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Serious injury! Surgery needed. Concerned that "red tape" is outweighing medical need

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Old 12-22-2011, 03:15 AM   #1
Join Date: Dec 2011
Location: Knoxville
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rita8480 HB User
Exclamation Serious injury! Surgery needed. Concerned that "red tape" is outweighing medical need

On Monday of this week, my boyfriend who lives in the state of Georgia suffered an injury which shattered his tibia and fibula below his knee cap and broke the bone in some areas as well. I am living in the state of Tennessee and due to circumstances (ie - a new job which I am in a 90-day period of NO excused absences for any reason) I have not yet been able to make it down there for him. Fortunately, a very good friend of his is staying with him to help in the meantime.

On Monday night he was "treated" at a hospital in Monroe, GA (Barrow County Medical) which really provided poor emergency care. He was essentially xrayed and then sent home in a cheap leg brace with no pain medication or anti-inflammatory medication. From what I hear, his leg is horribly swollen and there are many bone fragments that need to be removed.

He was referred to a specialist who could not see him until Wednesday morning. The specialist seemed very concerned with scheduling surgery as quickly as possible, so my boyfriend was told he would recieve a call sometime later in the day with the details on surgery to be done Thursday (which is now today). The surgery requires removing the shattered bone fragments and then installing (I am giving this information as accurately as I can based on what my boyfriend told me) a hinged metal plate in his knee cap, because essentially the bone is no longer connected.

Within a few hours of the appointment, he recieved very upsetting news: they were unable to provide him with the surgery unless he paid $12,000 up front. He does have insurance, but obviously it doesn't cover anything close to what he needs right now. They worked with him to reduce this to $6,000, but between both he and I we do not have even CLOSE to this amount of money.

At this point, he is in a great deal of pain and under a lot of stress, and on top of that was very frustrated with the level of apathy that this hospital was treating such a serious injury. He had his friend drive him to another hospital ER in the Atlanta area (not sure what the name of the second hospital). He was treated with much more care at this hospital, given prescriptions for his pain and also anti inflammatory. He said they also wrapped up the leg tightly in an something like an ACE bandage, which he said made the leg - albeit extremely painful - much more comfortable. I am beside myself that the hospital he was treated at initially did not do anything close to this on the NIGHT OF his injury!

Another VERY helpful thing was that they sent someone in to talk to him about getting assistance from Medicaid.

He was referred to another specialist so that he can schedule surgery... yet again. We are now moving into nearly 48 hours past the injury and I am very anxious to see this treated properly. He will be contacting the specialist at 8am, as soon as the office opens. If things do not start moving smoothly, I am going to have to risk my job security to go down there and see that things start happening to get this surgery underway.

I am extremely concerned that if this is not treated VERY SOON he is going to run into even more serious complications.

I have several questions and I am open to any and all advice and suggestions:

1) How long can such a serious injury be left basically untreated? He has shattered his tibia and fibula below the kneecap and all he has gotten so far are crutches, an ACE bandage and some anti inflammatory meds. Also, there are bone fragments loose in his leg.

2) If he is unable to qualify for Medicare or there is a holdup in the process, then what? How long can a hospital REFUSE a treatment for something like this due to insurance and red-tape??

3) After the surgery is done, he is going to move in with me permanently. I will be taking care of him while he recovers. We were planning on moving together by the end of January anyway. HOWEVER, what is going on with him presently is happening in GA and I live in TN. Obviously there is going to be need for follow up care, but obviously he is going to need a lot of help getting around and that is not available to him where he is at now.

Also, this is provided that he qualifies at all. I spoke to him when he got home from the ER tonight, but he was so exhausted and in so much pain that I barely got any information from him before he had to go to sleep.

This is very stressful and frustrating for us both. ANY ADVICE would be much appreciated!!
Thank you!

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Old 12-22-2011, 09:43 AM   #2
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Re: Serious injury! Surgery needed. Concerned that "red tape" is outweighing medical

I answered you on the other thread you posted...just wanted you to know.

Good luck..............Jen

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bone surgery, emergency room, insurance, medicare

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