Vacation nightmare

Thursday, Sept. 28, 2006 | 7:27 a.m.

You are thousands of miles from home in a resort city on holiday, and one member of your vacationing party comes down with a debilitating illness that requires emergency surgery and a lengthy hospital stay.

You are unfamiliar with that country's patient privacy laws, and at every turn you are frustrated by hospital officials seemingly stonewalling you instead of helping you get vital information about your ailing loved one.

David and Teresa Hudd of Cheltenham, England, say that they experienced such aggravation in Las Vegas after David's cousin - Terrence "Terry" Brace, 62, of Bristol - had emergency gallbladder surgery here late last month.

What was supposed to be a one-day stay following surgery at University Medical Center has turned into a one-month hospitalization at the county-funded facility for reasons that have not been made clear to - of all people - Brace's relatives.

"The hospital keeps hiding behind this thing called HIPAA," David Hudd, 62, says. "They pretend to be nice and considerate, but when we ask about something they say, 'Oh, sorry, that's a privacy question.' It has been very frustrating here getting any information at all.

"What we have seen is that HIPAA is not so much for the patient's point of view as (hospital officials) claim but rather for their (the hospital's) own protection."

HIPAA, the Health Insurance Portability and Accountability Act, was enacted by Congress in 1996.

Designed to maintain health insurance coverage for workers who change or lose their jobs, it set national standards for health care issues to protect electronic patient data.

On April 14, 2003, the privacy portion of HIPAA kicked in, establishing regulations for the disclosure of what the government calls "Protected Health Information," which includes a patient's health status.

Hospitals and medical workers, who face stiff penalties - including potential imprisonment - for violations of the privacy rule, have interpreted the law to include almost any part of a patient's medical record.

In Brace's case, UMC officials say that in the lineage of relatives, a cousin, such as David Hudd, is low on the list of next of kin.

For Hudd to learn just what happened to Brace during his Aug. 27 surgery, he must first gain power of attorney. Brace, whom the hospital lists in fair condition, is not cognizant enough to sign such a legal document, Hudd says.

Kristina Zemaitis, a UMC spokeswoman, says the patient's right to privacy is foremost in these matters. She says Brace has a half-sister in England whom the hospital is attempting to contact.

"There is a legal lineage we have to follow," Zemaitis says.

In England, Hudd says, family members go to a hospital and talk with the head nurse - called the "sister of the ward" - who briefs them without first determining how they rank among relatives.

Zemaitis says UMC's HIPAA policy officer helps a patient's relatives and friends navigate through the complexities of the federal regulation, and that the Hudds were offered that employee's services.

She says while HIPAA does not spell out exactly what can be released or not released regarding a patient's condition, the hospital is required under the law to "use professional judgment" regarding just what information is released "in the best interest of the patient's care." That is especially the case, she says, when the patient cannot communicate. Brace, according to his family, was on a ventilator for several weeks following surgery.

The hospital has declined to say what happened during Brace's operation or release the name of the surgeon. The surgeon Brace's family believes operated on him did not return calls from the Sun seeking comment.

Brace is an art teacher at City of Bristol College, the equivalent of an American prep school. He came to Las Vegas on Aug. 24, intending to stay one week.

Late on Aug. 26, Brace was having a restless night and was in pain. He called a cab to take him from the Plaza Hotel to a local hospital, and the cabbie recommended UMC, Hudd says.

A doctor recommended surgery to remove Grace's gallbladder, and he agreed.

What happened during that operation, however, is unclear, although the family believes his bile duct may have been severed or mistakenly removed, they say.

The costs have been staggering.

According to Brace's insurance provider, UMC's bill is approaching $450,000, Hudd says, which is as ironic as it is expensive. Because England has national health care, there would have been no charge for Brace's emergency operation and recovery in a British hospital had he gotten ill in his homeland.

And the Hudds' pocketbook is hemorrhaging as well.

To date, they have spent $2,000 on phone calls alone to Britain to keep friends advised of Brace's condition.

David Hudd, a window repairman, and Teresa Hudd, a bookkeeper for a firm in which she is part owner, said the Plaza has given them a special room rate of $250 a week.

"We never gave any thought of leaving Terry here alone no matter what the cost was to us," David Hudd says.

Brace could be hospitalized for several more weeks.

The Hudds' primary goal now is getting Brace home on a medical flight, which they say will cost about $80,000. It will be months before Brace is able to travel on a normal commercial flight, David Hudd says.

The Hudds have obtained a Las Vegas attorney, and vow not to leave Las Vegas until they have legally gained access to the hospital's records to learn what happened to Brace during surgery.

Stevie Ferguson, a registered nurse and family friend, came here from England in mid-September to help the Hudds navigate the medical maze.

She says that she is unimpressed with America's apparent obsession with patient privacy to the point of denying information to others that may be helpful in determining the best course of the patient's care.

She said UMC officials have refused to tell her not only about Brace's surgery but also what medications or treatments he is receiving.

Frustrated by what she considered a lack of professional courtesy from UMC, Ferguson met on Sept. 14 with British Consulate representative David Slater of Los Angeles, who was in Las Vegas on unrelated business.

Even if UMC or one of Brace's doctors did something wrong, there likely will not be a lawsuit stemming from it.

Because UMC is a county-owned facility and because the surgeon of record was acting as an adjunct professor for the University of Nevada School of Medicine, there would be a state-mandated cap on any jury award - $50,000 from the hospital and $50,000 from the doctor.

Las Vegas attorney Gerry Gillock, who specializes in medical malpractice, says that he was contacted by someone from the British Consulate who inquired about such caps at UMC, which he confirmed. The cap on Nevada's private hospitals is $350,000, he says.

The consulate representative also told him Brace was on a respirator, Gillock says.

The Hudds say this visit has left deep scars.

"Over the years, we've been to Las Vegas 15 or 16 times, but at this moment we don't think we'll be coming back," David Hudd says.

"We feel a bit bitter. What has happened has left a nasty taste."

Sun reporter Mary Manning contributed to this story.

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