By Lou Anne Epperley, DVM
For Veterinary Practice News
Iwas about to enter the exam room to vaccinate a woman’s cat. I had accidentally declawed it two
years earlier. Despite believing I’d made peace with a
bad mistake and its aftermath, the prospect of facing
the client again had me quaking with anxiety.
I opened the door and looked her straight in the
eyes. Besides the cat, she had brought a dog to be
vaccinated. With a straight face and without a word,
I looked carefully at the paperwork, removed the cat
from the carrier, vaccinated it, replaced the cat, then
vaccinated the dog.
My hands were shaking very hard, and I hoped it
wasn’t noticeable. Neither of us spoke. Then I left the
room and closed the door.
Billy Joel, the Piano Man, is one of my favorite rock
This story brings to mind these words from one of
Just like a boxer in a title fight, you’ve got to walk
in that ring all alone. You aren’t the only one to make
mistakes, but they’re the only thing that you can truly
call your own.
End of story.
Thanks to everybody who took the time to weigh in.
When I get up every morning, I look forward to what
I’m going to learn that day. ;
SOME READER REACTIONS:
You made your bed …
I feel that you are blaming the client for her reaction
to the situation you created.
Obviously you made a mistake; you’re human, it
happens. Your initial response in explaining to the
owner what happened was correct. If it were me, I
would only add a new protocol so a similar situation
would not happen again.
The owner’s initial reaction is understandable given
that she was morally opposed to declawing. In our li-
tigious society, I would say her later response
She wasn’t sure what was going to happen
Adam Staff, DVM
with her cat’s health. Would she need fol-
low-up care? Would there be complications,
Your reaction to her returning to your
clinic is a bit of a surprise to me. The cli-
ent decided not to pursue any complaints
or litigation against you. Yet after two
years you feel angry that she has re-
turned to your clinic for services? You
should be a little more grateful toward
this person. You should walk into the
exam room, acknowledge who she is
and what happened, and move on with
Déjà vu all over again
I read your article about “Lucretia” with a sense of
deja vu and relief. I had a similar experience five years
back. In my case it was two black cats named Midnight, and only one of them was to be declawed.
I had a similar response from the clients, too. I
made very sure I owned the problem. I told them that I
would like to make it up to them and I vaccinated two
of their other animals for free, and they were mollified
if not thoroughly appeased.
When I have problems on my watch, I seek first to
make it right with the owners, and second, to ensure
it never happens again. In this case, I instituted two
Every animal that is to have surgery has two pieces
of masking tape listing its name and all procedures to
be performed. One tape stays on its cage, and the oth-
er goes on the animal’s forehead when anesthetized.
This also ensures that the right black cat gets back to
the right cage.
; Every single time I perform a declaw, I double
check the tape to make sure I have the correct animal.
I also count to make sure I have five (or more) claws
per foot, but that’s another story.
; Every time I have two animals with the same first
name—it happens surprisingly often—I make sure to
identify them by first and last name, and I always try
to do surgery on the smallest one first, to preclude the
possibility of ugly anesthetic mistakes as well. Really,
if you can imagine the remote possibility of an error, it
can crop up some day.
I would have done
much as you did. I would
not have batted an eye
to see her two years later. I would have seen it
as either a sign that she
decided to trust me after
all, or that she just liked
to complain but not follow through.
Really, she was within
her rights to consider complaining to someone. She
took a somewhat venal approach to her grumbling,
which ultimately was probably less trouble than had
she reported it to the Board. We make honest mis-
takes, we weather them, and we try to limit them.
I was pleased to see you put this in print. I myself
am not feeling that brave at this time; I would prefer
you print it as anonymous.
Name withheld by request
‘Sorry, we can’t help you’
I got an emergency call from our boarding kennel
manager that two dogs had gotten in a fight through
their chain link kennels and needed medical attention.
One dog was a client’s Labrador with mild bruising
and swelling. The other dog was a pit bull temporarily
living at the boarding kennel waiting for adoption.
I came in immediately and assessed both dogs. The
pit bull had two minor lacerations on her face and the
Lab had bruising, but no significant punctures. The
owner was contacted and came into the clinic to visit
her dog. I administered pain medicine and SubQ fluids
and explained all of this to the owner. I told her that
the next day we would sedate and shave the dog to
further examine for any puncture wounds.
The next day, the dog was happy and appeared
normal, but I sedated as discussed and began to shave
the neck. At that time, the owner showed up and demanded her dog be returned to her so she could go see
another vet. I explained that she was sedated on the
table right now, but the owner insisted.
So I stopped what I was doing, gave a reversal
agent and printed out a full history to send with the
dog to the next veterinarian. My feelings were sincerely hurt, as I had spent a lot of time with these owners
and felt like I had been communicating very well.
A month later, the state veterinary board informed
Adam Staff, DVM
Decla w ing cats is my least-favorite elective sur- gery, but because my employer offers it, I long ago made up my mind to become very good at it and use the maximum possible pain medication that would be safe for the patient. Since our practice has an age and weight limit on declaw surgery, many patients pres- ent for simultaneous spay and declaw procedures. T wo years ago, I accidentally declawed an 8-month-old, 5-pound kitten that was at the clinic for only a spay. When I began entering the surgeries into the comput- er, the surgery consent form stared back at me with the sim- ple word SPAY. I gasped. No amount of squinting at the line or fiddling with the paper’s angle would change the fact: I made a mistake, the claws were in the wastebasket, and I had to cowgirl up and eat a slice of humble pie. Taking a deep breath, I called the client and put my cards on the table. I apologized, explained our pain manage- ment protocol and told her I would send home a bag of spe- cial cat litter used for declaw patients, all at my expense. Lucretia (not her real name) took the news well, and by the way, she asked if the kit- ten seemed physically sound.
It seemed her toddler daughter had been a little rough with the kitten after it had scratched her. I told her I hadn’t noticed anything amiss, and hung up feeling grateful and relieved. Maybe I’d done them a favor. Taking Responsibility When Lucretia arrived to pick up the kitten, I reviewed her home-care instructions, again emphasized our pain-con- trol policy and told her how sorry I was and that her un- derstanding was deeply appre- ciated. While we spoke, I be- came aware of an older woman with a small child nearby who seemed to be eavesdropping. I later learned they were Lucre- tia’s mother and child. I returned to my office, shaky but fairly confident I’d dodged a bullet.
But about 20 minutes later, a staff member reported that he moment I was out of sight, Lucretia, flanked by her mother, was appealing to the reception- ists for information on who to report the incident to to request compensation for damages. She said she believed declawing was inhumane. Betrayal is powerful and sharp. I was hurt and angry. If that was how she felt, why allow me to believe my mistake was forgiven? I sought out my bosses and told my story. Sure enough, Lucretia called shortly and informed them she wanted a monetary settlement for the un- wanted declaw surgery. They were surprised at my error, and a bit nonplussed at her demand. I called my veterinary malprac-
tice insurance representative to start a case file. He instructed me to refer Lucretia to him for further discussion, and told me it was unlikely the company would pay a claim on a correctly per- formed surgery for which the client was not charged. If it had been a show animal, he said, the client might have had grounds for compensation. At least I had allies, but I was taking this hard. It’s easy to forget that a first-time client would have no way of knowing my true character and inten- tions. I felt humiliated. The next day, Lucretia showed up at the front desk with the patient and another woman. She said she needed help removing one of the ban- dages. I invited them to the exam room, took the kitten to the back, deftly removed the bandage and returned.
I offered another pain injection for the kitten. “Oh, do you think she’s in pain?” she asked. Why did I get the feeling that anything I said could and would be used against me? “I don’t know,” I said, “but I told you yesterday I’d be glad to give a pain injection if you wanted me to. By the way, I have contacted my malpractice insurance company about the surgery,” I added. Then her companion jumped in. “Oh, we’re not trying to get anyone in trouble,” she said. “We just …” “Of course you aren’t,” I smiled.
Lucretia then asked if she
could have the bandage I’d just removed from the paw, “just in case I need it later.” I gazed at her, probably a little longer than normal, then nodded and produced the bandage in a Zip- loc bag. “Call me if you need me.” I bade her goodbye with a clench-toothed smile. And that’s the last I saw of Lucretia and her declawed kitten. She called my bosses a couple more times to ask for money, which they did not pay, but failed to follow through with her malpractice claim.
Later On … Fast-forward two years lat- er: During a vaccination clinic, I heard Lucretia checking in. Was that who I thought it was? I quickly called up the name in the com- puter and it all came
flooding back. Suddenly I was trembling with anger. Could I refuse service to her? The women at the desk were checking in her declawed cat and a dog, calmly and efficient- ly processing the paperwork with no idea of the back story. I looked around for some- one to turn to. What to say? How to behave? I hoped Lucre- tia couldn’t see how hard my hands were shaking as I turned the knob and entered the room. OK, my veterinary colleagues. I know what I did. But I’d like to know what you’d have done, faced with this situation. Please e-mail your thoughts, and we will print as many as we can, plus the rest of this story.●
Lou Anne Epperley, DVM, may be emailed in care of VPNEditor@ i5publishing.com. Put “Dr. Epperley” in the subjectline.
32 l Veterinary Practice News l September 2013
What would you do?
;;;; ; ;;;;;;;;;; ; ;;;;;;; ; ;;; Circle No. 137 on Reader Service Card
Circle No.130 on Reader Service Card
Facing up to the past after an accidental surgery Betrayal is powerful and sharp. I was hurt and angry. If that was how she felt, why allow me to believe my mistake was forgiven?
10/9/13 1:08 PM
The rest of the story
PracticeManagement 36 l Veterinary Practice News l November 2013 VeterinaryPracticeNews.com
In the September issue of Veterinary Practice
News, Dr. Epperley wrote about an incident in
which she discovered that she had mistakenly declawed and spayed a cat that was in for sterilization
only. She apologized to the client, who appeared
to take it well, but who later asked staff who she
could report the incident to.
Two years later, at a vaccination clinic Dr. Epperley was working, she heard the client’s voice
and froze. She asked readers: What would you
Anyone who has been practicing
long enough has at least one
horror story, even if they are very,
—Cindy Wade, DVM