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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7746
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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March 2012Went to major university in CALIFORNIA, chief of

Customer Question

March 2012
Went to major university in CALIFORNIA, chief of Neurosurgery performed a anterior approach surgery at L4-S1 using this device:

http://www.alphatecspine.com/products/isobar.asp

One hour before surgery, the doctor comes into my pre-op room and tells me the hospital somehow "forgot" to order the right size of this device. These rods come in several lengths, but he tells me that he has a mismatched pair, and that he could cut the longer one to match the other one (which was the right length).
Now I have even more back pain, in places I did not have it before. The rods do not look symmetrical at all. One looks like the images on the manufactor web link I provided, the other rods looks like a bent up mess. I have post op xray film, and its apparent these are two completely different rods.
My understanding was that these particular rods are NOT meant to be modified (although my understanding is that standard, traditional rods are modified all the time). My question is, as a medical professional, would you modify this device? Is there a possibility this doctor may have violated "standard of care." Please justify you response, in light of the fact that this doctor could have post-phoned the surgery and waited until the right, matching pair could be obtained from the manufacturer. I have film and medical records, I can upload xray images of the rods to this site if need.
If you are a physician in California, would you be interested in writing a medical opinion for a fee?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Rick, MD replied 1 year ago.
Good morning. I am online and available to assist you today. Thank you for your patience.

First of all, however, I would like to discuss your lack of giving positive feedback on this site. You have posted 10 questions and, even though you have received assistance on many of them you have not supplied positive feedback and, as such, your experts have not been compensated for their time and expertise.

What are your intentions on this question?

Concerning you issue, let me ask you some questions:

1. Why wasn't the surgery postponed?
2. Why do you think your new paid if from the modified rod?
3. Are you looking for a medical opinion that you can present in court during a malpractice suit?
4. Have you contacted other doctors in person for an opinion? If so, what did they say?
5. Have you hired an attorney?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.

Customer: replied 1 year ago.

Dear Rick,


Thank you for your time, you have a valid concern regarding my lack of feedback. I have now posted feedback on the questions that have been finalized, I am new to the site and wanted to be sure this was a service that can be trusted and lived up to its advertisement (seems like it does so far!). I hope I have demonstrated a reasonable level of good faith.


 


I will try to answer your questions directly and in a manner that is understandable. But before I do please let me state that I am a 34 year old male that is not hell bent on suing or causing a medical professional to lose their licence. I want to know what my options are medically (if there are any, now with all the screws are in place) and if the actions taken by the doctor are legally actionable.


 


1. Why wasn't the surgery postponed?


I have no idea and the management level Representative for device manufacturer (name left out on purpose) was wondering the same thing.



2. Why do you think your new pain if from the modified rod?


Honestly, I am not sure if it is from the modified rod, all I really know is that post surgery, for the past 10 months I have been in alot more constant chronic pain in new areas. I haven't been able to get off of the perocet, which I get from my family doctor and I am not working. The surgeon cleared me from his care a few months after surgery saying pain would decrease with time. He said there is nothing more that can be done, as he primary concern was the screws were holding place post op.



3. Are you looking for a medical opinion that you can present in court during a malpractice suit?


If it came to that yes. But I dont think I am at that point yet. I understand that is something I would have to pay for, directly or indirectly through an attorney. I certainly would not try to use information from this site, it would be a more formal, legally binding opinion.


 


4. Have you contacted other doctors in person for an opinion? If so, what did they say?


After 8 months of constant followup with the device manufacturer I FINALLY got them to give me a name to another surgeon (who is familiar with this device) that might be able to shed light on this matter. The problem is that the consultation is 450.00 dollars and before I spend that kind of money I wanted to see what an expert on here thought. This appointment is scheduled for April 8, 2013.


 



5. Have you hired an attorney?


I do not have legal presentation as this point because I dont know if there is claim. I did seek some advice from one however, and he said he would not get involved until I found out if another doctor had a problem with the care I received.


Expert:  Dr. Rick, MD replied 1 year ago.
I'm glad that JustAnswer has been a helpful place for you to go to and I thank you for taking the effort to go back and give positive feedback on your previous questions.

Thank your for that additional information.

From what you have posted I can safely say that your plan to consult with a surgeon recommend by the manufacturer is an excellent one. This doctor, while she charges a lot for a consultation is uniquely qualified and motivated to look at your medical care and surgery without any bias. She will tell you the truth no matter where that truth might lead.

As far as a medical opinion here, I would be happy to review your documents but I do not believe it will be of much value to you as you really need to keep the above appointment no matter what.

So. What is my "take home advice"?: Continue doing what you are doing, consult with the surgeon recommended by the manufacturer (perhaps she might recommend a therapy to control or eliminate your pain) and, one you have all the data in hand, decide what your next step will be.

I realized that this was not the answer you were hoping to hear but it would be unfair to you and unprofessional of me were I provide you with anything less than truthful and honest information.

Surely, you prefer that I tell the truth rather than what you wish to hear. Because it reflects very poorly on me unless you press one of the top three faces, keep this in mind when rating my answer and please do not punish me for being honest. I understand that this may not be easy to hear, and I empathize.


I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick MD FACS


Once again, I would like to thank you for taking the time to give positive feedback on your past questions.

I wish you the very best. Have a good day.

Customer: replied 1 year ago.

I wont not leave bad feedback for a answer I didn't "like," and I thank you for your candor. There is a way to upload images on here, and I will scan my xray so you can get an idea of what the surgeon did. I will follow up with my upcoming appointment.


I have considered other methods to control the pain, it has been so difficult, because the joints seem to "lock up" as opposed to before the surgery, where the joints would "pop", while that was painful, this locking up sensation is horrible and stretching/ movement does nothing to help.


Thank you.

Expert:  Dr. Rick, MD replied 1 year ago.
Is the xray on digital media (flash drive, disk etc)? If so, it will be fairly easy to upload.

If it is a image, you could scan it an upload it.

Here is one site you can use to upload your xray:

Save your picture on your computer, someplace easy to find it such as your desktop.
Go to www.tinypic.com
Upload your picture to the site tinypic.com by browsing for it as directed.
This opens up files on your computer. Double click on the picture you want to upload then hit open (bottom right of the screen). This will take you back to the tinypic page. Hit "upload now" then do the secret code thing and your picture will upload into the system.
Once you do that it gives you a bunch of links you can use, one of which says "direct link for layouts" It is important to use this box. It is the forth one down from the top of the page.
Copy the link from inside this box and then paste it into your justanswer dialog box and send it to your expert.
Customer: replied 1 year ago.

 

CLEAN "INSTALL" OF SAME DEVICE AT SAME LEVELS, SOURCE: MANUFACTURER

Customer: replied 1 year ago.


 


EXAMPLE OF DEVICE ON ANOTHER PATIENT, SAME PROCEDURE AS MINE

Customer: replied 1 year ago.

Customer: replied 1 year ago.

Customer: replied 1 year ago.

The last two images are the xrays a few months post op. If you download the images you can zoom in and out with windows picture manager.

Expert:  Dr. Rick, MD replied 1 year ago.
Thank you for those images.

Your rods sure are much different on Xray then the other patient and the ideal placement as shown by the manufacturer.

Could this be the cause of your pain/poor result? It very much could be...... but, it may be difficult to prove. Your consultation on April 8th will go a long way toward proving (or disproving) this fact.


It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7746
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
Dr. Rick, MD and 2 other Medical Specialists are ready to help you
Expert:  Dr. Rick, MD replied 1 year ago.
I was just thinking about your case today and wondering if you still have your appointment scheduled for April 8th with the manufacturer-suggested surgeon.

If you have a chance, I'd love to hear how your appointment turns out. If our old thread is not still open, you can just drop me a line on JustAnswer by requesting me.

I hope things turn out well for you. Have a good day.

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