Subdural hematoma: physician obligated to inform FAA when patient is a pilot?

Very happy to see you back online; I'd been thinking about you. Thank you for keeping us posted. :)
 
Glad to hear you're on the road to recovery. Good luck & best wishes for a full and fast recovery!
 
I just wanted to thank everyone for the concern, well wishes, and overall respectful tone. A couple of nights ago I checked the parallel thread on the RB for the first time since being transferred to this facility. The contrast was night and day. There, I was accused of trolling, and was spoken of in condescending tones as someone who is not "right in the head", confused due to a brain injury. No less than Dr. Bruce himself pronounced my friend who was to send in my medical as "non-existent". I tried to set the record straight but my post, and a more detailed (and admittedly more critical) followup, did not appear.

POA, thanks again for being the more civilized, and more compassionate, of the two boards.
 
Unregistered said:
I just wanted to thank everyone for the concern, well wishes, and overall respectful tone. A couple of nights ago I checked the parallel thread on the RB for the first time since being transferred to this facility. The contrast was night and day. There, I was accused of trolling, and was spoken of in condescending tones as someone who is not "right in the head", confused due to a brain injury. No less than Dr. Bruce himself pronounced my friend who was to send in my medical as "non-existent". I tried to set the record straight but my post, and a more detailed (and admittedly more critical) followup, did not appear.

POA, thanks again for being the more civilized, and more compassionate, of the two boards.
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Okay I'm going to log in, to respond to this.
I have suggest that this poster comb my posts on the red board to find that statement. It doesn't exist.

If anyone is interested I have laid out the situation over there and won't trouble this readership. But there appear to be some cognitions issues in this poster's resentment, and a bit of an attack by an unreg, here..

http://forums.aopa.org/showthread.php?p=1842739#post1842739

So I say, glad you are better, but you have a long road ahead. So, why don't you sign up one of those $2,000 organizations to help you out....
 
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I think the post he referred to was the last pagraph of #71 in that thread. There may have been a context problem between what you were trying to say and how it was received.
 
Matthew said:
I think the post he referred to was the last pagraph of #71 in that thread. There may have been a context problem between what you were trying to say and how it was received.
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Correct, and I allowed for the possibility of a miscommunication in my last reply in that thread.

As far as Midlifeflyer's point in that thread about not taking advice, what advice am I not taking, other than opening myself up for more abuse by contacting Dr. Bruce privately? I will be in communication with my own AME once I have regained driving privileges. He is yet another first-rate difficult case AME and I've never known him to be abusive, though he doesn't moderate (or participate in) any internet boards.
 
I think it's a mistake to get too wrapped around the axle about what we believe other posters think about us. Defending our reputations seems kind of pointless when posting anonymously.
 
Not sure if this applies to the HIIPA rules we were discussing here but...

The commercial airline pilot got into an argument with Echols when he complained about the State of Heart Cardiology clinic. Echols subsequently told the patient he had been terminated as a patient of the clinic, and that she would be sending his medical records to the FAA. The pilot instructed her not to disclose the medical records, but Echols still sent them to the FAA against his wishes. According to the court documents, Echols disclosed the records with intent to cause malicious harm to the patient. Echols has also been charged with three counts of making false statements after lying to the Federal Bureau of Investigation.
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http://www.hipaajournal.com/texas-h...isclosure-of-patient-health-information-8223/

Hope you are doing well OP.
 
Everskyward said:
Not sure if this applies to the HIIPA rules we were discussing here but...



http://www.hipaajournal.com/texas-h...isclosure-of-patient-health-information-8223/
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OP here. Thanks for this info. I suspect Echols's record of fraud has much to do with her being so aggressively prosecuted in this. But it does call into question Dr. Bruce's assertion (I think it was on the Red Board) that HIPAA has no teeth.

I wonder what false statements she made to the FAA. Anyway she sounds like a really bad apple. I think my rehab director is simply misinformed, and a victim of bad legal advice. Hasten to add that I have no idea if he ever sent my information to the FAA, or still plans to when I am discharged to go home (see below).

Hope you are doing well OP.
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I've had my 3rd and final surgery (replacement of bone flap, removed two months ago due to infection) and am back at the first rehab center for a week. I'm scheduled to go home on Tuesday. All neurological symptoms have resolved. It will still be a long road to completely recover my life - I'm badly deconditioned from being mostly bedridden for 3 months. Forget about flying for now, a more immediate concern is driver rehabilitation (since I live in a state that requires it), for which the waiting list is several weeks long. In the meantime I will be largely housebound and dependent on private pay agencies for transportation to stores for necessities. :(
 
OP here. Testing the anon posting feature of the board. I tried to reply earlier to Everskyward. It appeared to be successful, but unless the rules have changed and mod approval is required now here, my post vanished into the ether.
 
Unregistered said:
OP here. Testing the anon posting feature of the board. I tried to reply earlier to Everskyward. It appeared to be successful, but unless the rules have changed and mod approval is required now here, my post vanished into the ether.
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This one worked, how are you doing?
 
Everskyward said:
Not sure if this applies to the HIIPA rules we were discussing here but...



http://www.hipaajournal.com/texas-h...isclosure-of-patient-health-information-8223/
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Okay, seems to be working.

Thanks for this info. I suspect that part of the reason Echols was prosecuted so aggressively is her record of fraud. She seems to be a real bad apple. My rehab director, on the other hand, is I think more likely a bit overzealous, but mainly misguided, a victim of bad legal advice.

I have no idea if he ever sent my info to the FAA, or still plans to, when I'm discharged to go home (see below).

Hope you are doing well OP.
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I've had my third and final surgery and am back at the original rehab facility, waiting to go home. Discharge is scheduled for next Tuesday. All neurological symptoms have resolved, and I'm mainly just very weak from deconditioning (mostly bedridden for 3 months). And I have a long road to put my life back together again. Forget about flying for now, I have to get through driver rehab first (I live in a state that requires it), and the waiting list for that service is several weeks long. In the meantime I will be dependent on private pay agencies for errands and transportation. :(
 
The rules HAVE changed (apparently). I tried to post again and this time noticed a message flashed on the screen saying the post wouldn't be visible until approved by a mod. Obviously some posts don't require moderation, not sure what the criteria are. (More than one paragraph? Quoted material?) Anyway my (two) posts should eventually appear, and I won't try to post again until someone clarifies what triggers moderation.
 
I am not sure why some posts end up in moderation and some don't, but I have approved your two posts.

Glad to hear that you are going home soon. Good luck with your recovery!
 
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To the OP:
I think you are beginning to see that recovery is a slow thing.

This is an FYI:
Reading from the FAA's internal certification reference:

"TBI (Traumatic Brain Injury, aka closed head injury:
The mandatory waiting periods before consideration are based on the severity of the TBI and risk of post-traumatic Epilepsy (PTE). Similarly the required work-upis based on the severity of the TBI. Consideration is predicated on both recovery of normal neurocognitive function and absence of aeromedically significant increased PTE risk. An applicant can have attained full recovery of normal neurocognitive function but sill have an unacceptably high risk of PTE and thus remain disqualified.

All Classes
Must demonstrate full function recovery, NO NEUROCOGNITIVE dysfunction and NO seizures after TBI....

...Neurocognitive testing is required if there is any clinical indication of cognitive dysfunction....."

...and if the director was going to try to report you, it's a good bet that's all over your record.

I'm sorry that anything BLUNT is perceived as "abuse", but you were just not getting this back in October. I think you've "got it" now. You have to drive first, before you can fly. And if you go for neurocognitive too early, even though "you feel fine" it's a waste of money and a return trip.

I have a fellow (a captain of industry, flew a turbine ship) who has felt just fine after his subdural, for a year....and did badly at neurocog at one year; He couldn't understand why he couldn't just get approved. He is is going back for a second swing this coming June. It will have been 2 years. The impairment is very very subtle, but consistently there, and he "feels fine". He can afford multiple $3,000 evaluations.

Just an FYI.
 
Unregistered said:
The rules HAVE changed (apparently). I tried to post again and this time noticed a message flashed on the screen saying the post wouldn't be visible until approved by a mod. Obviously some posts don't require moderation, not sure what the criteria are. (More than one paragraph? Quoted material?) Anyway my (two) posts should eventually appear, and I won't try to post again until someone clarifies what triggers moderation.
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I think I might have figured out what triggers the moderation. Try not posting any links, even ones from quoted posts. I noticed that you quoted me both times in the posts which ended up in moderation, and my post had a link.
 
Dr. Bruce: thanks for the info. What would be appreciated even more would be if you could give pointers on how I can know when I am ready for the testing. Are there "practice tests" one can take?

p.s. I don't know why you think there was something I didn't "get" back in October. I have NEVER thought that it would be a cakewalk, or that I could avoid the neurocog testing or jump back into flying after a couple of months. I don't know what my "score" is in regard to PTE risk or how it is assessed, but I never had a seizure. This time around the SLP therapists are putting me through the wringer with cognitive tests and they say I'm "doing very well" on them. But I have no idea how these tests compare to the ones required by the FAA, nor do I know my numeric score on this battery, though I'm sure I could get it.
 
Everskyward said:
I think I might have figured out what triggers the moderation. Try not posting any links, even ones from quoted posts. I noticed that you quoted me both times in the posts which ended up in moderation, and my post had a link.
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Thanks.
 
This depends on
(1) How you interview
(2) Whether or not your "update" MRI has any hemosiderosis. You have to ask the radiologists specifically to look fo that.
(3) a short cognitive battery such as a "Colorado" which is an office test.
(4) Opinion of the neurologist.
(5) Whether or not you had any distortion of the central ventricles due to the hematoma (If so, Unlikely ready within a year).
 
A reminder to all, especially to the person whose post I just deleted. The Rules of Conduct regarding anonymous or guest posting still applies even though guest users now need to make up some sort of user name.

  • Pilots of America permits anonymous posting in the Medical Topics forum, as well as in the Lessons Learned forum, but ONLY when disclosing your OWN potential or existing medical condition, potential violation of FAA regulations, incident or accident in which you may have been involved. Posts made anonymously in response to such posts will be deleted unless the content of the response requires anonymity.
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Get a letter from the surgeon and the inpatient rehab doctor.

The rehab manager has no say once an MD has signed off on the release. A manager has no MD (or DO) behind their name and no say if the physician says you are OK.

When my wife operates on a pilot, we issue a letter stating they are released from care.

If they have further questions, their AME talks to her.

I have not seen a pilot not be able to fly once this has happened.
 
Two years of nursery school and they think they know everything.
 
flyingron said:
Two years of nursery school and they think they know everything.
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I still like the coffee mug you found and shared with Dr. Bruce the AOPA board.

Google-doctor-mug-300x300.jpg
 
Bruce has two of those cups now. I bought him one not realizing that he went out and bought one when I made that post.

The nursery school quote comes from this:
 
I saw thus thread and I could get some advice from you guys and gala out there. Like the OP I have found my self in similar a situation ...except I was actually reported to the FAA. I am an airline pilot and was in a car accident. I was knocked out and I did suffer from vertigo and headaches for the first month. My final diagnosis was post concussive disorder secondary MVA. After my initial ER visit the treating physician reported me to the FAA. To be clear this asshat was not a neurologist but an internal medicine Doc. Needless to say I'm more than livid! I didn't even get the chance to see a neurologist let alone self ground! I've since been cleared as fit to fly by a neurologist and have had several tests saying I'm ok... CT, EEG, MRA. I'm now wrapped up in read tape and waiting on the FAA. It's this improper reporting that has me held up. If I had reported this as required it wouldn't have been an issue. My problem is that I can't prove who actually reported me. There are three doctors names that are on my discharge paperwork. On top of the the HIPPA guy at the hospital wants prof the leak came from there. Besides the obvious dates and it's the only hospital I was seen at I have nothing. I put in a FOIA request for info but there is a statute of limitations. Since this is my career I will throw as much money at this as needed. Any advice? I live in San Diego and am having a hard time finding a lawyer that is knowledgeable on HIPPA and the FAA. Any advice is appreciated!
 
Unregistered said:
My question though is in regards to the rehab agency director's stated intention to inform the FAA of my medical condition, against my express wishes, because he happens to know that I am a private pilot (3rd class med cert only). He claims that the rehab agency's lawyers have counseled him to do just that (though he apparently made some initial anonymous inquiries to the FAA on his own). I am furious because I do not want to have to deal with this now, indeed want to leave the Sport Pilot option open. My understanding is that if OKC demands my certificate, that is effectively a denial or at least a revocation, and forecloses the Sport Pilot option. But even if I decide to pursue recertification, I have no desire at this time to engage in any kind of back and forth with OKC. I would like to work on my health first and worry about flying later.
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How does he happen to know? Is it their policy to check whether each patient is a pilot?
 
I don't remember anything from that day. Nothing but I was probably asked and told them. This is where honestly bites you in the ass...My mistake, I've been hurt much worse in the past and it's never been an issue. This occurred at a Navy Hospital so I think this Dr thought it was like the Navy where you report every bump and bruise to the flight surgeon.
 
Glad you are ok after what sounds like a very serious accident. I guess my first question for you is are you sure it was the doc who reported you and not a concerned coworker or relative or other therapist? Second question is that considering that you are caught up in the system now what benefit is there in finding out who reported you other than getting payback somehow? I can't see how that will help your medical and I doubt you would get anywhere if you sued. I would let it go. I'm thinking that you do require some medical certification help and there is a guy, a doctor, who occasionally checks out this board and runs the AOPA medical forum who specializes in helping people like you to get through this. He will advocate for you with the FAA and will tell you what you need to have to get re-certified. Were I you I would call him or contact him directly, give him your details, pay his fee, which I think is quite reasonable, and follow his advice to a tee, even if you don't like what he says, listen to him, he's done this many, many times before and will get you through if that is possible. His name is Dr Bruce Chien, Senior AME and you can find him here: http://www.aeromedicaldoc.com/ I hope you are successful getting your medical back.
 
My biggest take-away of this thread is if I'm ever in need of medical attention then I should hide the fact that I'm a pilot. I'm considering burying my cert in my wallet so it's not easy to find if I end up in the ER.
 
You're prob grounded regardless of what the rehab facility does until you get the FAA AMD what they need - thats a medical certification question from Dr. Bruce.

Now, legally, others have pointed this out - you simply present a letter to the Rehab agency which says in substance:

"I have been informed by [name, date] that your firm has decided to notify the FAA of my medical condition. This is clear violation of a) your patient privacy practices presented to me, b) HIPAA and c) the medical privacy rules pertaining to your license in the State of X. I revoke any consent you may believe you have concerning disclose of my protected medical information to any third party. If you wish to craft another HIPAA release limited solely to my treating physicians and my insurer, please feel free to do so. Any violation of my medical privacy rights will be protected to the fullest extent of the law. "

Then, you're gonna need a need a new rehab center because they will kick you out. After that, you file a complaint with the state licensing agency - -- and you'll prob need a lawyer to pursue the HIPAA violation.
 
Note that there are two posters involved here, the OP who started the thread, and Crazyaviatrix who resurrected it.
 
comanchepilot said:
You're prob grounded regardless of what the rehab facility does until you get the FAA AMD what they need - thats a medical certification question from Dr. Bruce.

Now, legally, others have pointed this out - you simply present a letter to the Rehab agency which says in substance:

"I have been informed by [name, date] that your firm has decided to notify the FAA of my medical condition. This is clear violation of a) your patient privacy practices presented to me, b) HIPAA and c) the medical privacy rules pertaining to your license in the State of X. I revoke any consent you may believe you have concerning disclose of my protected medical information to any third party. If you wish to craft another HIPAA release limited solely to my treating physicians and my insurer, please feel free to do so. Any violation of my medical privacy rights will be protected to the fullest extent of the law. "

Then, you're gonna need a need a new rehab center because they will kick you out. After that, you file a complaint with the state licensing agency - -- and you'll prob need a lawyer to pursue the HIPAA violation.
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Wow! That certainly would get their attention!
 
PaulS said:
Glad you are ok after what sounds like a very serious accident. I guess my first question for you is are you sure it was the doc who reported you and not a concerned coworker or relative or other therapist? Second question is that considering that you are caught up in the system now what benefit is there in finding out who reported you other than getting payback somehow? I can't see how that will help your medical and I doubt you would get anywhere if you sued. I would let it go. I'm thinking that you do require some medical certification help and there is a guy, a doctor, who occasionally checks out this board and runs the AOPA medical forum who specializes in helping people like you to get through this. He will advocate for you with the FAA and will tell you what you need to have to get re-certified. Were I you I would call him or contact him directly, give him your details, pay his fee, which I think is quite reasonable, and follow his advice to a tee, even if you don't like what he says, listen to him, he's done this many, many times before and will get you through if that is possible. His name is Dr Bruce Chien, Senior AME and you can find him here: http://www.aeromedicaldoc.com/ I hope you are successful getting your medical back.
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Thanks for your response. Yes, It was the Dr. I verified this in conversations with the FAA medical . I'm fine, I've been fine . This accident was back in Aug 5th and I was reported to the FAA on the 5th. They said in their report they were the treating physician. I've verified this in conversations with the regular Flight Surgeon in LA. I've been out of work since Aug and have lossed about $42,000 in lost wages so I'm not about to let this go. Especially since this is still on going. I appreciate everyone recommending Dr Bruce but it's not necessary. I have union representation and their medical personnel but they can't fix what was done before I even stepped out of the ER. Again,I have to stress that I've been found fit to fly by several tests and a neurologist. This disclosure has hurt me just because it was done. My AME and the union guys all day it was inappropriate, unwarranted, and a HIPPA Violation. With that said I'm looking for legal help.
 
MassPilot said:
My biggest take-away of this thread is if I'm ever in need of medical attention then I should hide the fact that I'm a pilot. I'm considering burying my cert in my wallet so it's not easy to find if I end up in the ER.
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I'm not sure that's the best idea, most of the doctors I've run into
Crazyaviatrix said:
Thanks for your response. Yes, It was the Dr. I verified this in conversations with the FAA medical . I'm fine, I've been fine . This accident was back in Aug 5th and I was reported to the FAA on the 5th. They said in their report they were the treating physician. I've verified this in conversations with the regular Flight Surgeon in LA. I've been out of work since Aug and have lossed about $42,000 in lost wages so I'm not about to let this go. Especially since this is still on going. I appreciate everyone recommending Dr Bruce but it's not necessary. I have union representation and their medical personnel but they can't fix what was done before I even stepped out of the ER. Again,I have to stress that I've been found fit to fly by several tests and a neurologist. This disclosure has hurt me just because it was done. My AME and the union guys all day it was inappropriate, unwarranted, and a HIPPA Violation. With that said I'm looking for legal help.
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Well, that's terrible and I hope you can recover some of your loss and get back to flying soon.
 
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