Is the Customer Always Right?

(A disclaimer: this post is actually about my recent miscarriage, so read with caution. There are some specific details later in the post.)

How strictly do you adhere to your expectation of good service?

When you take a garment to the dry cleaners? When you order a meal at a restaurant? When you have your car serviced? When you order something from an online retailer?

Do you expect that you get what you requested, in the time frame promised by the provider? Do you expect quality work? Do you expect to be charged a fair price for services rendered?

And, here, dear reader, is the question I'm really getting at: what do you do if you don't get the service you expect?

If your garment comes back still soiled, I suppose you could have them clean it again. If your meal is delivered incorrectly, you send it back to the kitchen, or maybe suffer in silence, but request a complimentary dessert. If your car is not serviced to your satisfaction, you ask that they continue to work until the problem is resolved.

But what do you do if poor service received is unchangeable? Irrevocable? What if something that you expected to have done properly and in order wasn't, and yet, you are still expected to remit payment in full, whether or not you were satisfied with your service? Do you refuse to pay?

Here is our quandary...and I guess, let me preface by saying that, yes, we have sought legal advice, and yes, we are taking some actions to address this situation. I'm posing the question more out of my wrestling with this on a moral level....

So here goes.

When I was taken to the hospital in October during the miscarriage of our twins, I received beyond-inferior care. Negligent and almost life-threatening care. Care that made me wish that, as horrific as the experience would have been, I'd just as soon have gone through it at home.

When I was wheeled into the emergency room, I was asked to fill out standard paperwork and "just wait" until it was my turn to be seen, regardless of the fact that I was hemorrhaging so greatly. I was losing so much blood that other waiting patients, stunned to see my life's blood spilling over the wheelchair seat and down the halls, began to panic and insist the nurses take notice. Had it not been for the fury of my father, who merely ignored the nurses' scolding and wheeled me past triage, screaming for help, I'm not sure how severe the outcome would have been. (And for the record, once we found a competent orderly to assist us, he assured my dad that he had done the right thing.)

Once I was situated in a trauma room, my care was competent. I was changed, medicated, monitored, and assessed, as best as they could, until my ob/gyn could be reached. As contractions began to intensify, the ob/gyn on call delivered Baby A. From this, she informed me she thought the pregnancy was between 8 and 9 weeks. I watched her contain Baby A, and she informed me that all tissue would be sent to the pathology lab for testing. I was sad, but relieved for this news.

About an hour later, I was informed that I would need an ultrasound to determine if I had delivered all the fetal tissue, or if I would require surgery. As my orderly wheeled me up to radiology, he informed me that he would be waiting in the hallway with Jim, and that the procedure would be quick and that the technician had been "fully appraised" of the situation, so as to make it as easy on me as possible.

In a word, no. No, it wasn't, and she hadn't been, at all. Questions that at first I tolerated as routine (i.e. "what brought you to the ER tonight?" and even "are you experiencing any bleeding?") quickly turned to "are you experiencing any pain?" and "have you passed any tissue?" I sat up on the table as best as I could, and as calmly as I could muster, said to her, "Miss, I know you are just trying to do your job, and it's late, and from the look on your face, you obviously don't want to be here, but I just delivered a nine-week fetus, so in answer to your questions, yes, yes, and yes. Now, I was informed that you were aware of this situation, and that does not appear to be the case. Am I correct?" She just looked at me blankly and then down at the chart and said, "I was just ordered to to a TV [transvaginal] ultrasound. I don't know about anything else."

I insisted that she confirm those orders before she put that wand anywhere near me, and I laid back down on that table and sobbed.

Once she returned, she did, in fact, perform the ultrasound, at which point we found Baby B. Somewhat redeemed herself by honoring my request to look, just once more, to make sure that there was no heartbeat.

I was returned to the ER, only to find my very, very angry ob/gyn yelling at the ER nurses. He eventually told me that there had been a "mix up" with my labs, and that they were refusing him an operating room to do my D&C, because, according to the blood work, I wasn't pregnant. Never mind Baby A delivered and sent to testing. Never mind Baby B still in my womb. The blood test said "not pregnant," so.... The nurses were all just standing there with blank looks on their faces.

So, they redrew the blood, and two hours later, I was laying on a gurney outside the OR. But even up until the last minute, there seemed to be confusion and chaos. Both my ob/gyn and the anesthesiologist looked upset and pensive. Thankfully, the procedure itself was quick and easy and by the next morning, I was back in the antepartum ward with a fantastic nurse. Actually -- and here is the one bright spot in this story -- the nurse I had after surgery is the same nurse that discharged us after Seth was born. And she remembered me! What a blessing Kathleen was in such a dark hour.

My recovery was relatively easy; my greatest pain afterwards was more from the intubation than anything else. I expected that once I had my follow-up appointment with my ob/gyn later that week, that we would continue to heal and move forward from this.

I knew something was wrong as soon as my doctor walked into the room at my follow up appointment. I doubted that he had pathology reports back on the babies yet, as it had only been a week, but I thought maybe he'd found something wrong with me. I resolved right there, I would do whatever he was about to tell me.

Fortunately, the path lab had not found anything wrong with me. Unfortunately, the path lab hadn't found anything. That's because they didn't test anything. That's because they lost the fetal tissue. Not only that, my doctor told me, but after he did some further investigating as a result of the "not pregnant" lab results, he'd found that my blood work had been mixed up, and that had he had to do a transfusion (which, at one point, was very likely), the results may have been fatal. He informed me that my case had been sent before a sentinel board (I'm still not entirely sure what that means), and that even the president of the health care system was aware of the severity of the case and the what-might-have-beens.

So, there, in a nutshell, is the experience we had with our last loss. No babies, and no answers as to what may have caused my body to let go of them. As I now prepare to find a new ob/gyn in TN, I wonder how far-reaching the effects of the negligent care will reach.

And I also am looking at the bills. We have received the bills from the hospital for my 24 hours of "care." It's not too bad, as far as the dollar amount; under $500, from the $18,000+. But it is the principle of it. According to them, I was "never pregnant" and without the fetal tissue there is no proof that there was a baby, so how can I be expected to pay for a miscarriage?

Anyway, we are working to resolve the billing issue. Basically, we are requesting that they waive the balance in lieu of us pursuing legal action.

But what would you do? How far can one take an expectation of good service, and are we in the right to refuse to pay?

I'd be interested to hear your thoughts, dear reader. And if you've made it through this whole post, I applaud you. I know it was long. Thank you for listening, as always.