Friday, August 29, 2008

2 Counts of Substandard Care and 5 Recordkeeping Violations for Maryland Vet Richard Springer

This entry is about Richard Springer, of Brandywine Animal Hospital in Clinton, Maryland.

In early 2005, an owner brought "her dog 'Baby,' a four-year old male Yorkshire Terrier, to Dr. Springer for veterinary care, believing that her dog was constipated. According to the Veterinary Board's charging documents, in her complaint against Dr. Springer, [the owner] noted that Baby had been 'acting strangely' and yelped whenever he was picked up. In his written response [to the complaint] Dr. Springer noted that Baby was presented for 'pain.'

"In his written response to [the complaint], Dr. Springer also noted the following: (a) Baby had never been to his office and had no history of being seen by a veterinarian in two years; (b) On physical examination of Baby, the noted 'a large fecal mass in [dog's] posterior colon"; (c) On visual examination of the dog's oral cavity, he noted a 'moderate tartar accumulation on most teeth, gingivitis, and probable periodontal disease'; (d) He could not obtain an accurate body temperature for the dog rectally; (e) Because of the dog's medical history, he made a differential diagnosis of canine disk diease, and decided to take an abdominal radiograph;" . . .

OK, pay attention to the next part . . .

"(f)Baby 'defecated and urinated freely and became temperamental when placed in a right lateral [recumbant position]; (g) Baby 'bit freely into the X-ray gloves'; (h) He noted that the radiograph was 'negative for obvious disk disease,' but showed a large air density in the [dog's] posterior colon;' and (i) He made '[a] diagnosis of colonic obstruction due to fecal impaction," and injected cortisone for inflammation, and then discharged the dog."

The Board goes on to say that the information Dr. Springer provided in response to the complaint did NOT appare in the patient record. They say that Springer did not record Baby's medical history and condition, did not record his diagnosis, did not record his treatment or the medications given to Baby, and did not record the "progress and disposition" of the case.

They further noted that Springer failed to meet standards for taking x-rays. Specifically they said that "For diagnostic purposes, a minimum of two radiographic views is highly recommended. For radiation safety purposes, the radiography should be limited to the specific area of interest. Neither standard was met . . . "

The Board adds -- pay attention here, and ask yourself what the implications are . . .

"Dr. Springer noted that Baby was an excited, fractious patient. In such cases, tranqualization or sedation of the animal may be necessary, unless contraindicated, to secure the radiographs, patient comfort, and handler safety."

So -- since he did get x-rays -- how then, did he get this fractious patient to lie in the right position and hold sufficiently still without any sedative? And what might his method of achieving this have to do with Baby's fractured jaw - if anything at all?

The Board continues:

"Having diagnosed that Baby was suffering from colonic obstruction due to fecal impaction, Dr. Springer's workup should have included a more focused examination to rule out colonic, rectal, or prostatic pathology. In the absense of an underlying disease, treatment should have included digital evacuation of the rectum-colun an/or administration of mild enemas. Dr. Springer has not provided any information indicating that he performed any of these procedures. Dr. Springer administered cortisone to treat inflammation, but such drug may have been contraindicated under these circumstances."

The Board also notes that Springer made no plan to treat the periodontal disease he identified.

The document goes on to say:

"When [the owner] went to the hospital's kennel area to help retrieve Baby from his cage, she noted that her dog's mouth was bleeding and in an open position. [The owner] asked Dr. Springer about this, and he told her that Baby was "Okay," that the dog had just cracked a tooth. If Dr. Springer examined Baby's mouth, he failed to note the severity of the injury the dog had sustained."

"After arriving home, Baby would not eat or drink . . . [the owner] also noted that that dog was unable to close his mouth. [The owner] called Dr. Springer and informed him of this problem, and asked that he examine her dog. Dr. Springer directed [the owner] to take Baby to Southern Maryland Referral Center located in Waldorf, Maryland."

The owner took Baby to another hospital, where the vet told her that Baby had a fractured jaw. He was sent to an emergency clinic where a "mandibular fracture" (broken jaw) was repaired.

Most of this detail does not appear in the "Consent Agreement," however.

The Board fined Springer $1,850. They suspended his license for 2 weeks, BUT STAYED THE SUSPENSION, which means that NOT ONE DAY of the suspension was enforced.

They placed him on probation for 6 months, but that probation is pretty meaningless, since the only term of the probation is to obey the regulations he already should have been obeying in the first place.

So -

How did Baby's jaw get broken?

And why did Springer tell Baby's owner that Baby was "Okay" and only had a cracked tooth when she arrived at the vet hospital to see her dog Baby bleeding from his mouth which was apparently hanging open?

Did Springer really not KNOW that Baby's jaw was fractured? (How unobservant, or ignorant, would he have to be not to know that?)

Or did he know it but just not say?

If the latter, why? Does it have anything to do with uh, Baby's "fractious" ness?