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Pheochromocytoma

My Memorial Regional Hospital Surgery Disaster

September 16, 2019

 Memorial Regional Hospital Hollywood Retroperitoneal Adrenalectomy Incident

Adrenalectomy to remove Pheochromocytoma Monday September 16, 2019

Dr. Courtney Edwards served as a lead surgeon, with Dr. David Bimston assisting in a Retroperitoneal Adrenalectomy. The surgeons, in error, severed the renal artery and the ureter due to lack of visibility. When asked what happened, they stated they had limited visibility but continued with the procedure anyway. This resulted in the severing of the vital organ instead of the planned adrenal. They had no answer when asked why they kept on knowing they could not see what they were doing. When asked why they didn't utilize the imagery sources available at Memorial Regional, such as ultrasound, MRI, and others, to confirm they were in the "right place" they had no answer.

The accidental nephrectomy, in my opinion, and that of several other specialists and attorneys whom I consulted, was due to their negligence and considered malpractice. The procedure should have been converted to a transabdominal procedure (opening you up like a frog in biology class), which I had authorized prior to the procedure see page 877 of the medical record. It was their decision to continue blind that caused this. This resulted in major blood loss requiring 3 units of blood and increased potassium to toxic levels (known as hyperkalemia), which typically results in death or irreparable damage to the patient's vital organs.

I have called the doctors out for proceeding blind which was an unnecessary risk.and give Kudos to those who stepped in, including Dr Dario Arenas, Dr. Kathryn Shaw, Dr. Fernando Pedraza, and Dr.  Tjasa Hranjec.  I was in such bad shape that they took the kidney out and put it in the cooler. I was in SICU for 8 hours before I was stable enough for them to put my kidney back as an auto transplant. I had died and come back to life thanks to the Memorial Transplant Team and the nurses who took care of me. I want you all to know we are thankful for everything you did to bring me back. I think of you every single day I wake up.

The images below are graphic so please stop here if you wish not to see them.

The Damage

The aftermath

After all the drama, I was left with reduced kidney function, which has now culminated in end-stage renal disease. I am currently getting on the transplant list at the Miami Transplant Institute and am now waiting for a donor. Memorials, like other public hospitals, are protected by sovereign immunity, which essentially prevents you from recovering for damages suffered given the low recovery limits set by the legislature years ago which have remained unchanged, .Attorneys refuse to take these cases for malpractice against these entities because of these low limits. This is because the cost of pursuing these cases gets high given these case last for a while and have a high costs due to the expert witnesses required, and they know it and take advantage. The common theme is attorneys cannot in good faith take on the case as even if they win, the client will not receive a dime as the recovery is only enough to cover the costs of pursuing the case and the limited recovery amount.

 

We contacted Memorial Hospital Risk Management for relief. They refused to provide reasonable relief. They billed me for deductibles and follow-up care which are still owed. 

As a privileged special district serving the people of our community here in South Broward they had an opportunity to do the right thing. 

In my opinion they should have taken responsibility and offered me after care for life for anything relating to this incident. We also should have been compensated for pain and suffering given the hardship my family continue to face because of this. 

Tjasa Hranjec, MD on 9/16/2019 5:01 PM page 14 of surgical file wrote

"I spent 72 minutes examining the patient, evaluating laboratory studies and imaging as well as making an
assessment and plan for Pablo Andres Soto. The patient is critically ill due to severe hyperkalemia and need
for extensive resuscitation in a setting of an auto-transplant. Without our intervention patient would not survive."

Final thoughts

While mistakes happen, there are consequences for those mistakes for most. Not here. Every citizen should be able to recover damages incurred due to the fault of others. Memorial Regional Hospital, you can not start a fire and then pat yourself on the back for putting it out. They said they did enough to save me. Now that each day goes by, I am closer to dying prematurely because of their actions. The South Broward Hospital District abuses of this protection and takes risks that other health care professionals would not dream of doing do to liability concerns but most of all because it would have been the right thing to stop. They simply don't care. I contacted every single officer named below and South Broward's Hospital District legal counsel. No one cares of the lives they destroy. The letter sent in desperation is also provided below at the bottom of the page.

Aurelio M. Fernandez, III, FACHE
President and Chief Executive Office
r
Memorial Healthcare System
Nina Beauchesne, FACHE
East Operations
Executive Vice President

Memorial Healthcare System
Stanley W. Marks, MD, FACS
Senior Vice President and Chief Medical Office
r
Memorial Healthcare System
Frank Rainer
Senior Vice President and General Counsel

Memorial Healthcare System
David Smith
Senior Vice President and Chief Financial Officer

Memorial Healthcare System
Maggie Hansen
Senior Vice President and Chief Nurse Executive

Memorial Healthcare System
Matthew Muhart
Executive Vice President and Chief Administrative Officer

Memorial Healthcare System
Zeff Ross, FACHE
Executive Vice President MHS and Chief Executive Officer

Memorial Regional Hospital

I know many will wonder  how this happened. I am opening this chapter of my life up to the world in the hopes that it will be shared, and change comes from it. I ask the Florida Residents to sign a petition to change this law. These are public hospital that enjoy several additional benefits in addition to sovereign immunity and free kill law which many don't know about. This law states that : If you are 25 or older, unmarried or widowed, and have no children under the age of 25, your what critics of Florida's law call a “free kill.” If that's you, subsection 8 of Florida's Wrongful Death Act says your loved ones can't sue the doctor or healthcare facility for mental pain and suffering damages.

Change.org Link

https://chng.it/cyyXZ5b6HM

I have also opened up my surgical file for everyone to view and judge for yourself.

Memorial Hospital and the South Broward Hospital District responded by stating:

Mr. Pablo Andres Soto 
Pembroke Pines, FL 33028-2025 
Dear Mr. Soto: 

 

"We are in receipt of your correspondence dated January 13, 2020 and have 
completed our review of the care and treatment provided to you by employees of the South Broward Hospital District d/bla Memorial Regional Hospital, including but not limited to Courtney Edwards, M.D. and David Bimston, M.D. 
Although we sympathize with your situation, it is our position that your surgery was  performed within the standard of care and when a recognized complication occurred, the plan of care was managed in an extraordinary fashion by our staff. The removal of the pheochromocytoma as well as the required autotransplantation of your kidney was successful and your subsequent course of treatment has been managed appropriately."

 

Patricia. Marks 
Corporate Director of Risk Management

Second letter received after a follow up letter was sent

 

Mr. Pablo Andres Soto 
Pembroke Pines, FL 33026-2025
Dear Mr. Soto:
We are in receipt of your correspondence dated June 22, 2020. I would like to
clarify some points you made in your recent letter, relating to your concerns of future complications. The complications you cite about lifelong care, and reduced life expectancy of the organ and the individual are potential complications when a patient receives an organ transplanted from another individual. Your procedure was an auto­ transplant of your own 
kidney, which is not at all the same thing. An auto-transplanted kidney does not carry that risk of rejection that a donor kidney has. It is our impression that you should have a normal lifespan of  your kidney. You do not require the lifetime follow-up and medications regimen that a donor kidney 
recipient would have.
Your urinary-related concerns are not uncommon in patients with an underlying history of diabetes and are not felt related to this surgery. The leg swelling is also not felt related to this surgery.

 

As cited in my previous letter, your surgery was performed within the standard of care and, when complications were encountered, it was managed in an extraordinary fashion. Your subsequent course of treatment was managed appropriately.

Patricia J. Marks, RN CPHRM, CPPS
Corporate Director of Risk Management


I guess for them this is just the normal course of business. By the way swollen legs is one of the first signs kidneys are not working correctly. My kidney function went from a GFR of over 50 to 14 in less than three years and a direct result of their actions. The incident was so incredible it got around the whole hospital. When i meet people that work there and I tell them what happened I typically hear "So you're the one." This is not a reflection on all who work there as previously mentioned as they did take care of me well and brought me back. The issue is with administration and how they handle mishaps that occur. We must all be held accountable for damages caused. Like I told them You cant start a fire and then pat yourself on the back for putting it out.

What now?

GFR keeps dropping and I will be on dialysis soon if a donor is not found. If I still can't find a donor, dialysis will beat me to death. Meanwhile, both surgeons that screwed up remain at Memorial Regional, with Dr Edwards posted on the hospital lobby wall as a proud member of the surgical team. No relief was ever provided, and ironically, all the doctors who saved my life are now gone from this institution. To my knowledge there was no disciplinary action taken against these surgeons. This does not surprise me given they think they did nothing wrong.

Dr. Edwards

Dr. Courtney Edwards

Final thoughts

While mistakes happen, there are consequences for those mistakes for most. Not here. Every citizen should be able to recover damages incurred due to the fault of others. Memorial Regional Hospital, you can not start a fire and then pat yourself on the back for putting it out. They said they did enough to save me. Now that each day goes by, I am closer to dying prematurely because of their actions. The South Broward Hospital District abuses of this protection and takes risks that other health care professionals would not dream of doing do to liability concerns but most of all because it would have been the right thing to stop. They simply don't care. I contacted every single officer named below and South Broward's Hospital District legal counsel. No one cares of the lives they destroy. The letter sent in desperation is also provided below at the bottom of the page.

Aurelio M. Fernandez, III, FACHE
President and Chief Executive Office
r
Memorial Healthcare System
Nina Beauchesne, FACHE
East Operations
Executive Vice President

Memorial Healthcare System
Stanley W. Marks, MD, FACS
Senior Vice President and Chief Medical Office
r
Memorial Healthcare System
Frank Rainer
Senior Vice President and General Counsel

Memorial Healthcare System
David Smith
Senior Vice President and Chief Financial Officer

Memorial Healthcare System
Maggie Hansen
Senior Vice President and Chief Nurse Executive

Memorial Healthcare System
Matthew Muhart
Executive Vice President and Chief Administrative Officer

Memorial Healthcare System
Zeff Ross, FACHE
Executive Vice President MHS and Chief Executive Officer

Memorial Regional Hospital

I know many will wonder  how this happened. I am opening this chapter of my life up to the world in the hopes that it will be shared, and change comes from it. I ask the Florida Residents to sign a petition to change this law. These are public hospital that enjoy several additional benefits in addition to sovereign immunity and free kill law which many don't know about. This law states that : If you are 25 or older, unmarried or widowed, and have no children under the age of 25, your what critics of Florida's law call a “free kill.” If that's you, subsection 8 of Florida's Wrongful Death Act says your loved ones can't sue the doctor or healthcare facility for mental pain and suffering damages.

Change.org Link

https://chng.it/cyyXZ5b6HM

I have also opened up my surgical file for everyone to view and judge for yourself.

Memorial Hospital and the South Broward Hospital District responded by stating:

Mr. Pablo Andres Soto 
Pembroke Pines, FL 33028-2025 
Dear Mr. Soto: 

 

"We are in receipt of your correspondence dated January 13, 2020 and have 
completed our review of the care and treatment provided to you by employees of the South Broward Hospital District d/bla Memorial Regional Hospital, including but not limited to Courtney Edwards, M.D. and David Bimston, M.D. 
Although we sympathize with your situation, it is our position that your surgery was  performed within the standard of care and when a recognized complication occurred, the plan of care was managed in an extraordinary fashion by our staff. The removal of the pheochromocytoma as well as the required autotransplantation of your kidney was successful and your subsequent course of treatment has been managed appropriately."

 

Patricia. Marks 
Corporate Director of Risk Management

Second letter received after a follow up letter was sent

 

Mr. Pablo Andres Soto 
Pembroke Pines, FL 33026-2025
Dear Mr. Soto:
We are in receipt of your correspondence dated June 22, 2020. I would like to
clarify some points you made in your recent letter, relating to your concerns of future complications. The complications you cite about lifelong care, and reduced life expectancy of the organ and the individual are potential complications when a patient receives an organ transplanted from another individual. Your procedure was an auto­ transplant of your own 
kidney, which is not at all the same thing. An auto-transplanted kidney does not carry that risk of rejection that a donor kidney has. It is our impression that you should have a normal lifespan of  your kidney. You do not require the lifetime follow-up and medications regimen that a donor kidney 
recipient would have.
Your urinary-related concerns are not uncommon in patients with an underlying history of diabetes and are not felt related to this surgery. The leg swelling is also not felt related to this surgery.

 

As cited in my previous letter, your surgery was performed within the standard of care and, when complications were encountered, it was managed in an extraordinary fashion. Your subsequent course of treatment was managed appropriately.

Patricia J. Marks, RN CPHRM, CPPS
Corporate Director of Risk Management


I guess for them this is just the normal course of business. By the way swollen legs is one of the first signs kidneys are not working correctly. My kidney function went from a GFR of over 50 to 14 in less than three years and a direct result of their actions. The incident was so incredible it got around the whole hospital. When i meet people that work there and I tell them what happened I typically hear "So you're the one." This is not a reflection on all who work there as previously mentioned as they did take care of me well and brought me back. The issue is with administration and how they handle mishaps that occur. We must all be held accountable for damages caused. Like I told them You cant start a fire and then pat yourself on the back for putting it out.

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