Dawn Rich, Healdsburg CA

Published on

Back in 2004, I had Kaiser health insurance through my employer. I was diagnosed late that year with a fibroid uterine tumor and the doctors said I needed a hysterectomy. After the surgery that December, at Kaiser in Santa Rosa, my cervical bleeding never stopped, and I have it to this day. I was fatigued, had dizzy spells, first rarely and ultimately almost every day. I had constant pain in my side.
Right after the hysterectomy I lost the Kaiser insurance, on January 1, because my employer at the time dropped employee insurance altogether. I kept going back to Kaiser, asking for help, telling them something was wrong.  I tried to pay cash, but they said I had to be a member. I then applied for an individual policy from Kaiser but they denied that, too, because of my “preexisting condition”— the bleeding after their surgery.

I’m now completely uninsurable because of what Kaiser did, and wouldn’t correct.

I never got to see a Kaiser doctor after that surgery, but I did talk on the phone with the surgeon and told him about the bleeding. He told me not to worry about it, it could be some "endometrial tissue" left attached to the cervix. I mentioned the pain and he said that couldn’t have anything to do with the surgery.

It took me four years to find out what was wrong, that Kaiser had used the wrong internal sutures, a kind that does not reabsorb into the body. Kaiser has more or less admitted the error but won’t do a thing for me. They know that I can’t sue them. Lawyers in California will not take ordinary malpractice cases because of the $250,000 cap on damages.
After the surgery, I had no insurance and ended up in the emergency room several times with the pain.  It just disabled me. The docs there could never figure it out. I had x-rays and blood tests over and over again. It just kept getting worse, and I thought I was going to die. I was dizzy all the time.

I was able to get onto Medi-Cal for a while, even though I worked from time to time, and I saw a doctor at Sutter Family Health Practice.  They gave me tests for breast cancer, colon cancer, all kinds of blood tests. Finally an ultrasound picked up something abdominal. They thought it was a cervical polyp. Just before my Medi-Cal ended in July of this year (my family circumstances changed, and I no longer me the income limit), they scheduled me for surgery.

I had also been calling Kaiser, continuing to ask for help, but every appeal I filed was turned down.
I had the second surgery at Sutter in June 2008, paid for by Medi-Cal.  They found sutures that were still intact from 2004. They were tight and pulling my cervix. The sutures had never dissolved. The surgeons had to remove the sutures instead of doing the planned surgery, because the sutures were in the way. They didn’t do the original procedure to stop the bleeding, in part because they would have needed a new Medi-Cal approval.
Even so, right away my dizziness was gone, and a lot of other symptoms including the continual pain, but I still have the bleeding. And the anemia and constant fatigue. I had spent a lot of time bedridden, and also gained weight, so I’m still struggling with that.

After finding out about the sutures, I obtained my medical records on the original surgery by Kaiser and it said they had used “Vicryl” sutures. I contacted the manufacturer of those sutures. They told me, and wrote to me, that the Vicryl sutures always absorb.
Then, in the laboratory report from the second surgery, the lab said the sutures were “Cromic” sutures, which do not reabsorb. The sutures were removed from my cervix but I still probably have sutures on my ovaries.

I contacted an expert who testifies about sutures, and he said the sutures Kaiser used could not be Vicryl, because they are purple in color and always reabsorb. He gave me the info over the phone, but to get a written report would cost $1,200.

So now I still need at least cauterization of my cervix to stop the bleeding—someone needs to do what the first operation was intended to do. And remove the sutures that may still be in my ovaries—I need an ultrasound or MRI to see the extent of those sutures.

The bill for the surgery in June was $52,000. So the taxpayers paid to fix the mistake that Kaiser made.

I no longer have Medi-Cal, and I’m uninsurable.

Kaiser keeps denying me any help, even though I need another surgery. I called their resolution center and they told me “I thought Medi-Cal was going to pay for this,” because they knew I had been on Medi-Cal. Even when I tried to set up some kind of payment program to get the final surgery, they wouldn’t do it.

Each time I dispute them and offer proof, they think of a different reason to turn me down.

Kaiser keeps telling me that “those sutures normally absorb,” even though they are acknowledging that they were the wrong sutures. And they say my symptoms were not caused by the sutures anyhow. But my dizziness and swelling and other symptoms, except for the bleeding, went away right after the second surgery at Sutter.
I contacted the Department of Managed Health Care last month and sent them all my documentation. They said they would make a decision on my complaint by the end of September.
When I called Kaiser for my records, they put in my records that I had been notified there could be “cyclical” bleeding after the surgery. They never told me any such thing, because I would have had the cervix removed as well if I’d known that. And the bleeding wasn’t cyclical, it was every day.
Oddly, they also said in the records that they used staples to close my stomach, but they didn’t.
All I want to do is get the surgery to remove the rest of the sutures and stop my bleeding.  I want to be well and go back to work.

Right before the Kaiser surgery I had just completed all my prerequisites for a nursing program and had been accepted for the program. I was incredibly excited. But afterward, I had to drop all those plans.
I just want to be normal again.

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