Examples of medical issues we have encountered
Diagnosis
Incomplete Evaluation
Incomplete evaluation for diarrhea. Identified missing tests and patient completed them.
Workup was incomplete for multiple miscarriages. Reviewed all tests and recommended those not performed.
Immune deficiency found and incompletely worked up.
Missed Diagnosis
Patient was having trouble weight bearing but was encouraged to work through the pain. On review of x-rays, foot fracture was missed. Patient clinically worse. Repeat x-rays showed no significant change. Treatment was changed.
Identified acute renal failure, identified cause as a medication side effect, removed medication and returned kidney function to normal. Prevented a potential permanent kidney injury.
Review of blood work taken revealed prostate cancer reoccurrence.
Patient had multiple infections seemingly unrelated. Found an immune deficiency.
Incorrect Diagnosis
A patient was incorrectly treated for depression and due to a persistent friend (who paid for our services) was directed to the correct medical care for her diagnosis of Lymphoma and is home doing well.
A patient with symptoms of Parkinson’s disease was seen by a local neurologist and two “Parkinson’s experts” who diagnosed Parkinsons. We identified an alternative diagnosis and referred the patient to diagnosis expert neurologist who provided the correct diagnosis.
Initially diagnosed with Chronic Lymphocytic Leukemia (blood cancer) requiring treatment. Our investigation identified the correct diagnosis, MLB Monoclonal B Cell Lymphocytosis (not cancer).
Routine chest x-ray revealed rib fractures. After identification these were old fractures dating back ten years. No treatment was necessary.
In Emergency Room, patient was diagnosed with a stroke and released to follow up with a Neurologist. We received and reviewed data. Revised diagnosis of TIA was given same day, treatment changed and referral to appropriate neurologist was made.
Diagnosis on a biopsy was incorrect and corrected. Result was a completely different treatment.
Vasculitis diagnosed by a specialist who recommended a biopsy. Diagnosis identified as incorrect.
Education
Navigating the Medical System
Safety during hospitalizations
Obtaining medical records
Doctors’ visits and how to record and track information
Diagnosis Specific Information
Explain the condition so that there is understanding and specific questions can be asked of the clinician.
Providing a patient history, key conditions, research on the issues and key questions that need to be answered.
Providing a list of key questions to use and ask when going to a clinician appointment.
Provide guidance on home care versus nursing facilities.
Treatment
Preventing Unnecessary Interventions
Patient was advised to have lung immediately removed due to cancer. We determined that cancer was very slow growing and does not spread. Referred to specialist who confirmed that operation would have a higher mortality rate than watching.
Incidental finding shows a nodule on larynx and biopsy was recommended under general anesthesia because it could be cancer. We researched issue and felt it was highly unlikely to be cancer and referred to a different ENT.
Patient had a longstanding sacral tumor. Neurosurgeon wanted to biopsy with high risk of complications given its location. Determined it was a slow growing tumor that if biopsied might spread the tumor.
Offered Different Treatment Options
Patient had intractable pain that could not be treated in usual way due to other diseases and ineffectiveness. Found alternative solutions.
Patient has osteoporosis. Treated with a drug that has side effects. Less harmful drug recommended and clinician agreed.
Treatment options identified for expedited wound healing.
Found clinical trial with a new medicine for a neurological disease which traditionally has no treatment.
Referrals
Finding Specialists
Breast Cancer – Memorial Sloan Kettering (New York), Dana Farber (Boston).
Neurology – University Pennsylvania (Philadelphia), Georgetown (Washington DC)
Lung Cancer – Yale (New Haven), Mayo Clinic (Rochester MN)
Primary Care Physician
Prostate Cancer – Mt. Sinai (New York)
Ear Nose Throat – Columbia (New York)
Ophthalmologist – Local clinician (Lawrence, NJ)
Orthopedics – Hospital for Special Surgery
Getting Faster Appointments
We are often able to reach world class physicians on weekends, after hours and while on vacations (Italy, Greece, Baltics)
Explain the situation and provide full record backup as well as key medical points that need to be discussed.
Many specialists are booked out for six months. Able to squeeze patients in.