Background. Alice had a $5,500 TPLO surgery at Horton on April 6th. I'd had a prior bad experience…read morebefore the surgery and written to Dr. Jacobek, the Chief of Staff. He responded professionally and promised any post-surgical complications, office visits, and x-rays would be covered. That promise was not honored.
The visit I'm describing was Alice's third post-op follow-up. She had been vomiting for two days and couldn't stand on her surgical leg. I called Horton. The front desk told me Alice already had an x-ray appointment scheduled for the next day. I told them she couldn't wait. She couldn't stand, she'd been vomiting for two days, and I was concerned. They put me on hold, went and spoke to the doctor, and came back with: the doctor said you can bring her in tonight if you're that concerned.
Then I raised the x-ray issue. I'd been told Horton's machine was broken, which is why the x-ray the next day was scheduled at a different facility in downtown Columbia. I asked the front desk directly: if I drive her in tonight, can you do the x-ray here? She said yes. I asked again to be sure. She said yes, she was sure.
I live two hours away. I drove the two hours. Sat in the exam room another two hours.
Dr. Amanda Hanzel walked in. First thing she said: the x-ray machine was, in fact, down. Her explanation: "We posted it on Facebook." I don't use Facebook. She blamed a miscommunication with the front desk. After I had asked twice on the phone.
She moved on to the exam. Her tone was positive. She said Alice's leg looked good, she was happy with the progress. She said the belly was soft and palpable, no pain. She said the vomiting was just GI issues, unrelated to the surgery. She said she'd send someone in to discuss options for treating the vomiting and left.
A few minutes later, the tech walked in with a bill for $900.
I pushed back with the tech. I told her this was related to the surgery and should be covered per Dr. Jacobek's promise. I told her I knew she was caught in the middle and I wasn't trying to make her uncomfortable, but I needed to speak to Dr. Jacobek.
Dr. Hanzel came back in. Her whole disposition had changed. Condescending. Short. Visibly aggravated. She informed me she was also a Chief of Staff and could make decisions. I told her I'd had a bad experience the first time and I just wanted to speak to Jacobek. Her response: "Yeah, I heard all about your first event." Condescending. Accusatory. She reiterated she was a Chief of Staff and the call was hers.
We argued back and forth. I raised the possibility of a surgical site infection. She dismissed it. She said she was not going to split hairs with me anymore. The only thing she could do was remove the $165 office visit fee. The rest was out of pocket.
I asked again for Dr. Jacobek. Unavailable. Classic gatekeeping.
I said fine, give me my dog, we're leaving. She then said Alice had vomited twice in the back and offered a $200 anti-nausea injection or a $50 alternative. I paid the $200 expecting medication I could take home. It turned out to be an injection given in a back room I never saw.
The next day, Dr. Hanzel emailed me. She wrote that she had spoken with Dr. Jacobek, that they were "aligned," and that "the complications Alice was evaluated for last night were unrelated to her recent surgical procedure."
Alice died Saturday afternoon, May 16th, at the emergency vet in Springfield, Missouri. Cause of death: septicemia from a bone infection at the surgical site. The exact concern I raised at Horton and Dr. Hanzel dismissed. The exact concern Dr. Hanzel put in writing was unrelated to the surgery.
Acknowledging it was surgery-related would have meant redoing the surgery at their cost. So they didn't acknowledge it. They sent her home. She died forty days after surgery.
If you're considering this hospital for a major procedure: get every promise in writing. Don't trust what the front desk tells you. The Chief of Staff's word does not bind the rest of the practice.
Dr. Jacobek is a professional. The system around him is not.
Brandon Sterne, RN BSN
LCDR, USN (Ret.)