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Family, Internal Medicine, General Medical Questions/Pain in shoulder and arms, injury from surgery

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QUESTION: March of Last year I went 2 days after I had my son to have a tubal ligation. When I woke up from the procedure I was told that there had been an accident in the operating room and that once I was sedated the arm boards that I was strapped to fell off. I was actually told my arms "fell off" and being just out of anesthesia I immediately felt to make sure they were there. Not relevant, I just still find that funny. What wasn't funny was that I was in pain and it was more so my left arm than my right. They did an x-ray and didn't see anything broken so I was told to follow up with Ortho. I left with my left arm in a sling and was told no heavy lifting, nothing heavier than the newborn baby. Well being as though I had a rough recovery from the tubal, recently had given birth to my 5th child, and my husband had to quickly return to work...well as one can imagine I didn't have chance to do that follow up. Not to mention 6 months later my 10 yr old had a stroke and well obviously I was distracted and very busy. I continued with an overall achy feeling that didn't so much improve but I just sort of dealt with and got used to. Well recently I have tried to live a slightly more active lifestyle. Things are settling down and I have done very light exercises. And doing so has been very very painful. And now my left arm hurts even when I am not doing anything. Lifting my now 15 month old is painful and leaves me aching for days. My left shoulder grinds, makes a rubbing sound and pops at even the simple movements like getting something from the spice cabinet (its on the top) The pain is in my shoulder joint and also seems to affect the muscle from the left side of my neck across my shoulder and down to my elbow, occasionally the whole arm hurts. These days I am back in a sling by the end of the day because the weight of carrying my arm at my side is too painful. I'm quite certain the pain is from the injury when i had my surgery. Would it be best to get a report of the surgery or see if the hospital has an accident report of some sort to take to my doctor when I go get checked out? With my insurance I dont have to get a referral so should I just try to get in with the doctor they had visit me post-op after the surgery? I am so unsure how to go about this since its really a strange situation. But I am at the point that I need to see someone because it is interfering with me caring for my children so I just wonder where should I start.

ANSWER: first of all when you are under anesthesia, you are like a limp doll.... and if an arm flops, you don't protect that shoulder and could have injured the rotator cuff in the shoulder pretty easily.......     I would get a full evaluation by an ortho.... a plain xray isn't going to tell much.... you should have an evaluation including an MRI.  One would think that if they admitted the error and the injury is connected, they should cover that evaluation....... good luck with it.

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QUESTION: I ended up in the ER due to the pain being that severe. I am not sure why its gotten so bad lately but that's not exactly my question. I was told that of course I would have to see an Ortho and get an MRI but that the pain I was having (located anterior just above my underarm, also causes neck and back pain stiffness and sore biceps, not sure if that is related) sounded like a labral tear. Which in that case might need more treatment than I expected. Without getting too far ahead of myself I wonder how would I go about speaking to the hospital in terms of helping in the evaluation. I know they admitted the error not only to me but to my family that was waiting and worried that the quick procedure took much longer than they were told. But I still worry that they would deny it. I do have a statement from my insurance of the arm x-rays (when I went in for a tubal) on that day. But being as though I have never nor do I know anyone that has ever had anything like this happen I have no idea what to do. I am not going to let that slow down my seeking treatment. I waited this long because it was tolerable, a nuisance, but tolerable. At this point it makes caring for my family difficult so whether they help or not I will be getting treatment, I just wonder where to start.

ANSWER: First, talk to an administrator.... But I feel they might not talk due to risk of litigation.... But it is quicker to work something out if they do, otherwise, if they don't, you may need a lawyer........

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QUESTION: Thank you for your answers. They have been quite helpful. I have another question. What sort of administrator would I have to speak to? I am not familiar with the inter-workings of the hospital. Recently I had my medical records (surgical report, doctors & nurses notes, discharge information) and I assumed that being as though it occurred once I was already under anesthesia it should be detailed somewhere. Well the Orthopedic Surgeon's office got them and the only indication that I saw an ortho was that there was information saying I had to follow up.

I have an even more urgent desire to know what exactly happened to me that day. I feel very uneasy not knowing why I am in so much pain. I do recall as I was being put under, while I felt very relaxed due to the medication they had given me, that someone was strapping my arms down. I remember that quite clearly so I'm inclined to believe that the boards broke. In either case after having seen the Ortho and upon physical examination he feels I have bilateral SLAP tears. The pain and the sounds/catching it makes fits that perfectly.

I had an MRI w/out contrast recently. I only know the results of the left arm. From the report it says that they did not see a tear but they did see "Mild posterior superior humeral head subchondral cyst formation." I know that MRI w/out contrast is not as reliable in diagnosing labral tears but not sure if that would be the case here. It seems like they were more concerned after the MRI of my right shoulder than my left but that is the report I did not have. I am following up with my doctor next week to see what his plan of care is.

One question I do wonder is that I realized that my doctor has privileges at the hospital that the incident occurred at and he was definitely in line with the thinking that being as though it happened and they promptly took fault that they should probably help. However would it be considered a conflict of interest for him to treat me if in fact I have to seek a legal representative in order to get that done? I am assuming they would need him to testify or make a statement that the incident and injury are related. At what point should I seek a second opinion? I like my doctor very much but also do not want to put him in a rough situation.

Answer
I would attempt to talk to the head administrator.... the CEO of the hospital.  If he is willing to talk to you.

In the notes, it would be listed in the nursing notes, not the doctor notes, and there may be a separate incident report.   

If the doctor simply has privileges at the hospital, no big deal, but if employed by the hospital...... may be a little different.

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