Age: 30.0
Sex: F
Vaccine: TDAP
Symptoms: Impaired work ability, Injected limb mobility decreased, Injection site erythema, Injection site induration, Injection site mass
Clinical narrative: On June 17th 2013 I was sent to facility to have a routine TB test before I could begin my work as a volunteer.   I met with a P.A. who gave me a brief medical exam and then a Medical Assistant who said she would administer my vaccine.  Shortly after I was given a vaccination in the right forearm and told to come back for a follow up reading for my TB test.   About an hour after I had left I received a call.  I was told that the vaccination I was given was incorrect. She stated that in error I was given the Tdap vaccine instead of a TB test.  I was told that I would be fine but to come back tomorrow for the proper vaccine.  I immediately called facility and spoke with volunteer coordinator to inform him of the error.  He stated that he was unaware of the incident and that "nothing like this had ever happened before" and agreed to meet me at the clinic for my follow up the next day.   The next day June 18th 2013 I awoke with my right arm swollen and red around the injection area which was forming a small, hot, hard  lump. I called facility and spoke with volunteer coordinator to inform him of the swelling and pain in my right arm he suggested that I come in as soon as possible that day instead of the late afternoon scheduled time.   On June 18th 2013 I went back to facility and asked for volunteer coordinator and he was not available.  I began working the medical assistant that gave me the wrong vaccine and Physician Assistant.  Medical assistant stated "that she had given me the Tdap because she thought the T in Tdap was for TB."  I was told by the P.A. that the injection for Tdap should not have been applied in my  forearm at all and that it was also applied incorrectly under the skin in the manner of a TB  that should have been given. The P.A.  examined my arm in the Lobby and stated that "the hard lump may need to be cut out if it continued to spread around my forearm."   I was not comfortable with the information I was given and asked to speak with a supervisor and waited in the Lobby for 30 minutes. I met with Dr. who took me into a patient room and examined my arm.  I was told to put ice to reduce swelling and given Tylenol and Aleve and told to come back the next day for a follow up. The following day I awoke with extreme pain and my arm even more swollen.  The area of injection was hot and painful and had become even more of a solid mass.  I returned to facility on June 19th 2013 my arm was examined by the P.A. and Dr. I informed them of the increasing pain from my entire hand up to neck on the right side, numbness and lack of function/movement.  My entire right limb was red, swollen and hot.  I waited in the exam room for nearly an hour and was given a bottle of prescribed antibiotics and more Tylenol by Dr. He said that I should take the prescription he had filled for me along with the Tylenol and I would be fine by weeks end.  Later that same day June 19th I returned to facility to speak with Dr. again about the pain in my neck and arm.  I asked for blood work and an ultrasound/ X-ray to be given but Dr. only tried to assure me the pain would be relieved with the antibiotics and Tylenol he had given me.  He stated "he had more than 20 years' experience and that by weeks end I would be fine."  He asked me to trust him and I was then sent to be attended to by a nurse whom I had not worked with.  She applied a topical ointment to my arm because the injection area was increasingly swollen and red/purple.  The area of injection was covered it with a bandage and I was told to come back with any further issues or concerns. On June 20th 2013 I returned to facility.  At this point my entire right arm up to my neck was swollen and in pain.  My right arm felt very hot and heavy.  The swelling had moved to the entire forearm, hand, thumb, index and middle fingers.  I was having trouble moving my entire right arm and pain was at a constant 8  10. I expressed my concern with the lack of progress, extreme pain and frustration of missing work for 3 days and told Dr. that it was best for me to seek immediate treatment at another facility. Dr. said that it was not necessary and seemed upset but assured me to call him with any information I was given and "to not worry about any billing or cost for any treatments needed he would take care of it all." On June 20th 2013 I went to Medical Center and was treated for the swelling and pain in my entire Right arm.  I was given intravenous medications and potassium for the pain and injury and told to come back if the swelling was not reduced in a few days.  I informed Dr. of my status from Medical center and he agreed it was good that I got checked out due to the severity of the injury.  At that time he again assured me that I would not need to worry about any of the expense from my visit to Medical center and to call him with any problems or questions I had in the future.  On 6/24/2013 I called volunteer coordinator left a message informing him of my injury and pain.  My call was never returned.  I called volunteer coordinator on 6/25 6/26 and 6/27 and my calls were never returned.  On Thursday June 27th I contacted volunteer coordinator via email to inform him that I was no longer interested in a volunteer position due to the ongoing medical situation and injury I sustained from Primary Care Medical.  I never received a response.  On July 25th I began receiving medical statements from medical center.   I contacted Dr. to inform him of the bill.  I gave him the payment information for medical center and he assured me the bill would be taken care of.  He stated "that I could contact him with any future problems or questions I had and that he wanted to help me get better."  On August 5th a billing statement was issued from medical center in the amount of $1424 I called Dr. on 8/12/2013  and left a message for a return call regarding the outstanding bill, my call was never returned.  On 8/12/2013 I contacted volunteer center and asked for volunteer coordinator and was told he was not available and was put on hold for a volunteer coordinator and the line was never answered after 10 minutes of being placed on hold.   I attempted to contact Dr. on the following dates: 9/09/13 10/7/13 11/04/13  in regards to the outstanding balance with Medical Center and ongoing pain in my entire right arm up to my neck.  I never received a return call.  On December 11th 2013 I contacted Dr. successfully and we spoke about the outstanding balance from medical center.  I once again gave him the billing information and he assured me that the account would be paid in full immediately.  At this time I also informed Dr. of pain in my arm, hands and fingers and explained how I have been attempting to contact him and volunteer coordinator for several months Dr. stated he was sorry for not being able to get back to me and the call was abruptly ended by Dr. On December 13th 2013 I received a call stating that the bill was paid in full on Dec 12th 2013.   On 1/20/2014 I attempted to contact Dr. via cell phone and at volunteer center due to the ongoing pain in my entire right arm up to my neck, my call was never returned.   On 02/03/2014 I attempted to contact Dr. via cell phone and at volunteer center due to the ongoing pain in my entire right arm up to my neck, my call was never returned.  On 6/13/2014 I learned that there was an outstanding balance due for my patient account with Medical Center.  I have made multiple attempts to contact Dr. and volunteer center in regards to the outstanding balance from medical center and the ongoing pain in my entire right arm up to my neck.  Dr., volunteer center and facility have refused contact me or help me with medical expenses and treatment after sustaining an injury as a volunteer due to their substandard care and unprofessional conduct. On 6/20/2014 I contacted facility for a copy of my medical records.  I was told the file would be available around 12pm that day.  When I arrived to pick up the documents I asked if Dr. was in and if I could speak with him.   After a few minutes I was   permitted to see Dr. in his office.   Dr. remembered me as a volunteer and asked "you were the volunteer with the forearm injury?"  I confirmed and began to explain to Dr. how I have reached out to him numerous times and was never contacted.  He apologized and said he was very busy and the best way to reach him was via his cell phone.  He asked me about my arm and how I was feeling and I explained to him the pain that I had been feeling in my entire right arm up to my neck. Dr. then asked me to perform a few ranges of motion and he palpated my right forearm and neck. He said "that it was likely that I had some damage to the nerves and that I would need a test for the cervical spine because maybe I had a pinched nerve." He stated that, there was a visible difference between my left and right arm and that he noticed the right one was maybe "weak" or "pained" when I could not hold it up equal to the opposite arm.  Dr. said "he wanted to help me and that he was so sorry that I was in pain for so long."  Dr. then brought up my insurance plan and asked if I was covered.  I told him I was not and he said he could help me get insurance coverage. Dr. asked me if I knew about insurance and I stated that I did not.  He said he could help me sign up for the insurance plan and that once I was signed up and approved he would take on my case and transfer it.  Once I was transferred I would be evaluated by one of the doctors as a routine but that he would then send me to a specialist and I could have and MRI and EMG testing because he did think it was important to find out what was going on with my arm.  I agreed that the plan was okay but I was not interested in insurance.  Dr. said that "without the insurance or any insurance he would not be able to help me."  I reminded Dr. of how and why I sustained my injury due to an error by his staff and asked him to please help me. Dr. then said "I am helping you. You need to have insurance and once you are covered I will get you the best medical treatment and the proper test to help you get better."   I was then ushered into an office where an assistant made a few phone calls to help enroll me into some medical program I was unclear of the exact details.  The assistant was unsuccessful at whatever the task was and called Dr. who had now stepped out of the office.  I waited for 30 minutes and then called Dr. on his cell phone and was asked to return at 2pm for further help.  I returned at 2:30 pm and worked with Social Worker. I was allowed to use the computer to sign up for insurance and asked a few questions about my volunteer status and work with the Hospice.  I briefly informed the staff working around me of my situation and explained how I needed help.  I was told that there were lots of complaints from patients and that I should not let the doctor get away without helping me.  I went back downstairs to Dr. office to speak with him. I informed him that I signed up for the insurance and asked if he could now help me be evaluated.  Dr. stated that I would need to let the process begin and that in a couple of weeks to come back when my case was assigned.  I told Dr. that it wasn't enough and I needed help faster but he said he could not and would not help me until I had insurance coverage.  Dr. was then needed elsewhere and I was asked to wait in the Lobby.  I waited for 10 minutes to follow up with Dr. when he did not return I went home. At 4:40 pm 6/20/2014 I called Dr. on his cell phone.  I told him that I did sign up for medical insurance and was willing to work with him if he was going to help me but I did not want to wait any longer to get the test because of the pain I was feeling.  At this point the call was ended by Dr. and he made no attempts to return my call. September 2014 I began to experience the following symptoms on a daily basis:   Painful muscle spasms in the neck and into the jaw; Periodic painful swelling in entire right arm; Discoloration in thumb, index and palm of right hand; Periodic sharp pain shooting throughout entire right arm; Loss of hearing in right ear; Decreased range of motion, periodic inability to use right hand or arm, muscle weakness, and extreme muscle tension/pain entire right arm; Daily headaches specifically limited to right side of body; Pain at injection site; Anxiety and insomnia.