Does anyone think this would be out of line?

Saturday morning I had to go to the ER due to a viral/bacterial infection ( likely food poisoning) making me very sick. I dehydrate easy as it is so I knew I needed fluids. Due to fever and being unable to keep my medicine down that helps control my tachycardia my heart rate wouldn't go under 110bmp resting.

The problem is that I'm on an odd medication, one most people aren't familiar with - Midodrine. It's used to treat low blood pressure, orthostatic hypotension, and tachycardia. The attending doctor tried to tell me that I shouldn't be taking this medication, that is causes tachycardia. I believe he looked up Midrine - a migraine and tension headache medicine.
Midodrine is the only thing that allows me to stand and function like a normal person on most days, so obviously I must take it.

Would it be out of line to try to pursue getting this doctor reprimanded? It was not busy in the ER that morning, so it was not that he was in any sort of hurry, I even spelled the name of the medication out for him - twice. His bad advice, if I didn't know better, could hurt me - imagine if he made a similar mistake on a medication that was vital to someone's life? On top of this he was also rather rude.

Which would be more likely to have an effect - call the hospital myself, or have my cardiologist call?

As you say, he could have made a crucial diagnosis/decision that could have been critical to someone's life. I think I would report him to the AMA.

It's possible he could have made a mistake; people do. But he should not be in the position he's in if he doesn't know what he's doing, IMO.

I'm not sure I see why you are upset? There are a gazillion medications out there and many are a single letter difference from one medication to another. He looked up the wrong medication, but it's not like he gave you a medication that made you ill or worse.

I see nothing to report.

Reporting him to the AMA is a waste of time.
Each state licenses their doctors, so you could go to the state board and lodge a complaint.

I would suggest a faster and more efficient step would be to write the hospital administrator. They know the staus of their doc's licenses, if there is a history of problems and can correct behavior quicker than the state board (which takes forever).
People are human and mistakes are made. The best ones learn from their mistakes.

Originally Posted by Natalie_ca

I'm not sure I see why you are upset?

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Would you like to walk around with your heart rate in the 150s or higher? It's not pleasant and I'm not entirely sure if it's all sinus tach as my holter monitor results were never included in my medical file for some reason.
Also, if he looked up the wrong medication how could he know if there was a possible drug interaction with the one I am on? I already know the pharmacy won't catch it...
There is a listed interaction for Phenergan and Midodrine - luckily I don't need the Phenergan as the worst of the nausea is gone now.


I'm going to call my cardiologist tomorrow and see what they suggest. I also found out from my MIL that this particular doctor has a habit of running up elderly persons Medicaid and Medicare (she works at a residential home and takes many of the residents to doctors appointments, and that doctor always causes them some problems).

Originally Posted by strange_wings

Would you like to walk around with your heart rate in the 150s or higher? It's not pleasant

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I'm sure it isn't very pleasant.

However, that isn't the issue behind why you appear to be upset with the doctor. You appear to be upset because he made a human error and looked up the wrong medication name. I don't really see a big deal in that. You seem aware enough of your medications and knew enough to not stop taking it, and it's my experience as a nurse that most people are of like mind as you and follow their regular doctor's instructions with their medications.

We're all human and subject to mistakes. Nothing bad happened to you as a result of his. So I really don't see an issue.

And to go and complain about him based on hearsay about his purported actions elsewhere is inappropriate at best.

I work in the health care field, and I know when there is something worthy to complain about. I really don't see this situation being such an episode.

I have had a 150 heartbeat and had meds for it. Talk to your Dr then decide what to do. I did report a dr a few years ago. I had pain in my chest,neck and shouldars which I get all the time and I also was very pale and tired. I was getting the 150 heartbeat just sitting down and I could not even walk. I go to the Dr and get a Ekg and he says its just Arthritis and gives meds for that. I kept getting worse and i go back and get the same Dr because mine isnt there and he comes in and slams the door and gives me a dirty look and dosent help me at all. Then I go to my Dr and get Blood Tests and its Severe Anemia. All he had to do was take a blood test and he would have known. Now I am on high dose Iron Pills. I told my dr and that idiot dr is teh head of the department. I hope it works out well for you.

The issue is, if he's thinking she's on one medication when she's on a completly different one. This can cause very serious effects, from him perscribing her another medication that is perfectly fine with the one he thinks she's on but lethal with the one that she's actually on. This is the reason they ask what medication you're taking. If he can't listen correctly to this crutial bit of information then he is jepordizing lives. The hospital needs to be informed. However I wouldn't say it was very serious, just something the hospital should be made aware of. I would get your doctor who perscribed it to contact them as he knows medicine and can explain that he got it wrong with credibility. You are, and no disrespect, just a no one. You don't hold much weight with them.

Assuming you're correct -- and it sounds like you are -- the most critical issue is making sure that the doctor is aware of his error. I think a letter directly to the doctor would be most effective in preventing future mistakes.

It needs to be brought to the attention of the hospital administration so they know an error COULD have been made that would have been harmful.

Some years ago my friend had a sick baby. The nurse came to administer a needle but before she could do it my friend asked the nurse what it was and how many cc's. When the nurse told her, she told the nurse there was no way she was going to administer that shot to her child, that the dosage would kill the baby. The nurse argued but my friend made her go call the doctor and verify that he ordered it. The nurse had made the mistake. Turned out my friend (who fortunately is a nurse) saved her baby's life by knowing about medications.

It makes me wonder how many deaths are due to mistakes made by doctors and nurses.

I think it would be out of line, though I do understand your frustration. Here are my thoughts. First, congratulations for taking responsibility for your own health. it drives me batty how many people blindly listen to doctors and do not question anything for themselves. No one should take an ER doctors advice about a long-term medication they are supervised on. They dont know your personal and total history, they dont know *why* your primary may have prescribed you a certain medication, and they dont know how honest you are being with them. Given that your heart rate was high, and you told him you were taking a sympathomimetic drug (mimics effects of epinephrine, which #1 effect is to increase heart rate) I dont think he made a mistake at all, except the mistake of not intimately knowing your specific mimetic - hardly what an ER doctor should concern themselves with. In any case, it is not a physicians job to know all medications, their indications, and their contraindications. That is what we (and they!) have pharmacists for.

Originally Posted by Natalie_ca

I'm not sure I see why you are upset? There are a gazillion medications out there and many are a single letter difference from one medication to another. He looked up the wrong medication, but it's not like he gave you a medication that made you ill or worse.

I see nothing to report.

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I would agree with this, except for the fact that she spelled out the medication she is on...twice...and he still got it wrong.

Basically, I don't think it's the ER doctor's job to tell you any medication you are on is wrong because, as some one else pointed out, they don't know your personal history. And since you didn't follow his advice no harm was done.

But, I DO think someone needs to know the fact that he wasn't listening to what you were telling him (ie...spelling out the medication). I agree there are a ton of medications out there, and no doctor is going to be familiar with all of them. BUT, if you spelled it out for him, he should have looked up that medication. The fact that he didn't, and basically disregarded what you told him and simply found the medication he was familiar with, has to be brought to someone's attention.

I think the best person to do that would be your own primary care physician or whoever prescribed the medicine to begin with. Probably doctor to doctor will have a bigger impact rather than going through the hospital board where they probably have a load of complaints and by the time they actually come to this one he probably will have forgotten all about it (if he hasn't already).

I don't think this is an uncommon situation at all, and they cover themselves by saying that you need to follow up with your primary physician ASAP.

I just spent a few hours in the ER this weekend myself, and listed off (spelling and dosages) all the meds I'm on currently or recently for MS. After all that, they said the problem for severely low blood pressure (and more) is the "diuretics" that I'm not taking. They didn't listen to one darn thing we said, didn't look up possible drug interactions, didn't do anything but push an IV, make sure I wasn't going to die and send me on my way. That's what they do in the ER - make sure you don't die. And regardless of how much state of the art technology they have to look up medications it doesn't much matter if they don't do it.

I'm sure there are some really great ER doctors and nurses out there. And I know they do save a lot of lives. But I wouldn't trust them about drugs as far as I can throw them.

I understand your anger. Nothing more frustrating than having people not listen to you. Here's my take on what will happen if you pursue different avenues.

Reporting to the AMA: sorry but I'm not sure they will care. You might get a little sympathy, maybe a nice letter. They don't license MD's, mostly they do political things and policy statements.

Reporting to the state board: Since no harm was done (because you wisely didn't follow his advice) not much will likley happen, you will likely get little more than some sympathy. They might go so far as to pass on to the MD this complaint.

Filing a lawsuit: Ok, I know you never even suggested this, but just for arguments sake. There would be no basis for a lawsuit. As bad as the consequences might be if you had followed his advice; there was no harm done because you had better sense. No harm done = no damages = no settlement.

Getting your cardiologist to call ER MD: Unless you have a very close relationship with you cardiologist, I doubt he will call to verbally chastise another MD. They tend to stick together. Mention it when you see him next and gauge his reaction.

Calling the hospital's administration: You can try this, the success of this action will be highly dependent on the MD's relationship with the hospital. If he is an actual employee of the hospital, he may actually be counseled about it. If he is like the vast majority of MD's he is on contract with the hospital. If this is the case, he will at most get a brief phone call or letter letting him know of your complaint. The hospital will likely be sympathetic and apologize (maybe).

Now if it was any other lower level employee you had an issue with. . . They would likely get called in, fussed at, possibly had a punishment meeted out. But probably not anything severe as once more I must point out, there was no harm done (even if the reason no harm was done was because you had better sense than to follow that bad advice).

^ You'er right about my cardiologist, it's hard getting messages to him even. Though I wouldn't expect him to say anything to the other doctor, maybe he could mention it to the hospital administration and have something added to my medical files, such as "patient has rare medical condition, is on these medications for a reason".

...I just remembered something. Both my FIL and MIL are good friends with the hospital administrator. Why do I keep forgetting this?

All the nurses there are great, just to be clear on that. I have never had a problem with them any of the times I've been in there for any reason. Though they seem to have issues with my veins - they complain that they're too small/hard to find. The main RN attending me even did a "poor man's tilt test ", as it's referred to by some, to check my response to changing positions. Surprisingly no doctors have tried this in their offices.


Luckily what I needed the most was IV fluids, 2 and 1/2 (or maybe it was 3) bags later I did feel a lot better. I hope it doesn't happen again in the future, but those with forms of dysautonomia tend dehydrate too easily so it may.


I did go ahead and risk the Phenergan with my Midodrine this morning so I could keep my medication down... It produced a very strange, though mostly tolerable, side effect. I startled extremely easily. Every time a phone rang (or a similarly shrill noise), I would jump - get a bust of adrenaline, and feel like I was getting sucked into the floor. Not putting those two together again, and I don't suggest anyone else tries it.

Originally Posted by TiffyRN

once more I must point out, there was no harm done (even if the reason no harm was done was because you had better sense than to follow that bad advice).

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Thank you That was my point exactly.