By Walter F. Roche Jr. | The Tennessean
Sitting at her dining room table, 61-year-old Amarjit Deol sorts through a mountain of bills and medical records, all the result of her bout with fungal meningitis.
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Continuing coverage of the fungal meningitis outbreak
Released from the hospital in January, Deol is weak and can walk only with the aid of a walker.
"My legs won't hold me," she says.
Amid the bills is a notice that Medicare will not pay for an MRI that her doctors say is needed to determine whether she has a lingering spinal infection at the site where she was injected last fall with a fungus-tainted steroid. The notice says she has exceeded a limit on those services.
The bills include her copay charges on dozens of prescription drugs and a notice from Medicare that it has processed hospital and doctor bills totaling more than $66,000, with $62,875 going to Saint Thomas Hospital, where she was a patient for some seven weeks. Still other bills went to her private insurance company.
Deol is one of dozens of area residents who face continuing health problems and mounting expenses from the fungal meningitis outbreak more than six months after it began.
While some of the local victims say they no longer need to take powerful antifungal medications, others, like Deol, are still ailing. All say they don't know when, if ever, they will be completely free of any aftereffects. While more than a dozen have filed lawsuits, most have been put on hold because the supplier of the tainted drugs filed for bankruptcy late last year.
Billing statements reviewed by The Tennessean for three patients show the amounts charged for treatment and hospitalization ranged from Deol's $66,000 partial bill to nearly $200,000.
Charges for the antifungal drug ambisome were $8,000 per treatment, with some hospitalized patients getting three treatments per day.
Rebecca Climer, spokeswoman for Saint Thomas Health, said the hospital has been billing the insurance companies or other third-party payers for the fungal meningitis patients as is its normal practice.
"Any one of these patients who cannot afford the care that was provided to them will be considered for financial assistance consistent with our charitable policies. In many cases, the Saint Thomas Hospital Care Management team assisted patients with securing payment for needed medications, including working with the manufacturer of the medication to obtain the medication at a reduced cost to the patient," Climer said in response to questions.
A decidedly different view was expressed by one of the attorneys representing outbreak victims.
"For the people who got sick from tainted injections at Saint Thomas, Saint Thomas is now charging tens of thousands of dollars to treat them," said Mark Chalos, a Nashville attorney representing some of the victims.
Saint Thomas Outpatient Neurosurgical Center, half-owned by Saint Thomas Network, was one of three Tennessee clinics that received shipments of fungus-contaminated steroid last year from the New England Compounding Center in Massachusetts.
Chalos charged that the clinic put profits over patient safety by buying the cheapest medicine for $6.50 a dose and then charging those getting the shots $1,000 or more.
Asked to respond for the clinic, spokesman Scott Butler said, "It is inappropriate at this time to comment on this ongoing litigation except to say that the health care providers at Saint Thomas Outpatient Neurosurgical Center always put patient safety first. The providers never put profits over patient safety. Period."
Recovery takes time
Randy Kinnard, an attorney who represents several victims or their survivors, said some of his firm's clients have been able to stop the antifungals, and for some of those, their fatigue level has decreased.
"Others feel no different. It will take a while before this medicine is completely out of their systems. Most of our clients, however, are still on the antifungal medicine and feel very tired," Kinnard said.
"As for bills, that varies. Most are paying something for the antifungal medicine, from a copay to thousands of dollars."
And the fees don't end with hospitalization.
Dennis O'Brien of Jamestown, one of the victims, says the drug treatment and home care bills have reached as much as $7,000 per month.
Janet Peay of Nashville has been recording the bills for doctor visits and prescription drugs, which now total nearly $50,000. That amount does not include the bills for her hospitalizations, which she said she has yet to receive. She was hospitalized three times for a total of 28 days.
But Peay, unlike Deol, is faring much better in a more important category: her health.
Peay says recent tests showed no trace of meningitis and she is no longer taking any medication.
"I can drive again," she said.
Peay, however, is not pain-free. She still suffers the severe back pain that led her to get the steroid shots in the first place.
O'Brien, too, says his underlying back pain problems have returned and worsened.
"I may be in worse shape now than before the shots. It feels like it's shooting bullets," he said, describing the pain that radiates from his side to his legs.
O'Brien says he has trouble performing routine tasks such as buttoning his clothes or tying his shoes.
"I'm better from the fungal meningitis, but I've gone downhill. Every day is hard. The quality of life is not good. But," he adds, "I've got a lot of faith in God."
Deol said she was told she could not be released from Saint Thomas Hospital until she came up with $950 for a supply of the drugs needed for her treatment at home.
"I told them I cannot afford all those bills," she said. She eventually came up with about one-third of the original request and won her release.
Deol, who had undergone three back surgeries, sought relief from back pain last fall by getting injections of methylprednisolone acetate at Saint Thomas Outpatient Neurosurgical Center.
After the first shot on Sept. 7, she said she began to feel weakness in her legs, but her doctor told her she should go ahead with a second treatment scheduled for Sept. 20.
After the second shot, she began to feel nauseated and weak.
"I was losing my balance," Deol said.
Not long after that, she got a phone call telling her that she might have been injected with a vial of medicine tainted with a fungus.
Three times, feeling weak and sick, Deol made the trek to the hospital for testing. Each time she was told she did not have meningitis.
After a fall while taking a family member to a clinic, Deol and her husband became more worried. She returned to the hospital for yet another round of tests.
"They called me back and told me to go straight to the hospital," she said.
The antifungal treatments brought her misery to the next level.
"I started losing my eyesight. Everything seemed to be falling," she said. "I was hallucinating. The medicine was making me very sick."
At one point, she said, she lost her sight completely and her blood pressure peaked to dangerous levels.
Still later, she said, she was rushed to the intensive-care unit when she appeared to be suffering heart failure.
Deol said she was finally released from the hospital in mid-January. She now takes oral antifungal medication, itraconazole.
She said she still cannot read because of vision problems, and doctors say they don't know when or if she will fully recover. She is appealing Medicare's notice that it will not pay for an MRI.
Although Deol has not filed a lawsuit, the notice she received last week from Medicare states that should she win a suit, Medicare will seek to recover its payments from any award.