[From the Gringo Gazette and TripAdvisor website.]
And is still alive
Folks, you have got to stop pitching yourselves over the railings of balconies. This spring break we had two deaths by falling off hotel balconies, and now Charles Sights, from California, has sustained major injuries from falling from a fourth floor balcony at the Bahia in Cabo San Lucas. Amazingly, he lived through it, but with major injuries. And with major trauma between his family and St Lukes hospital where he was taken by ambulance. He was diagnosed with collapsed lungs, five broken vertebrae and four broken ribs, liver laceration, kidney and intestinal issues.
The hospital demanded prepayment up front, so his girlfriend offered up Sights’ credit card she took out of his shorts he was wearing. The hospital sucked $4,078 off that and explained there was internal bleeding, they would have to operate to stop the flow, and $10,000 more was needed. Sights had travelers insurance that covered up to $10,000 of emergency medical and that was offered up next. Carmen Spoerer, Sights’ girlfriend called his Blue Shield carrier and was told they had to pay the Mexican hospital upfront and then apply for reimbursement. Of course, by this time they were tapped out and had no more upfront money.
“Mario Trejo, the hospital administrator, kept demanding more money until we literally were screaming and crying that was he just going to let him die over money?” recounted Spoerer later. “My friend Terry was there and they tried to authorize his card for all they could get which was about $2000.” However his card was never charged). Eventually St Lukes went ahead with the surgery without payment. According to Spoerer, after the surgery Trejo asked for an additional $50,000 U.S., telling them to call everyone they knew and ask for money. “We asked him to be reasonable,” said Spoerer. We were expecting about $15,000 as we understand this was a serious injury requiring surgery. But who has $50,000? Or even that kind of credit card limit? But he would not budge and the staff at the desk was unhelpful. Twice I asked to have them let Allianz fax or email me the application for air evac to get the ball rolling. They told me they didn’t have a fax and that they could not open the email.
I had to leave, go to the Bahia, and complete the forms and fax them. I also called both my credit card companies trying to get a higher limit. Almost right after they received the fax, Allianz told me they authorized him to be air lifted out of Mexico. We were so excited. We went back to the hospital; however Mario would not medically release him to travel unless we paid the $50,000.”
An attorney was called, as was the American consulate, which infuriated Trejo according to Spoerer, but it did push him into negotiating. “It was at that meeting that it became apparent why Trejo believed he could get $50,000 from us”, said Spoerer. “He told me he that originally Allianz had given a guarantee of $50,000. I said yes but the policy was only $10,000. He said oh, no it was “open”. I said no, look at the policy card I gave you. It clearly states $10,000 limit. It had $50,000 as emergency evacuation and I think that is what he saw and miss read.”
“He then said he would “ask about a discount” It was now about 8 or 9 pm. He came back about an hour later and offered 15 percent off, making it still out of reach. I begged him to reconsider. He then said he would go back and ask, (ask who, I don’t know) if they could go lower. I told him he needed to get back ASAP as I had to let Allianz know about the air evac. He came back and offered us somewhere around $32000. We told him we could get $17000 plus the $4,078 he already charged the card. He said that would be ok.” But when Sights’ mother called the hospital with her credit card number, the staff could not get the cards run correctly, however they kept trying for more than an hour. Trying so many times, they had created a fraud issue and despite the mother telling them they had to fix it on their end they wouldn’t believe her. Finally the mother got Chase bank and the staff on the line and they got it run. It was about 3 am Saturday morning, 24 hours after being admitted into the hospital. They thought they were home free, not knowing a doctor’s permission was needed for a patient to be evacuated.
“Finally Mario seemed to grow exhausted, and snapped at us to ‘just take him.’ We thought we were home free,” said Spoerer. But some other Mexican walked up and said he could fly Sights out right now. When told no thank you, that there was a U.S. team coming, they were told by Trejo that waiting time would incur costs. Spoerer frantically contacted Allianz, begging them to hurry and were told the plane was on its way, and it was. He was finally flown home. Total paid: $22,000 for treatment. According to Spoerer, Sights has developed a seven inch abscess that American doctors are trying to tame, and Spoerer believes he is infected due to the surgery in Mexico because she saw some nurses chatting on cell phones while they were attending him in intensive care. From the United States, she told this paper that his pancreas was nicked during the spleen removal, and he has a staph infection that will require a stent. He’s being moved to Stanford University for this procedure.
“I have been travelling to Cabo for more than 17 years,” says Spoerer, “I had heard of this kind of thing but it’s another story when it happens to you. We thought we had covered our ass: we had a primary insurance and traveler’s insurance. We were careful. We are law abiding citizens. We treat everyone with respect and have been extremely generous with tips to everyone as we have been in the service industry ourselves. If we hadn’t been in a large group with resources we would be bringing my boyfriend home in a casket. Needless to say not one in our group of 12 will ever return to Cabo San Lucas again.
When contacted for the hospital’s explanation of this unfortunate issue, hospital administrator Mario Trejo had this to say: I am so sorry to hear about the accident Mr. Sights had while he and his family were on vacation. Regardless of how it happened, thank goodness he is OK and home to recover around friends and family. Accidents are not programmed and expected, and we have to have the culture to buy travel insurance and for it to have good coverage. I am a local resident living in Cabo so I have some insight as to why the hospital payment was due prior to his release. This is the practice not only here in Cabo, but in all of Mexico.
St Lukes accepts direct payment from the insurance companies worldwide, but in this case the policy would not pay outside the United States. This is not something our hospital has any control over. It is up to the injured to have a policy that will pay outside the country if they are going to travel outside the country. I agree, what person has access to $20,000 to $50,000 to prepay? That is insane, right? However, the Mexican hospitals, and hospitals in most other countries, (including the U.S.A.,) require pre-payment otherwise travelers return home and the bills are never paid. Hospitals, physicians and providers have to be paid. It is not fair for everyone who did everything in their hands to save your life and then you go behind them and say they did nothing well but expect money. Yes this is a business also. Everyone works and expects to get paid so I can assure you that when a Mexican person experiences these situations, or have some kind of emergency, we do
everything that is in our hands to pay our bills. Yes hospitals are indeed here to stabilize you and save your life, but there is no law that says we are not entitled to get paid and to charge for services. Our hospital every day helps the local community, helping patients who really need help. And we donate services as charity every day but not to abusive family members like these that try to take advantage after someone has saved their loved one’s life. Think about how many bills would go unpaid if the hospital had the attitude “you can pay us when you get home.” Are there still honest people out there that would follow through and pay? Yes. Would most? No. Because of this, these policies are in place in tourist destinations. I can only imagine what the bill would have been had those procedures been provided in the U.S. Much more than $21,000.
This is because we do not have a broken medical system here and there aren’t insurance companies and lawyers involved at every turn. There are a lot of foreign patients who have to pay at the time services are rendered. Your advice to beware is great advice for all traveling to any foreign country, not just Cabo. The coverage you have at home is not the coverage you have once you leave the U.S. and that is not the Mexican hospitals’, doctors’ or providers’ fault. I’m surprised anyone would leave their country without better travel insurance. Health insurance companies are bad enough about covering things in their own country, let alone an in entirely different country. The problem is foreigners are used to paying zero for healthcare, period. The costs in Mexico are decent. The costs for the same services in the U.S. would have been four times or more! The patient had five fractured ribs, fractured vertebras, both lungs were hemo-thoraxed and he required chest tubes. We gave him immediate emergency surgery, intensive care, did CT scans throughout almost all of his body, gave him ultrasound, gave him many blood transfusions, and much more. The patient was brought into the operating room in hypovolemic shock caused by the enormous amount of blood loss from the spleen injury. The spleen had to be removed. The tail of the pancreas was inspected visually and a drain was left in
place, no further intraoperative testing was done as he was still recovering from shock. All these decisions were well defined and based on current standards of care according to the American College of Surgeons. He was after surveillance and testing, he was discharged home apparently with no outstanding issues.
Pancreatic fistulas are within the spectrum of possible complications from a splenectomy, however, because of his condition, there were few options to pursue. Knowing that a complication might arise from a life threatening condition prompts a good doctor to treat the condition accordingly; attempting to avoid complications but aware these might arise. Considering a life saving surgery a “bad” surgery could not be completely accurate given the setting. If the pancreas would have been injured during an elective procedure then we could probably give it such a name. In general, patients who have had splenectomies are prone to infections if not vaccinated, but we did not have the opportunity to do so because CDC recommendations are to provide vaccination 14 days after surgery. We must also consider that he was in two hospitals prior to this infection and it is very difficult to pinpoint the source of the infection.
This gentleman fell four stories and we saved him. Had we not done the correct things he would not have lived. His risk of incurring some infection and complications due to all the procedures he underwent, was high to begin with, but we plunged in anyway, saved his life, stabilized him, and then asked for what we feel was a reasonable fee. We all here at St Lukes hope all is well with Mr. Sights and he has a full recovery. We are proud of what we did to save him.
Here is what a Mexican doctor living and working in Cabo San Lucas had to say about all this:
I also live here in Cabo and work as a doctor, first of all, I have to say that Mario and his associates are crooks, they always do the same thing with patients. He is only looking for money and his hospital is not even finished, not to mention how he handles payments to doctors. While he collects the patients money, he pays doctors 3 months later and sometimes half of what he charged. For example, if a doctor does a procedure on a patient, the doctor charges 5, he modifies it to 10 and then pays The doctor 5 minus 20% of commission.
On The other hand you have to understand that If you do not charge some patients up front, then patients are discharged and you never hear from them again and never get paid, i can tell you I have that happened many times to me.
The problem here was that the hospital did not deal with The insurance company from the start, again, that is because the hospital and their managers always want the money right away, which is not right I know, since insurance companies take like a month or so to pay the hospital. The patient is not to blame for this and he or she does not even know that.
Bottom line, don’t go there. Their way of working and their staff are very unprofessional and not well qualified, most of their staff have been working and fired from other hospitals in the area, trust me I know that.