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  1. #1
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    Oct 2013
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    Default Treated for Depression Without Diagnosis of Underlying Cause

    My question involves medical malpractice in the state of: Texas

    First off I want to say that I am brand new to this forum and this is my first post. I have done quite a bit of research but have been unable to draw a sufficient conclusion to my question from what I've discovered thus far. In turn, a google search brought me to this page, and I would like to thank anyone in advance for their assistance with my dilemma. Please bear with me as this may not be a short post and I like to be pretty descriptive to cover all bases.

    Basically my research so far indicates that to have grounds for a malpractice lawsuit you must prove that:

    A) A doctor or other medical professional made a mistake pertaining to my medical care, and,
    B) I was harmed by that mistake.

    Now I just want to say right off the bat that I am not in this in an attempt to scam someone for money or because I'm greedy and want to make a fast come-up. I do believe the mistake I'm about to describe to you is legitimate grounds for a lawsuit and I did indeed suffer very much because of it, mentally, physically, emotionally, financially, etc.

    About me: I am a 22 year old male who is very healthy in most physical respects.

    Here's the story:

    Basically, since approximately February 2011, I have been suffering with severe anxiety and depression, the cause of which was baffling to me. It came on very suddenly and very strongly and absolutely devastated and debilitated me. As many who have experienced anxiety should know, I spent tons of time on "Dr. Google" researching and trying to come up with a cause for my issues. I began seeing a psychiatrist who prescribed me several mild anxiety and depression medications (strattera, hydroxyzine, gabapentin, buspar), as I did not want to be on anything strong or addicting. They helped a little bit. For the next approximately 6 months, I was in a very very dark place. I did not work, I did not go outside the house, I sat at home and anticipated sleep as it was my only escape from my hell of a reality. During this period of my life, I spent the majority of my time researching online, googling for cures and remedies, potential PHYSICAL causes of the issues I was having (versus mental). Now it is relatively common for anxiety sufferers to believe that there is something physically wrong with them rather than having a mental disorder, and as such I strongly believed this. As a result, I had many tests run via my family doctor (not the psychiatrist), including an MRI of the brain, hormone testing, vitamin deficiencies, disease testing, etc., the list goes on and on. Everything came back "normal", or so I was told. I continued to see the psychiatrist at least weekly, whom I mostly visited just to ask questions and reassure myself that I was not going to die. Thankfully I have medical insurance, but it still added up to quite a chunk of money. I felt that the medications I was on were harming more than helping so I stopped taking them. Time went on, and in my misery I began using recreational drugs as an escape (or "mask", rather) from the horrible way I constantly felt, prescription painkillers in particular. The drugs did mask my pain enough so that I was able to work. During this time I did have several jobs, but for no more than several months at a time, as my terrible mental state did not allow me to be a reliable employee and thus I ended up losing those jobs. After about 6 more months, so approximately March 2012, the painkillers became a financial problem, and as such, I was forced to stop taking them. This is when I replaced the hydrocodone with a more mild painkiller called tramadol. Tramadol helped me a little bit but certainly did not cure me. I returned to my family doctor and being that I returned to my old self which was unbearable, he put me on an SSRI antidepressant called Celexa. I have been taking tramadol and celexa ever since (the tramadol initially came form an online pharmacy, and has since been prescribed "off-label" [for a purpose other than it's FDA-approved usage] monthly by my psychiatrist).

    Fast forward to September 2013. Still taking tramadol and celexa (which are by no means good for you). Here I am having improved very much, I believe mostly due to my mental strength improvement after having dealt with such things for so long. However, although my life has improved and could be considered somewhat normal, I have still been unable to maintain a job, have made very little progress in school, and made no progress in life overall, in fact I still live at home with my parents who take care of me financially. I have always felt that something was physically wrong with me, but allowed that idea to drift to the back of my mind as those around me and everything online was adamant that anxiety is a mental problem and not caused by any physical ailment. Being that my mood and energy level is always so low, a google search brought me across something called "adrenal fatigue". The symptoms associated with the disorder seemed to fit the way i feel constantly, and as a result, I went to my psychiatrist to discuss the possibility of me having the condition as well as having blood tests done to diagnose it. The blood work comes back, and no adrenal fatigue. However, included with the adrenal fatigue panel is a measurement of testosterone level. Here's the bombshell: My testosterone level was a 279. This is extremely abnormal for someone of my age, in fact was described as being "lower than an 80 year old's". The testing lab's "reference" parameters (being a high and low end) vary from lab to lab, but are generally accepted to be normal when resulting between 300-1000, adjusted for age of course.. Needless to say, someone of my age should be at the high end of that scale. The average is like 700 something. Anything below 300 is regarded as low in the United States and it is rare for someone in the 400s to feel good. The doctor and I had a discussion, he orders a testosterone replacement gel for me and I'm awaiting it's arrival. Now for those of you who don't know, although testosterone is generally associated with aggression, masculinity, and muscles, a quick google search will reveal that a low testosterone level can cause a slew of problems, including anxiety and depression, low mood, etc etc. It is involved in many processes including focus and memory, which by the way I lacked extremely during the course of my anxiety and depression. While awaiting my testosterone supplement to arrive, I decide that it is probably best to get a 2nd testosterone level test simply to confirm that the result was not somehow skewed. Instead, I decided to call my family doctor's office to see if I had had my testosterone level checked in the past. Lo and behold, in 2011 (not sure of the exact month, still looking into that), my testosterone level was a 220! Even lower than it is present day, and the nurse on the phone told me that their reference levels from the lab were 244-800. So my level was even BELOW the low end of their reference, yet they failed to mention it. This office never gives copies of the results, they simply have the receptionist call and tell you that everything was "normal". So, my testosterone supplement comes in, I begin using it, and I feel absolutely 100% better and like my old self again! The low testosterone was my problem the whole time. Exciting news, and it's wonderful to have a normal life back. I was able to get off the tramadol and celexa with no problems. So I get to thinking, why the hell did they not tell me I had a low testosterone level back in 2011! I could have been feeling better 3 years ago. I asked the nurse why they did not mention it and she said because if it's a little bit low, there's no cause for concern, which is clearly not the case based on my experience as well as the vaguest piece of information to be found on the subject.

    So the subject of my suit: My family doctor's negligence to mention such an extreme physical problem which caused many many problems and pain and suffering for the last several years of my life. I don't think this is my psychiatrists fault as I had always told him that I have had a full array of bloodwork done and everything had come back normal. Accordingly, he ordered no such tests over the course of my treatment. Also, he is a psychiatrist and as such understandably has little interest in hormone levels. I have a strong clue as to what the cause of the low testosterone was and while it was a personal choice that would probably be none other than my fault, I asked for the tests to diagnose it and the results were not relayed to me.


    Now, as far as the grounds for a lawsuit go, I think part B is absolutely covered. Supposedly this is usually the hard part in malpractice cases. I have a wealth of proof of the problems that this mistake caused me:

    • -Pain and suffering for approx 3 years (constant discomfort, insomnia, inability to focus, lack of interest in life, low appetite, severe depression and anxiety, virtually no sense of well-being, daily headaches, ineffective exercise which could have otherwise helped me tremendously)
    • -Inability to maintain a job and the resulting financial hardships
    • -Permanent body disfigurement in the form of stretch marks as a result of the weight gain due to low testosterone levels
    • -deteriorated health as a result of insufficient testosterone levels (could have many permanent negative health effects, including weak bones, diabetes, etc.)
    • -lots of money spent on medical bills that would have otherwise been unnecessary
    • -potential damage to by body due to the prescribed anxiety/depression treatments
    • -potential damage to by body due to the recreational drug use which were used as an attempt to correct and underlying problem
    • -deteriorated relationships and family life due to my condition (including being emotionally unavailable for my family during the grieving for the loss of 2 grandparents)
    • -inability to be "all there" for my nephew as he grew up
    • -inability to progress let alone be enrolled in school due to low mood, anxiety, inability to focus as a result of low testosterone.
    • -forced to give up the parental rights to my daughter as I was unable to take care of myself and thereby also unable to take care of her
    • -there is potential that the testosterone replacement therapy (which I am still on) can cause infertility and thus inability to have children.



    Many of the problems above would have been less severe or have less potential to become an issue if the low testosterone did not go on for so long.

    I truly believe that all these issues were a direct result of my very low quality of life due to this ailment which went ignored by a medical professional. I believe any medical professional should have known that such miniscule levels of testosterone were NOT sufficient for a male of my age, let alone any age. My psychiatrist did, and he is no hormone specialist. I truly suffered for a long time because of this and to be quite honest I am angry about it. My life was a living hell when it didn't have to be. I don't suppose the levels had to be absolutely zero for them to recognize a problem. The doctor did usually dismiss my concerns and blame everything I brought up on anxiety. Do a little research and you will learn just how miserable someone can be with insufficient testosterone levels. I was.

    I think part A is the larger issue here. The mistakes made were:

    • -Failure to mention a major medical issue to me, their patient whom was suffering
    • -Misdiagnosis as generalized anxiety disorder & depression and the subsequent placing me on an antidepressant as a treatment



    But it seems that proving this may be difficult. The nurse admitted to me over the phone that this she and the doctor viewed as a normal result, and it is ABSOLUTELY NOT a normal result. She also said that they won't pay low testosterone levels any attention unless symptoms are present, which would include many sexual side effects. Luckily, I did not have any of those typical effects, but it demonstrates an extreme lack of knowledge and professionalism that a so-called medical professional was unaware that low testosterone levels can cause much more than sexual side effects. I don't know if their phone calls are recorded or if I'd have some way of obtaining it.


    I also have no clue if I would need a lawyer for such a case or how to file one, or how to find a good attorney for such a case. But I suppose the first step is determining whether or not I have a case, so I will cross the next bridge when/if I get to it.

    Not too sure where to go from here. I'm sorry for the book. Please let me know your thoughts and thank you for your time.

    --Richard

  2. #2
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    Default Re: Am I Mistaken or Do I Have a Strong Case Here

    Given that a low testosterone level can be completely benign and not affect the patient whatsoever, I'm doubtful that you have a valid case here - and you certainly won't convince a court that (for example) your low testosterone forced you to give up your parental rights, made you unable to get a job and that stretch marks are somehow detrimental to your life (think about it - should a woman sue her partner for making her pregnant and causing her stretch marks?). I'm honestly not trying to bury you, but most (if not all) of the things you describe won't help you at all.

    If you have any concerns, you should take your medical records to a med-mal attorney. If the attorney won't take the case on contingency, this would suggest that either you don't have a case, or the case would not be financially viable to litigate.

    - - - Updated - - -

    As an aside, if you tried to litigate this yourself you'd likely end up buried in legal fees before it even reached an initial hearing - and that's assuming it wouldn't be dismissed. Remember, you're talking about suing an entity or person who/which has an entire legal team on their side.
    An intelligent hell would be better than a stupid paradise - Victor Hugo

    Do not microwave grapes

  3. #3
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    Oct 2013
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    Default Re: Am I Mistaken or Do I Have a Strong Case Here

    Whether you have a strong case or not is best judged by an attorney and you will certainly need one to represent you in a malpractice case. The fact that some of your symptoms (lethargy, general malaise) may have been caused by the illegal use of narcotic depressants would not work in your favor imho. I am not aware that low testosterone levels are particularly associated with physical pain. If you mean emotional pain and suffering, Texas has a cap on malpractice damages that can be awarded under non economic damages. http://www.**********.com/law-librar...e-damages.html

    That brings up something else to consider. In my own state finding an attorney willing to work on a contingency basis is no harder than reading the side of a bus or the back of a phone book. Because Texas and several other states have placed caps on recoverable damages, finding a lawyer willing to work on a contingency basis may prove harder. You will need to discuss fees with any attorney you contact. With a maximum cap on non economic damages set at $250,00 I doubt many lawyers will be willing to risk their time and expertise for such a small and uncertain return. But I am nowhere near Texas and really have no idea if you will find that the case or not, Best bet is to contact a malpractice attorney. An initial consult may be free but you 'll want to check on that before scheduling an appointment.

    I don't think you'd qualify for punitive damages based on the brief info cited on the web page I referenced. I would find it hard to say your delayed diagnosis was outrageous or malicious on the part of both your attending doctors. Low testosterone levels are not life threatening and do not rise to the same level of damage as a missed diagnosis of cancer causing delayed treatment. But what I feel may not be how your courts see it. If you want to pursue this you really need to do so under the guidance of an attorney.

    Good Luck and I'm sincerely glad you are finally feeling better.

  4. #4
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    Default Re: Am I Mistaken or Do I Have a Strong Case Here

    That's right - Texas does indeed have a cap on malpractice awards.

    I still stand by what I said. I don't see a case here at all - and thank you to Shortcake for reminding me of the cap
    An intelligent hell would be better than a stupid paradise - Victor Hugo

    Do not microwave grapes

  5. #5
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    Default Re: Am I Mistaken or Do I Have a Strong Case Here

    Quote Quoting Dogmatique
    View Post
    That's right - Texas does indeed have a cap on malpractice awards.

    I still stand by what I said. I don't see a case here at all
    I would tend to agree with you but who knows what a jury would decide.

    No offense OP but consider yourself lucky to be young with plenty of time to find that special someone and start a family if you choose to do so. Though there may have been a delay in your diagnosis that caused you some discomfort, I see no permanent lasting damage resulting from the handling of your case that would cause you continued suffering or disability in the future. The uncertain nature of getting a minimal return from a lawsuit and the anguish and financial hardship you will put yourself through in the years this may take to come to trial are not worth it, imho.

  6. #6
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    Default Re: Am I Mistaken or Do I Have a Strong Case Here

    Then somebody says "I'm from Texas, do I have a good medical malpractice case", I think about more than damages caps - I think about the other "reforms" Texas has imposed which make it extremely difficult and expensive to prove even a valid malpractice case.

    When somebody goes to a doctor and describes depression, accompanied by the accelerating use of illegal drugs, and reports no symptoms suggesting an underlying medical problem, they're apt to be treated for the symptoms they report. When they start complying with treatment and respond positively to the prescribed medications, that suggests that the doctor is prescribing appropriate medications (particularly given the patient's refusal to consider "anything strong or addicting" that the doctor thought might be more effective, while going out on his own to take street drugs).

    You say, "I have a strong clue as to what the cause of the low testosterone was and while it was a personal choice that would probably be none other than my fault, I asked for the tests to diagnose it and the results were not relayed to me." If you are telling us that you caused your body to stop producing testosterone at normal levels by taking huge levels of steroids you bought on the street, the question becomes, did you bother to tell your doctor that your depression was precipitated by your using huge levels of steroids? Your intake sheets with the doctors who treated you would have asked about drug and alcohol use - did you answer honestly? When did you stop taking those steroids, assuming you did?

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