Billed For Medical Mistakes

By Stephen Stock

TALLAHASSEE (CBS4) ― Most people believe that you shouldn't pay for something you don't get. If your restaurant meal is lousy, you ask the manager to take it off your bill. If the new TV doesn't work, you demand your money back. But the CBS4 I-Team has uncovered a practice in the medical profession which basically forces patients to pay for their medical care, even when medical professionals make mistakes, a practice some are calling wrong and unethical.

CBS4 I-Team investigative reporter Stephen Stock uncovered this business practice which has been an open secret in Florida's medical community for years, but is unknown to most people getting medical care.

Even though most patients don't pay the bill, virtually everyone pays for the practice through higher insurance premiums. Many times it is the insurance companies that foot much of the bill for surgeries that never happen or go wrong in the operating room.

The practice has so concerned legislators in other states, laws have been passed preventing it, but not in the Sunshine State. Medical and Insurance experts agree that in Florida, it's for doctors and medical professional to bill parents or insurers for their mistakes.

Rusty Juergens knows this financial nightmare from firsthand experience.

Last Thanksgiving, the 53 year-old father and church youth leader went in for routine knee surgery but never made it that far. A problem with the general anesthesia caused him to flat line, in effect, to die on the operating table.

Quick action by doctors brought Rusty back to life on the operating table. He had no ill effects after the problem he experienced in the hospital with the general anesthesia, and is now back at work in the Ocala hair salon he's owned for 8 years.

But, Rusty still has a bum knee. He never had the surgery he needed, but he did get something for his time in the hospital; Juergens got a hospital bill for his near-death experience.

"About a month after the surgery they started coming," Juergens said.

Not just one bill, Juergens said, but several bills from health providers responsible for the surgery he never had.

"When the bills started to come I waited then I called Blue Cross Blue Shield and I let them know," Juergens recalled. "I told them, you know, I just need to let you guys know that I went in for knee surgery and did not get knee surgery and you guys are paying for this."

Juergens was surprised by the insurance company's response.

"And they seemed to feel that that was okay," Juergens said, incredulous.

The CBS 4 I-Team discovered that these types of mistakes are more common than most know.

They are classified by researchers and those in the medical field as wrong-side, wrong site, wrong procedure, wrong patient adverse events, or WSPEs.

According to the Archives of Surgery, there have been 5940 WSPEs nationwide since 1991. In Florida, there have been 494 WSPEs since 1991. And since 2000, according to the Archives of Surgery, there have been an average of 75 WSPEs a year in Florida. According to the Centers for Medicare and Medicaid Services, in 1999 alone, medical errors cost patients 2.4 million extra hospital days...and 9 point 3 billion dollars in excess charges. This is the last year this type of data was available through the Centers.

"It is really happening out there," says Becky Cherney of Florida's Health Care Coalition.

The CBS4 I-Team discovered that 11 states currently have rules or procedures in place to prohibit doctors and hospitals from charging patients after these medical mistakes.

According to both the National Quality Forum a Washington DC based non-profit healthcare group, and Florida's Health Care Coalition, those 11 states are Delaware, Georgia, Illinois, Maine, Massachusetts, Minnesota, Oregon, Pennsylvania, South Carolina, Vermont, and Washington State.

Florida is not on the list.

Though adverse events must be reported under Florida law, there is no law prohibiting charging for WSPEs in the Sunshine State.