted making a mistake that could have endangered an animal. It’s not clear whether those results can be extrapolated to the larger profession, however.
In the absence of better data, most industry experts look to human medicine, where medical errors kill at many 98,000 people a year, and likely more, according to a decade-old Institute of Medicine report widely regarded as a baseline.
“There’s no reason to think that it’s so different than what occurs in humans,” said Kathleen Bonvicini, chief executive of the Institute for Healthcare Communication Inc., a New Haven, Conn., nonprofit that had to add sessions on veterinary errors several years ago to address a growing demand.
Complaints on the rise
Still, the number of complaints against veterinarians seems to be going up, rising by about 14 percent between 2005 and 2007 according to a survey by DVM Newsmagazine, which monitors the industry.
A check of several states showed that many dismiss a large proportion of their complaints. In Texas, there were 469 new complaints in 2008, with 172 carried from previous years. Records show that more than 40 percent, 263 complaints, were dismissed without action.
In Alabama, 30 of 50 new complaints filed in 2008 were dismissed, or about 60 percent. And in Nevada, 65 of 79 new complaints that year were dismissed, or 82 percent.
But using numbers of complaints to gauge the quality of veterinary care can be misleading, noted Thomas Mickey, the executive director of the North Carolina Veterinary Medical Board. Some customers use complaints as a way to get out of paying what they regard as high vet bills.
“They have to justify a reason for not paying that bill,” he said.
The AVMA stands by the state discipline system, Hochstadt said. At the same time, the group has staunchly opposed efforts to allow courts to impose non-economic damages for animals, arguing that the move would drive up costs, push vets out of the profession and create many of the problems found in the medical malpractice realm for humans.
“Our position is that the current legal structure is working well,” Hochstadt said.
That sentiment outrages some pet owners, prompting them to take their plight to the Internet. Greg Munson, 44, a Mesquite, Texas, businessman created the Web site www.vetsfromhell.net after the 2005 death of his beloved 8-year-old Shih Tzu, Stempy, from an alleged veterinary error after surgery for a bladder stone.
Munson's site, which features flaming letters and "story after story of EVIL Vets from HELL,” was designed to gain attention — and prompt action, Munson said.
“Vets in this country literally get away with murder,” Munson said. “Even when a vet board does hold a vet accountable, it’s nothing more than a slap on the wrist.”
When mistakes occur, they’ve devastating to the animals — and to their owners.
Jared Genser, the 37-year-old Washington, D.C., lawyer, said he and his wife, Lisa, 32, a social worker, suffered “extreme distress” when a pathologist’s report from the University of Pennsylvania School of Veterinary Medicine said their 5-year-old Greyhound, Finnegan, had osteosarcoma, an aggressive and deadly bone cancer.
“We cried for 24 hours,” he said. “They said we should probably consider putting him down to spare him the pain.”
Reluctantly, the pair scheduled the euthanasia. The day before the appointment, however, they got a second opinion from a Greyhound expert at Ohio State University, who ruled out cancer and said the dog was recovering from an injury. Three years later, Finnegan remains happy and healthy.
“It was either a spontaneous recovery or the pathologists at U Penn were wrong,” Genser said.
Jenn Diederich’s dog, Ted, a 7-year-old female Corgi-Blue Heeler mix, required four surgeries to repair the damage caused when Utah veterinarian Eric Bonder mistakenly operated on the wrong leg — and then botched that operation as well when a bone plate fractured during surgery.
“Her left leg, the one that had nothing wrong with it, had to have three surgeries because he did such a bad job on it,” said Diederich, 35, who works in law enforcement. “No dog should have to go through that.”
Stenfani Olsen said Toonces, her diabetic cat, spent the last two years of his life grappling with severe brain damage, while she spent $16,000 caring for him. It turned out that the vet who cared for Toonces, Marc S. Katz, of Silver Spring, Md., had allowed his adult son, who was not licensed as a veterinary technician, to administer insulin to the animal without supervision, records show.
The penalty levied by the Maryland State Board of Veterinary Medical Examiners against Katz was a $250 fine and 30-day suspension of his license, which was stayed. He was placed on six months probation, records showed. Katz did not return calls and e-mails from msnbc.com.
“What would happen to a human medical doctor if that happened?” Olsen said. “What I’m saying is a $250 fine and a stayed suspension is completely inadequate as a deterrent.”
‘How do you sleep at night?’
For many owners, that’s the worst part: They’re upset that the mistake occurred, but they’re outraged when no one seems to take it seriously.
When Diederich, who was upset, confronted the vet, Bonder, about the mistaken surgery, she said he told her: “By law, your dog is worth only $100 anyway.”
“You take your animal to a vet clinic and you just assume that they care about your animal,” she said. "I asked him, ‘How do you sleep at night?’”
Bonder, 45, of Salt Lake City, acknowledged that he did operate on the wrong leg, and that that operation went bad, too.
“I feel awful about it,” said Bonder, who explained that the original mistake occurred when a technician shaved the wrong leg. “Admittedly, I should have caught the error.”
But he said he never told Diederich that her dog was worth just $100: “I did not say it and I would not say it.”
He added that every vet who makes a mistake feels nearly as bad as the owners do.
“It’s more gut-wrenching than it is anything else,” Bonder said. “Once I realized it occurred, it’s ‘Oh my gosh, what happened?’ and then you go to ‘What do you do about this?’”
Diederich filed a complaint about Bonder with the Utah Division of Occupational and Professional Licensing last summer, but a spokeswoman said no action had been taken. Records show Bonder's veterinary license had been placed on probation for two years in 2002 after he "acted unprofessionally" while treating an injured cat. The move included stipulations that he submit to a psychological exam and retake the ethics portion of the state veterinary exam.
Bonder said he couldn't comment on the details of the case, except to say it didn't involve a medical issue.
In Genser’s case, the head pathologist at the U Penn vet school wouldn’t answer calls from the Greyhound's owner about the dog's incorrect cancer diagnosis. A letter to the dean of the school, Joan C. Hendricks, elicited a polite, but vague response, despite Genser’s demands for clear action to rectify the problem. Hendricks did not respond to calls and e-mails from msnbc.com
“I don’t expect perfection in my vets,” said Genser, adding that he did expect medical professionals to communicate with owners and to learn from their mistakes.
A culture change
Bonvicini, the health communications expert, said veterinary attention to medical mistakes probably lags human medicine by several years. In human care, a “mistakes happen” attitude has been replaced with concerted efforts to reduce errors. From Medicare penalties for hospital-acquired conditions to surgical checklists aimed at reminding doctors to follow protocols, the entire system has veered toward a new accountability.
“We’re talking about a culture change,” said Bonvicini, who teaches seminars on human medical errors as well. The PLIT, the liability insurance agency, has recently begun sponsoring the sessions.
Veterinarians are starting to feel the same pressures, said Mickey, the North Carolina vet board director.
“I think there’s a greater understanding in the profession that a mistake could happen to anybody,” he said. “We’ve got to be more careful. We’ve got to do a better job. I think the whole profession is on a gradual uphill.”
The change can’t come soon enough for pet owners, said Tischler, of the Animal Legal Defense Fund. In a nation where 63 percent of people own pets and many regard them as members of the family, according to the American Pet Products Manufacturers Association, more animal lovers are paying attention to medical errors — and hoping to stop them.
It’ll take more aggressive enforcement by vet boards and, perhaps, a change in the way animals are regarded under the law, she said. Until then, pet owners are on their own.
“I never met a person who wanted money,” Tischler said. “Every single one of them has said, ‘I just don’t want this to happen to anyone else’s animal.’”