Doctor's office issue, what can I do?

[Loowit]

To give some background, DS had a very bad reaction to the pertussis portion of the vaccine when he was a baby.  We were told that he should not have it again and instead should get the Td shot.  Last year when I took him for his check up the medical assistant told me that he needed a tetanus booster.  I let the medical assistant know before the doctor exam that he needs the Td, as he can't have pertussis vaccine.  After the exam the medical assistant came into the room with the vaccines drawn up.  She asked the standard questions about previous reactions and I again reminded her of his pertussis reaction and that he can't have that one.  She then gave him his shots and we left.

A couple hours later DS started to not feel well.  His whole body turned bright red like a lobster, his temperature shot up very high, he had a bad headache, and he was having trouble breathing.  I had a bad feeling that he was given the wrong shot, so after getting him treated and stable, I looked up his shots on the website for the doctor's office.  Sure enough the medical assistant had given him the Tdap, and even worse she lied to me that he needed the tetanus booster.  He had one the year before (Td).  I thought he had but with three kids it is hard to keep track and I didn't bring his immunization records with me, I (stupidly?) trusted the office to know and be honest with me.

The next day I had a long conversation with the doctor about it and she was very apologetic and said that the medial assistant would get retrained, and it was clearly marked in his chart that he is allergic to the pertussis vaccine.

A few months later DS went to the doctor for a medical issue and the same medical assistant was working.  She looked at his chart and said something about him having a reaction to his last vaccine like it was a complete surprise to her.  I was livid and do not want to deal with her ever again.

DS is due for another check up, he needs it for his medical form for summer camp.  He also may need a vaccine, but I do not want the same medical assistant again.  I do not trust her at all.  My question is, can I insist that if he needs a vaccine that someone else give it to him?  I could switch doctors but that would require me to go out of town, and I love his doctor, it is just the medical assistant that I don't like or trust.

[HomeAgain]

If you don't want to switch, I'd stand my ground and be loud.  Kick her out of the room when she comes in.  Tell her, loudly, exactly what is wrong: "You lied to me.  You threatened my child's life with your actions.  You are not to be anywhere near my child."  Be loud enough so that the office can hear you and know you are protecting your kid from them.  It shouldn't have to happen more than once, because they should be able to remember you.  But if it protects your kid, it's worth it.

[lynn]

You are your child's advocate.  Id speak up loud and clear that  so and so medical assistant IS NOT to be near my child.  if she came in the room is ask for someone else. She needed to be fired not retrained.  Can you go to another office?

[Carol in Cal.]

The doctor should have fired her.  This is ridiculous.

[J-rap]

I agree that the doctor should have fired her.  If it's that important to you to stay, I'd call the doctor herself and tell her you'd like to stay there because you really like her, but request that she put through an order for your family to never use that medical assistant.  Insist on it.  

[Liz CA]

Of course, you can request a different assistant. Make it clear right there at the receptionist's desk that you will not receive any treatment from her.

[SKL]

Yes, request a different assistant.

Also look into whether it would make more sense to just go to a Walgreens (they give vaxes) or a chiropractor for the well vislt. 

And whoever does it next time, I would ask to see the actual vial before the vax is given.  Tell them you had a life threatening incident with a vax in the past and you aren't taking any chances.

 

[SKL]

This reminds me of a time my friend ordered her celiac kids gluten-free noodles when we were at a restaurant together.  First she called ahead to make sure they had gluten free food and knew how to prepare it separately etc.  Satisfied with that, she came and placed her order.  She reminded them multiple times and they promised they understood and would be very careful.  The food comes, the kids start eating, and out runs the waiter saying he's so sorry but those actually aren't gluten free noodles.

I don't know how to make sure people hear what you say.  Make them repeat it back over and over? 

[Monica_in_Switzerland]

I would talk directly to the doctor, before the appointment, and I'd be mad.  I think everyone is correct- if she comes into the exam room, turn her right back around that minute, don't let her do any of the input, not height, not weight, nothing.  

To give you an idea of what *should* have happened... I had two kids due for vaccines.  I brought them in, as we can do pop-in appointments for vaccines.  I had their records with me, it was clear who needed what.  We took one kid into the exam room at a time, opened up the appropriate record, double-checked... and yes, the assistant STILL managed to screw up which kid got which vaccine.  Luckily, she caught it after the first kid got the shot, and it was a booster she had already had and didn't need.  BUT... it was a BIG DEAL in the office.  The doctor came out and talked to me seriously.  I have NEVER seen him upset like that.  He is very good-natured and calm.  But I could tell he was furious and the assistant was going to get chewed out very shortly.  And ever since then, she has bent over backward to apologize.  I think everyone realized just how serious it *could* have been - for example, your situation, a child with an allergy to a vaccine.  Frankly, I'm shocked your assistant wasn't fired.  She should have been, that was a life-endangering mistake.    

[ktgrok]

You know, I'm always in the "people make mistakes" camp, but this is beyond that. In 20 years in vet med I drew up one wrong vaccine, but I didn't give it, so the person giving it double checked (as is supposed to happen) and realized it. But, it wasn't a matter of an allergy in which case I'd have been way more cautious, it was a matter of the owner had multiple animals there for multiple things and I drew up one too many of one of the vaccines. But we did have a way to double check before they were given, and again, you stated it multiple times first which should have prompted her to triple check. i can't even imagine not only giving a vaccine that wasn't needed anyway, but the wrong one on top of that, and aFTER being reminded!

I'm as scatter brained as they come and cannot imagine that scenario. 

I would absolutely not allow that women around my kids. Period. And would be clear why. 

 

[Petrichor]

With the allergy I'd also want to see the vial so you can verify which vax it is yourself.

[prairiewindmomma]

I always check vials and syringes before my kids are vaccinated AND I have photographs on my phone and in the medical chart documenting the reaction. We talk about what I premedicated them with that day and I pull out the epipens to have at the ready to show the seriousness with which I take vaccinating my reactive children.

I have been surprised by the number of people who don’t seem to believe my words until I bring out the photos and ask them to re-reference the chart. Most doctors have hundreds if not thousands of patients on their case load. I do not assume that anyone will remember details about me and my family.

 

 

[Ellie]

Seems to me some legal action might be possible.

[vonfirmath]

1 hour ago, HomeAgain said:

If you don't want to switch, I'd stand my ground and be loud.  Kick her out of the room when she comes in.  Tell her, loudly, exactly what is wrong: "You lied to me.  You threatened my child's life with your actions.  You are not to be anywhere near my child."  Be loud enough so that the office can hear you and know you are protecting your kid from them.  It shouldn't have to happen more than once, because they should be able to remember you.  But if it protects your kid, it's worth it.

 

Be loud. Make her embarassed. This feels like she deliberately wanted to give you the Pertussis vaccine and was ignoring you. Especially since the kid did not need the tetanus

[AbcdeDooDah]

I always check the vial before vaccinations. Beyond that, you have the right to have your child treated by someone else. Make it clear.

 

 

[Jean in Newcastle]

https://wmc.wa.gov/public

[marbel]

Is there a head doctor/owner of the practice?  I would write a letter to that person, laying out all the facts of the situation. Copy your own doctor.  Ask them how they will ensure that  your child will not see that medical assistant.  Do this before you need your next appointment so they have time to respond. If they don't respond, call and leave messages. Hound them to give you a plan. Keep a paper trail.  

Of course it's also fine to say, in the moment, that you want another assistant, but if you like the practice in general and don't want to leave it, I would give them a heads-up so there is not confusion and chaos while you are there. In a busy practice, every person's time is limited and switching out medical assistants may cause delays for you and other patients. 

I'm not excusing the medical assistant. I would probably have left the practice if there were alternatives. Since there are not alternatives for you, I'd communicate clearly and firmly with the office ahead of time rather than waiting to react if that assistant is assigned to you. Of course be ready to react, but lay the groundwork so you don't have to. Actually, I'd say that if you have to despite your efforts to get it resolved ahead of time, that tells you something you should know about the practice. 

[Miss Tick]

I've taken my kids to a group practice and just patiently insisted that I was not interested in seeing the (jerky) senior doctor. They totally understood and just made sure it didn't happen. Similar situation with a nurse in nicu. 

When making the appointment I would clearly state that we can not be seen by the M.A. then repeat this on check-in. If, despite all tks, she enters the exam room, I would stand up and tell her that we need to speak directly to the doctor. I can't imagine anyone would question you, but you can just say that you have lost confidence in her care.

[Tap]

Since the doctor had the MA retrained, I would wonder if the MA was properly trained in the first place and that is why the doctor felt it was an appropriate first step. The doctor already helped to make sure the MA understands for the future what the mistake was and how to avoid it. 

Whatever the reason, just nicely ask the front desk for a different MA. There is no need to cause a scene, just be direct and confident about what you want, but also kind and nice to the staff. I work in healthcare, and I can tell you that the patients who bring concerns to us in a professional manner, get a ton more respect  than those who come in trying to cause drama. Inevitably, dealing with drama get the staff's attention, and not the patient. When there is drama, the staff are flustered, embarrassed and frustrated and are more likely to make more mistakes on other patients for the rest of the day.  It is counter productive.

From now on, double check the vials yourself and if you have any questions, have the doctor come in and verify with you that the correct vaccinations are being given. 

I have two daughters with significant health issues, including severe allergies. We have experienced mistakes in the past and I do understand the immense frustration you feel right now. Hopefully, this situation will only play out once every 7 to 10 years as the child gets revaccinated. 

Edited January 23, 2019 by Tap

[PeachyDoodle]

Definitely make it clear that you will not see the aforementioned MA. Say it when you call to make the appointment: "I would like an appointment with Dr. X. I WILL NOT see Medical Assistant Y for any reason. A different MA needs to be assigned for this visit." Say it again when you arrive and check in. Say it loudly if MA Y shows up at any point during the visit.

And don't feel shy about revisiting your reasons for refusing to see the Medical Assistant with the doctor when you see him/her.

There is a PA at my kids' pediatrician that I LOATHE. And not for any good reason like yours, lol! He always talks to me like I'm an absolute idiot who knows nothing about my children. I refuse to see him for any reason, and I make that clear when I call. (Interestingly, he's perfectly fine if dh is the one there...) It's never been a problem; they are very accommodating. I love our pediatrician and all his partners and office staff, except for this one dude.

[gardenmom5]

how many assistants does the dr have working for him?  if there are others, you can insist you only see another one.  if she's his only assistant, you are probably stuck finding a new dr.  It's serious enough, I would write a letter to the state medical board and inform them of what happened.  

[SKL]

Here's a dumb question - can't the doctor go get the vial himself if there isn't a trustworthy assistant available?

[gardenmom5]

3 hours ago, Tap said:

Since the doctor had the MA retrained, I would wonder if the MA was properly trained in the first place and that is why the doctor felt it was an appropriate first step. The doctor already helped to make sure the MA understands for the future what the mistake was and how to avoid it. 

Whatever the reason, just nicely ask the front desk for a different MA. There is no need to cause a scene, just be direct and confident about what you want, but also kind and nice to the staff. I work in healthcare, and I can tell you that the patients who bring concerns to us in a professional manner, get a ton more respect  than those who come in trying to cause drama. Inevitably, dealing with drama get the staff's attention, and not the patient. When there is drama, the staff are flustered, embarrassed and frustrated and are more likely to make more mistakes on other patients for the rest of the day.  It is counter productive.

From now on, double check the vials yourself and if you have any questions, have the doctor come in and verify with you that the correct vaccinations are being given. 

I have two daughters with significant health issues, including severe allergies. We have experienced mistakes in the past and I do understand the immense frustration you feel right now. Hopefully, this situation will only play out once every 7 to 10 years as the child gets revaccinated. 

tbh: I would wonder if the dr was merely placating my by saying " the MA will be retrained", and that that was as far as it went. I would want assurance the dr really took it seriously.  if the MA was surprised about the reaction, I would find out if the MA really did receive any retraining.  if she didn't - the means not only did the MA lie to do, so did the dr. about retraining the MA.

[Frances]

6 hours ago, Loowit said:

To give some background, DS had a very bad reaction to the pertussis portion of the vaccine when he was a baby.  We were told that he should not have it again and instead should get the Td shot.  Last year when I took him for his check up the medical assistant told me that he needed a tetanus booster.  I let the medical assistant know before the doctor exam that he needs the Td, as he can't have pertussis vaccine.  After the exam the medical assistant came into the room with the vaccines drawn up.  She asked the standard questions about previous reactions and I again reminded her of his pertussis reaction and that he can't have that one.  She then gave him his shots and we left.

A couple hours later DS started to not feel well.  His whole body turned bright red like a lobster, his temperature shot up very high, he had a bad headache, and he was having trouble breathing.  I had a bad feeling that he was given the wrong shot, so after getting him treated and stable, I looked up his shots on the website for the doctor's office.  Sure enough the medical assistant had given him the Tdap, and even worse she lied to me that he needed the tetanus booster.  He had one the year before (Td).  I thought he had but with three kids it is hard to keep track and I didn't bring his immunization records with me, I (stupidly?) trusted the office to know and be honest with me.

The next day I had a long conversation with the doctor about it and she was very apologetic and said that the medial assistant would get retrained, and it was clearly marked in his chart that he is allergic to the pertussis vaccine.

A few months later DS went to the doctor for a medical issue and the same medical assistant was working.  She looked at his chart and said something about him having a reaction to his last vaccine like it was a complete surprise to her.  I was livid and do not want to deal with her ever again.

DS is due for another check up, he needs it for his medical form for summer camp.  He also may need a vaccine, but I do not want the same medical assistant again.  I do not trust her at all.  My question is, can I insist that if he needs a vaccine that someone else give it to him?  I could switch doctors but that would require me to go out of town, and I love his doctor, it is just the medical assistant that I don't like or trust.

I don’t see any issue with it at all. At the dentist, I asked that my son specifically not see a certain hygienist after a bad experience. The dentist was very nice about it and told me who he thought would the very best one for my son to always see. And he was right. My son has enjoyed going to the dentist ever since.

[gardenmom5]

5 hours ago, prairiewindmomma said:

I always check vials and syringes before my kids are vaccinated AND I have photographs on my phone and in the medical chart documenting the reaction. We talk about what I premedicated them with that day and I pull out the epipens to have at the ready to show the seriousness with which I take vaccinating my reactive children.

I have been surprised by the number of people who don’t seem to believe my words until I bring out the photos and ask them to re-reference the chart. Most doctors have hundreds if not thousands of patients on their case load. I do not assume that anyone will remember details about me and my family.

 

 

Neither do I.  I do expect them to respect any warning that is written in the file.

[SKL]

4 minutes ago, gardenmom5 said:

tbh: I would wonder if the dr was merely placating my by saying " the MA will be retrained", and that that was as far as it went. I would want assurance the dr really took it seriously.  if the MA was surprised about the reaction, I would find out if the MA really did receive any retraining.  if she didn't - the means not only did the MA lie to do, so did the dr. about retraining the MA.

I agree - OP said the MA acted surprised about the reaction the next time she saw the file.  Why was she surprised?  Obviously she is not a good listener so who knows how many other things are being screwed up on her watch.

[Tap]

6 minutes ago, gardenmom5 said:

tbh: I would wonder if the dr was merely placating my by saying " the MA will be retrained", and that that was as far as it went. I would want assurance the dr really took it seriously.  if the MA was surprised about the reaction, I would find out if the MA really did receive any retraining.  if she didn't - the means not only did the MA lie to do, so did the dr. about retraining the MA.

If I felt the doctor was lying to me, I would change practices, not ask for a new MA.  The doctor would likely know the quality of training the MA was provided. Maybe the MA does a good job and just needed a refresher on vaccines. Maybe the MA asked someone which shot to give and they told the MA wrong. My guess is that the doctor knows more of the details, and if retraining was appropriate then I would hope that would solve the case.

I also know that they are some bosses that want zero conflict, so I can see the point that the doctor could be saying one thing, and doing another. OP will just have to judge that for themselves based on past history with the doctor.

[Jean in Newcastle]

It doesn't matter if the MA was trained a certain way or not.  The OP explained that there was a reaction.  There was already a note to that effect in the file.  I don't have special training on vaccines and even I know that I should listen and only give the Tdap.  Just how stupid is this MA?  No - I would never say it like this to the MA but really - even a modicum of common sense would mean that the MA should listen or if in doubt about policy should check with the doctor who should have talked to the parent if there was any doubt.

[Tap]

1 hour ago, Jean in Newcastle said:

It doesn't matter if the MA was trained a certain way or not.  The OP explained that there was a reaction.  There was already a note to that effect in the file.  I don't have special training on vaccines and even I know that I should listen and only give the Tdap.  Just how stupid is this MA?  No - I would never say it like this to the MA but really - even a modicum of common sense would mean that the MA should listen or if in doubt about policy should check with the doctor who should have talked to the parent if there was any doubt.

I agree. But I have trained a lot of pharmacy technicians who are right out of tech school. They know next to nothing about vaccines. As a parent, you have had years of experience with the different vaccines and the components. We have to train the new hires on vaccinations. There is no manual or procedures we follow to train them (our company doesn't provide training hours or staffing for that level of detail). Just a verbal "we offer these vaccines xyz, this is how you bill them, ask for help as you need it."  We give multiple vaccines every day (20-30 in the flu season) and I guess, I can see how a mistake can be made, and for the MA to not really understand the components of each vaccine. Simply, due to training. I 100% agree this is an obvious one, but it doesn't necessarily mean the MA is stupid.  We used to have an experienced tech who was very confident in her answers to trainees (or anyone), but would sometimes give wrong answers. She wasn't stupid either but had blood sugar issues and made lots of mistakes when her numbers were off. It took a while to figure out why she had good brain days and bad days.  The difference for us, is that the pharmacist was the one giving shots, so they all went through a second person first.  So, much of healthcare training is on the job. It is really hard to fathom how many mistakes are made, that are just never caught due to inexperience and  lack of attention to details.  

Edited January 24, 2019 by Tap

[SereneHome]

9 hours ago, Carol in Cal. said:

The doctor should have fired her.  This is ridiculous.

Yes!!!  And bc he didn't, I wouldn't trust the doctor either.  I am not the suing type, but I would ABSOLUTELY report the whole office to the medical board.  Without a doubt!!!!

Edited January 24, 2019 by SereneHome

[Loowit]

Thanks all.  After reading through the replies I am tempted to just switch doctors.  DS was talking about how he might be more comfortable with a male doctor due to the nature of parts of the exam, so maybe we should just look into changing.  But it would mean going out of town and that doesn't thrill me.  I think I will call tomorrow and find out what options I have.  All of you have given me a lot to think about.

[gardenmom5]

1 hour ago, Tap said:

I agree. But I have trained a lot of pharmacy technicians who are right out of tech school.  

this was a medical assistant, and she had the child's file in front of her.   this was not a pharm tech. 

[Bootsie]

When my kids were little, I was always shown the labelled vaccine, had to verify that it was being written on the chart, and sign, before the child was given a vaccine.  Maybe this isn't standard procedure (or has changed since everything is computerized today), but I would ask for that if I had a child with a reaction.  If I didn't trust the doctor to train and deal with an assistant appropriately, I would not be comfortable staying with that doctor.  

One thing I would wonder is if there is any chance that the assistant did get the Td rather than the Tdap, but when it was put into the computer the code got put in incorrectly, given that Tdap would be the norm?  I know there is the issue of the reaction, but I would have a thought in the back of my mind that there was a slight chance that it was a reaction to another component of the vaccine.  

[Loowit]

53 minutes ago, Bootsie said:

When my kids were little, I was always shown the labelled vaccine, had to verify that it was being written on the chart, and sign, before the child was given a vaccine.  Maybe this isn't standard procedure (or has changed since everything is computerized today), but I would ask for that if I had a child with a reaction.  If I didn't trust the doctor to train and deal with an assistant appropriately, I would not be comfortable staying with that doctor.  

One thing I would wonder is if there is any chance that the assistant did get the Td rather than the Tdap, but when it was put into the computer the code got put in incorrectly, given that Tdap would be the norm?  I know there is the issue of the reaction, but I would have a thought in the back of my mind that there was a slight chance that it was a reaction to another component of the vaccine.  

The way that the drugs/vaccines are handled in the office requires them to input the code into a computerized drawer system for the exact thing that they need.  Only that one drawer is opened and it records what was given, so I don't think it was a transcription error.  I was told that they did a full investigation into the matter and he was indeed given the wrong vaccine.

[Tap]

2 hours ago, gardenmom5 said:

this was a medical assistant, and she had the child's file in front of her.   this was not a pharm tech. 

Do you know how little training it takes to get a medical assistant license? The MA program here....just about the same as pharmacy tech. The training is very broad for breadth of the field.  I had an intern who was a licenced MA, who decided to switch to pharmacy and failed the pharmacy technician exam 3 times, so our company wouldn't hire her. She just wasn't good a medication names because English was her second language and wasn't great in math.  In our state you have to pass a nationally recognized pharmacy tech exam to get a license (didn't use to be the case but has been for many years now).

There really isn't any difference between an MA and pharmacy when it comes to shots. If the parent said 'tetanus and diphtheria only, no pertussis due to allergy'.It doesn't matter what was in the chart. Our computer screen in pharmacy, is the same as an electronic medical chart, but with a different focus.  We see allergies, medical conditions, medication history etc. 

Again, I would be upset this happened, but the only reason I continue to say there may be more to the story, is that the doctor who is accepting responsibility for her actions, it saying she felt retraining was appropriate in this case.

Edited January 24, 2019 by Tap

[Reefgazer]

I agree that the MA should have been fired; that could have ended in death.  That said, I would not go into the doctor's office making a scene and shouting for the MA not to come near your child.  What will that accomplish that couldn't be accomplished in a more dignified manner?  If your only issue is this dingbat medical assistant, then I would ask for an alternative person to do the injection.  But just so you know, you can ask to see the vial the vaccine is drawn from and verify yourself that it is the correct vaccine; it is clearly labelled on the vial.  I had an "incident" with an injection once, and I ask to verify the vial contents now, and I explain why I do so.

Edited January 24, 2019 by Reefgazer

[gardenmom5]

9 hours ago, Tap said:

Do you know how little training it takes to get a medical assistant license? The MA program here....just about the same as pharmacy tech. The training is very broad for breadth of the field.  I had an intern who was a licenced MA, who decided to switch to pharmacy and failed the pharmacy technician exam 3 times, so our company wouldn't hire her. She just wasn't good a medication names because English was her second language and wasn't great in math.  In our state you have to pass a nationally recognized pharmacy tech exam to get a license (didn't use to be the case but has been for many years now).

There really isn't any difference between an MA and pharmacy when it comes to shots. If the parent said 'tetanus and diphtheria only, no pertussis due to allergy'.It doesn't matter what was in the chart. Our computer screen in pharmacy, is the same as an electronic medical chart, but with a different focus.  We see allergies, medical conditions, medication history etc. 

Again, I would be upset this happened, but the only reason I continue to say there may be more to the story, is that the doctor who is accepting responsibility for her actions, it saying she felt retraining was appropriate in this case.

actually I do know how little training is required for both positions.  my dd is a PharmD who works in an inpatient hospital pharmacy.  as part of her duties - she trains nurses and doctors about drugs.   she also catches their errors.  

 

the fact that:

1. the MA had the child's file IN FRONT OF HER.  where it stated the child was to NOT have the Tdap.  and OP told her the child was to have the td. - but she gave her the "common' tdap anyway.  
2. later, the MA acted surprised about the whole seriousness of the reaction (which was caused by her error).  if she'd been informed when it happened while being retrained, - that kind of information tends to stick in a providers head.. 

Cynical me is led to question if she was actually retrained at all.  (which would imply the dr was just "humoring" OP.  Considering I've had drs LIE to my face,  I know for a fact it happens.) if it had been made clear this is serious business with potentially deadly reaction (which should have been part of the "retraining" to reinforce the seriousness of the subject) - that should have stuck in her head.   

 

eta: in our state - pharm tech's are not allowed to give vaccinations, or do anything involving a needle.  a pharmacist can only give an injection if they've had additional training and certification.

Edited January 24, 2019 by gardenmom5