Family battling Children’s Hospital to bring teen home for Christmas #2

[octobermoon]

Works with or for her father???
Someone please tell me what Lou does for employment?
When did he last work?

Seems they may live off SSI benefits and donations they've solicited.

IMO


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This article says he is a financial planner... (BBM)


http://abcnews.go.com/Health/advoca...-pelletier-held-state-pysch/story?id=22312907

"We never got anything in writing," said Lou Pelletier, a financial planner and father of four girls.

 

[sweetmom]

Works with or for her father???
Someone please tell me what Lou does for employment?
When did he last work?

Seems they may live off SSI benefits and donations they've solicited.

IMO


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His FB page says he is a financial planner, but this link:

http://brokercheck.finra.org/Indivi...Group=Individual&FirmKey=-1&BrokerKey=2340931
FINRA, the Financial Industry Regulatory Authority, Inc. says:
LOUIS G. PELLETIER
CRD# 2340931
Not Licensed
This broker is not currently registered with any FINRA firm.

A Globe story from Dec. 15 2013

http://www.bostonglobe.com/metro/2013/12/15/justina/vnwzbbNdiodSD7WDTh6xZI/story.html

said that Lou:

"....a balding 55-year-old financial planner with piercing blue eyes, had never been shy about escalating conflicts when he felt he was right. He had once reported his biggest client to the Labor Department, accusing the firm of unfair business practices, which had led to the termination of his contract and years of financial stress for the family. The toll of that and all the medical bills threatened the loss of their home and helped put them in deep debt."

 

[CHICANA]

The children of abusers often support the abusers. Child Abuse 101.

Yeah, but the children of abusers aren't usually as well adjusted as these three girls.

 

[CHICANA]

Many people? I guess I didn't realize there are all that many people who are supportive of parents who lose custody of their children because of their negligence or abuse. I can't imagine any of these fans are actually taxpayers footing the bill.

What legal basis do they have for a lawsuit and against whom? The only route I'm aware of that one can challenge a Judge is to file an appeal. I think this family should be grateful the state has been willing to work with them. Their antagonistic behavior and incredibly childish rhetoric has convinced me beyond all doubt that the state did the right thing.

JMO

I haven't seen any evidence of abuse or neglect.

I didn't think the state was supposed to take/keep children because their parents are antagonistic or childishly rhetoric ?

 

[sweetmom]

Yeah, but the children of abusers aren't usually as well adjusted as these three girls.

But we do not know how well-adjusted they are.
And if they are parroting false information first provided by their parents, they are not well-adjusted at all, IMO.

 

[CHICANA]

But we do not know how well-adjusted they are.
And if they are parroting false information first provided by their parents, they are not well-adjusted at all, IMO.

Imo, they are well spoken and appear to be well adjusted. That's all I have to go on. What false information do you think they were provided ? I'm just asking, I haven't been as involved as many of you have.

 

[CHICANA]

I was incorrect, this happened prior to June 2013:
http://www.bostonglobe.com/metro/20...l-uncertain/Y7qvYTGsq8QklkxUZvuUgP/story.html

"Still, for the family, not all the news out of Children’s was bad. The most encouraging sign had come in May.....A three-person hospital ethics committee, convened at the request of the Pelletiers issued a decidedly measured report on Justina’s case. ....As for its recommendation that Justina’s case be reviewed by doctors outside Children’s, previous efforts to do that — first at Tufts, then at Baystate in Springfield — had already fizzled."

Good article..

In short order, a team of different Children’s doctors had disputed Korson’s working diagnosis of mitochondrial disease for Justina and accused her parents of medical child abuse. This paved the way for the state child protection agency to intervene and strip the parents of custody on an emergency basis. From there, Justina, against her strong objections, was moved into the hospital’s locked psychiatric ward. Children’s and the state had ignored Korson’s requests to be included in a roundtable meeting to discuss Justina’s care.

 

[Linda7NJ]

Whatever happened to Alan Dershowitz?
He seems to have dropped the family like a hot potato!!!
Just like Dr. Phil ...the family wouldn't give him full access to medical records...

All IMO


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[sweetmom]

Imo, they are well spoken and appear to be well adjusted. That's all I have to go on. What false information do you think they were provided ? I'm just asking, I haven't been as involved as many of you have.

I think the false information includes saying Justina is at death's door (when in fact she is well enough to have been moved to a facility that is not a hospital), was harassed at the previous facility (no proof ever made public, if there is any), had her teeth broken at the previous facility (again, no proof, no pictures showing this)

Or for that matter, saying Justina was "kidnapped" by BCH. Yes, she was put in state custody because BCH thought her parents were medically abusing her. But not criminally kidnapped or held for ransom....it was done under a valid court order.

 

[jjenny]

I haven't seen any evidence of abuse or neglect.

I didn't think the state was supposed to take/keep children because their parents are antagonistic or childishly rhetoric ?

I haven't either. BCH appears to have considered refusing to threat her for somatoform as abuse or neglect. After all the treatment for somatoform, there appear to be no positive results either. I don't think she has anything of the sort.

 

[sweetmom]

http://guardianlv.com/2014/02/justina-pelletier-to-be-transferred-to-foster-care-facility/

Last summer, Justina could have been moved to Webster House in New Britain, Connecticut, but her father threatened to sue the facility if it took in his daughter. He toured the facility in September, but Webster House later told Lou Pelletier that they could not afford the risks involved in taking Justina, as that could put them directly in the center of a heated custody battle.

This quote is from a conservative website that supports the Pelletiers. Refusing to move Justina from the hated BCH locked ward A YEAR AGO to Connecticut because Lou had the idea that Webster was once an orphanage (and so what) seems pretty darn abusive of Justina to me.

 

[jjenny]

http://guardianlv.com/2014/02/justina-pelletier-to-be-transferred-to-foster-care-facility/

Last summer, Justina could have been moved to Webster House in New Britain, Connecticut, but her father threatened to sue the facility if it took in his daughter. He toured the facility in September, but Webster House later told Lou Pelletier that they could not afford the risks involved in taking Justina, as that could put them directly in the center of a heated custody battle.

This quote is from a conservative website that supports the Pelletiers. Refusing to move Justina from the hated BCH locked ward A YEAR AGO to Connecticut because Lou had the idea that Webster was once an orphanage (and so what) seems pretty darn abusive of Justina to me.

He didn't have custody. DCF didn't need his permission to move her anywhere it darn well pleased. So if it seems abusive to you, who is at fault?

 

[Linda7NJ]

He didn't have custody. DCF didn't need his permission to move her anywhere it darn well pleased. So if it seems abusive to you, who is at fault?

Lou's threats and toddler tantrums benefitted his daughter? Somehow prove his fitness as a parent?

IMO it proves the exact opposite. Her parents were incapable of acting in her best interest. It seems to be quite the trend.

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[Gardenlady]

He didn't have custody. DCF didn't need his permission to move her anywhere it darn well pleased. So if it seems abusive to you, who is at fault?

DCF can't just stick her wherever they want - the facility has to agree to accept the patient.

In this case they did not choose to accept her as a patient because of Lous threats and tantrums.


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[sweetmom]

Lou's threats and toddler tantrums benefitted his daughter?


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Exactly. Lou had the chance to move Justina to CT way back LAST JUNE. He chose not to, and he also opposed another MA placement that was offered, which at least would have gotten her out of BCH. His intransigence kept his daughter at BCH for many extra months. If not abusive, then he was at least thoughtless.

 

[Curiosum]

There are a few other things about the Pelletier’s version of the admission that do not make sense.
1) They claim that she was supposed to be a “direct admit”. However, they also state that they had not seen Dr Flores yet since his BCH move. As a general rule
A) Direct admits have already been seen by the doctor at that hospital and already have a medical file in that location
B) Direct admits are generally done when the doctor has already been working with the patient on that issue. From all reporting, this was a new issue (either due to the flu or a 4 month long exacerbation of her disease process.)
C) Direct admits are not taken through the ER. They go directly to the appropriate floor and the paperwork is either handled on the floor or the parents are sent down to admissions.

2) They say that they were directed by Tufts to have her admitted to BCH to be seen by Dr Flores.
A) No one at Tufts really has the authority to dictate who her doctor would be on admission to another hospital. They may have recommended that she see Dr Flores for her GI issue – generally accomplished by making an outpatient appointment. Or they may have recommended that she be hospitalized due to her reported symptoms. Or both. The parents may have interpreted this order as have her hospitalized under Dr Flores, but that is not a reasonable order from a Tufts physician.
B) Justina arrived at Boston Children’s Hospital by ambulance. It was the middle of the night, on a weekend, in a significant snowstorm. Linda Pelletier described the trip as treacherous to the Boston Globe. No doctor in his or her right mind would advise someone to undertake a 100 mile trek under those circumstances. If it were an emergency they would have directed her to the nearest emergency room. If it was not an emergency, they would have advised waiting.

3) Current articles and interviews often mention that Justina had the flu and “flu is dangerous to Mito patients”. There is no apparent mention of the flu in either the leaked Metabolism Consult from 2/12/13 or the Boston Globe article. (The interview for the Globe piece took place in April 2013 per Lou Pelletier but it was not published until 12/13.)

The public really is not going to know the complete story for a long time – if ever.

Yes, exactly! When I originally read about this it seemed quite clear to me that it must have been an ED to ED transfer. I brought this up awhile ago and several people kept insisting that wasn't the case but I think you're exactly correct that this was never an ED to inpatient transfer because if it had been she never would have gone through the ED at BCH. When patients are going from one hospital's ED to a new hospital these kind of transfers are simpler and often appropriate. The accepting physician is the ED physician and the patient must go through the ED and then be admitted (or in some instances perhaps discharged if the ED physician deems that appropriate) from there.

As far as the Tufts physician directing to admit to BCH. You are right that they can't order that (unless of course the physician has admitting privileges at both facilities) but understanding how transfers work as physician who has taken kids in transfer and transferred kids to other facilities my guess is that the poor ED physician initially called Korson and Korson recommended he call BCH instead. He can make the recommendation, he can't make the ED physician do his bidding but most physicians try to do what needs to be done for the patient so if it played out that way most ED physicians would make that call.

It is unclear if she truly had the flu as in Influenza A/B or this was just some semantic slippage and she had some other viral syndrome. Febrile viral syndromes in general certainly do worsen many underlying chronic illnesses and the complication rate is higher in these patients so even if it wasn't truly Influenza the viral syndrome may have been of some consequence or at least evoked the concern of potential consequence.

 

[jjenny]

Exactly. Lou had the chance to move Justina to CT way back LAST JUNE. He chose not to, and he also opposed another MA placement that was offered, which at least would have gotten her out of BCH. His intransigence kept his daughter at BCH for many extra months. If not abusive, then he was at least thoughtless.

He didn't chose anything. DCF can move her into whatever facility they want. They moved her into CT facility without her father's permission.

 

[Linda7NJ]

He didn't chose anything. DCF can move her into whatever facility they want. They moved her into CT facility without her father's permission.

Again, due to Lou's antics the placement of Justina was reject by the facility.




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[Curiosum]

I'll throw in one more thought.

One of the biggest "red flags" for medical child abuse is the aggressive claim by a parent that "only Dr. XYZ knows what's going on with my child". "Only Dr. XYZ can make decisions for my child."

Several of my colleagues are so adamant about this, that when a parent says "you are so wonderful and such a good doctor-- I only want YOU making decisions for my child, and I won't accept anyone else" that they want to immediately sign off the case, permanently.

Medical child abusers doc shop until they find one, or a couple, that have such an enormous ego, they accept the parent's embrace as the "only" doc that can treat their complex child. Ethical docs and providers know that none of us are irreplaceable. There are LOTS of good, competent, and ethical providers out there.

I do agree that it can be a red flag but how much of one it is depends a bit on context. We see this at our hospital sometimes with a lot of our ED physicians who just really aren't super comfortable with kids in general and kids with complex medical issues specifically so pediatricians do a lot of ED consultation and even a fair amount ED resuscitation and I think parents just kind of adapt to the culture and don't hesitate to push the ED physicians to contact their child's pediatrician or the on call pediatrician if things aren't going well. So the mom who wants some PCP communication before her kid gets discharged home from the ED with DKA may just be concerned and advocating for her child. When she posts on Facebook that Dr. X is the best doctor she may really just be being appreciative. I think the line crossing is when mom can't be just as appreciative and able to work with Dr. X's partner Dr. Y if he/she is on call when her kids has their crisis or Dr. Z if Dr. X feels the need to consult someone else.

I do agree that physician ego plays a role in some of this, can set up some pretty dysfunctional physician-patient relationships, and can miss medical child abuse. I also think that a lot of the misuse of patient (or parent) satisfaction with care as a proxy for quality of care can play into this as well. Hospital reimbursement is tied to satisfaction so I think physicians are often under a lot of pressure to satisfy and may get stuck in a place where they end up sacrificing their clinical judgement in the process. My husband and I always strive to do what we truly believe is in the patient's best interest, respect patient's and parent's rights to make medical decisions, and stand strong against demands that deviate from the standard of care, accepted patient safety standards, and our own state laws (or all three at once).

 

[Curiosum]

A medical professional really believes that seizures are not caused by medical condition, comatose states? It shows me that the medical profession can't always find the cause and then blames it on the patient, ie. all in their head.

Well, if the seizures are non epileptiform pseudo seizures, then, yes.
Additionally, conversion disorders can present with neurologic manifestations not explained by any kind of an organic basis.