Hey, just letting you know that I submitted my case to the Oregon board last Friday. Also to the FTC. The board said it would likely take a couple weeks, as he has a backlog of cases and it's a 20 hr/wk position.
Also, got a partial refund from Banfield for the deep wound repair/antibiotic treatment that wasn't done, as well as all the money for sedation they didn't do. However, they are claiming they DID take an abdominal fluid sample still, and that it was documented somewhere in the records they sent me?! So I am not being refunded for the histopathology/cytology interpretation fee also.
Oddly enough, he surely didn't state the color of the fluid, or actually go into any specifics regarding taking this fluid sample with me. All I see is that he documented her to have a high protein level (300) & mild leukocytes:exudate ....is that all that is entailed in a cytology/histopathy report is just stating your findings? I want to know what color that fluid was and if he did the Rivalta test, or what? I know you don't know....just thinking outloud. Regardless that the protein level was indicative of FIP, or maybe it was ALSO indicative of heart disease?!?! ... and the fact that abdominal fluid/pleural effusion existed he had nothing else to go off of. The 2nd vet said "it would certainly not have been the 1st conclusion I would have come up with." Regardless, this goes beyond having heart disease or having FIP it has to do with leaving my animal to suffer indefinitely til her demise from drowning in her fluid / terrible infection. Plus, the reasoning is INEXCUSABLE! This guy should be a professional liar instead of a veterinarian.
QUESTIONING CAT DIAGNOSED WITH F.I.P....VET/TECHS...help!!!
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darksatellites
- Posts: 21
- Joined: Tue Aug 23, 2011 11:32 am
- Location: Oregon
Re: QUESTIONING CAT DIAGNOSED WITH F.I.P....VET/TECHS...help
First, did Banfield also state they would refund you the cost of the Midazolam? This is that sedative I talked to you about earlier, it is listed as a separate sedative.
Second, the vet didn't take a fluid aspirate from the pericardio or the thorax region, he took it from the abdomen, therefore, it probably wouldn't have shown heart fluid unless the heart sac was actually leaking. The sample he took probably would not have been diagnostic for heart failure (except that the protein content being high normal should have been put on the list of secondary rule-outs, like HEART DISEASE). He wasn't looking for heart failure, he was falsely assuming FIP, so any cytology, under that assumption, was essentially useless. I suspect he was only looking for certain cells, bacteria, etc, and obviously, protein content, yet, the protein content wasn't highly indicative for FIP. Also, the "exudate" he was referring to in the fluid sample analysis refers to inflammation. That inflammation could have been anything and from anywhere, but obviously the heart was suffering inflammation from it's enlargement. Other organs could also have been inflamed as a response to the overload of fluid.
Any fluid that is aspirated for cytology should be measured for turbidity, specific gravity, protein concentration, cell counts. Likewise, when there is any suspicion of disease, no matter what it is, when you're taking a sample for cytology, you also want to do a CBC, which is pretty much standard procedure in a case like Sienna's. The vet didn't bother with a CBC, I can't explain his reasoning for not doing one. A CBC could have detected infection, high white blood cell counts, inflammation, etc. But then, this probably would only have supported his false assumption of FIP.
You should know that heart fluid can also appear yellowish. A high protein level in any fluid can also indicate heart disease (in which you then want to put heart disease on your list of rule-outs and perform additional diagnostics). Since the sample was taken from the abdomen, this may be rather redundant now, unless the board determines the vet was negligent for exploring heart disease more diligently). However, he should have noted the color of the fluid he took, especially since he was falsely assuming FIP. It's possible the fluid was not even yellowish-colored, hence, the absence of that detail in his notes.
Perhaps the board (and Banfield) can question/review the vet's reasoning for ruling out heart disease (when the evidence upon xrays and ECG are pretty much undeniable), his less than stellar record keeping, combined with not being honest about the procedures he did and did not do and also did not exactly discuss in detail with you. I would think any vet worth their credentials could have spotted heart failure from the xrays and ECG alone and would have made that their first rule-out/diagnostic plan. I really really really question the vet's audacity to use the terms "heart enlargement", pleural effusion, etc, yet write negative for HCM in his notes for the ECG. One wrong doesn't make a right, and two wrongs make for negligence in my opinion.
Second, the vet didn't take a fluid aspirate from the pericardio or the thorax region, he took it from the abdomen, therefore, it probably wouldn't have shown heart fluid unless the heart sac was actually leaking. The sample he took probably would not have been diagnostic for heart failure (except that the protein content being high normal should have been put on the list of secondary rule-outs, like HEART DISEASE). He wasn't looking for heart failure, he was falsely assuming FIP, so any cytology, under that assumption, was essentially useless. I suspect he was only looking for certain cells, bacteria, etc, and obviously, protein content, yet, the protein content wasn't highly indicative for FIP. Also, the "exudate" he was referring to in the fluid sample analysis refers to inflammation. That inflammation could have been anything and from anywhere, but obviously the heart was suffering inflammation from it's enlargement. Other organs could also have been inflamed as a response to the overload of fluid.
Any fluid that is aspirated for cytology should be measured for turbidity, specific gravity, protein concentration, cell counts. Likewise, when there is any suspicion of disease, no matter what it is, when you're taking a sample for cytology, you also want to do a CBC, which is pretty much standard procedure in a case like Sienna's. The vet didn't bother with a CBC, I can't explain his reasoning for not doing one. A CBC could have detected infection, high white blood cell counts, inflammation, etc. But then, this probably would only have supported his false assumption of FIP.
You should know that heart fluid can also appear yellowish. A high protein level in any fluid can also indicate heart disease (in which you then want to put heart disease on your list of rule-outs and perform additional diagnostics). Since the sample was taken from the abdomen, this may be rather redundant now, unless the board determines the vet was negligent for exploring heart disease more diligently). However, he should have noted the color of the fluid he took, especially since he was falsely assuming FIP. It's possible the fluid was not even yellowish-colored, hence, the absence of that detail in his notes.
Perhaps the board (and Banfield) can question/review the vet's reasoning for ruling out heart disease (when the evidence upon xrays and ECG are pretty much undeniable), his less than stellar record keeping, combined with not being honest about the procedures he did and did not do and also did not exactly discuss in detail with you. I would think any vet worth their credentials could have spotted heart failure from the xrays and ECG alone and would have made that their first rule-out/diagnostic plan. I really really really question the vet's audacity to use the terms "heart enlargement", pleural effusion, etc, yet write negative for HCM in his notes for the ECG. One wrong doesn't make a right, and two wrongs make for negligence in my opinion.
..........Traci
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darksatellites
- Posts: 21
- Joined: Tue Aug 23, 2011 11:32 am
- Location: Oregon
Re: QUESTIONING CAT DIAGNOSED WITH F.I.P....VET/TECHS...help
They refunded $130.00 Interestingly enough adding up the sedatives, and the laceration repair it totals $171.25. I can only speculate they thought they could charge some nominal fee for their half-done cleaning. The lady on the phone said she was refunding all the sedatives.
Do you think that I should continue to contest the cytology/histopathology report in the same details in which you describe, or should I let the board get into these exact questionable details?
Do you think that I should continue to contest the cytology/histopathology report in the same details in which you describe, or should I let the board get into these exact questionable details?
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darksatellites
- Posts: 21
- Joined: Tue Aug 23, 2011 11:32 am
- Location: Oregon
Re: QUESTIONING CAT DIAGNOSED WITH F.I.P....VET/TECHS...help
Also, upon questioning of some of these items, the records were sent to me again, this time with additional pages I had not seen prior, (this time it said a release was signed), however, I do not see anything seemingly more private to be considered confidential. I will be scanning these later today and will notify you when they are on my flickr.
They didn't give you an accurate refund. If they charged for "partial/incomplete" wound flushing, fine, but they should have itemized exactly what they refunded you for. But, better yet, I would contest any flushing/wound care the vet said they did, and that Banfield didn't refund you for, because it didn't resolve the problem - that being a large, open, gaping wound with muscle exposed, and no suturing, stapling, or topical, or injectable antibiotic given. You might as well have cleaned the wound yourself if this is how they do business. I'd allude to something along those lines, that you expected professional services and you are extremely disatisfied you only received "partial" services and were charged for services NOT RENDERED. I think in a court of law, a judge would look at that unkindly, as well as question the fact they checked you out that day knowing they didn't perform those procedures, but knew they were charging you for them. Granted, it's your responsibility to check the invoice before you pay and bring up anything questionable, but what they did was just plain wrong. I have to wonder what other services they say they perform on their patients but don't actually perform them, charge for them anyway, and most clients do not always scrutinize their bills, they trust the vet to charge properly and accordingly.
You can't contest a refund of the cytology, since it was printed on the invoice, as well as noted in Sienna's health chart. However, you can certainly state your displeasure at the fact the vet told you that he couldn't do an aspirate due to Sienna being fractious or uncomfortable, yet did it anyway, and didn't tell you. Please refresh my memory, didn't he call you during the day to tell you the fluid analysis indicated high protein or did you LATER learn it was done and learned that by other method?
What you can contest is the vet's competence level when he told you first, that he couldn't do an aspirate because of that erroneous assumption the immune function would attack itself (upon his assumption of FIP). Then, for some reason, he did it anyway, going totally against his erroneous information he told you in the first place. There is a lot amiss here, from what I gather from your posts, he said he couldn't do an aspirate because of that hairbrained idea in his head about the immune function, then said he couldn't do one because Sienna was fractious, then finally did it anyway, I've never known a reputable vet to be so quirky, undecided, wishy-washy and a hem-haw attitude to boot. At any time, did he bother to get your consent for an aspirate? Did he tell you he did so, in a phone call, or ???
Which reminds me, be absolutely certain you inform the board (and Banfield) that this vet told you to first wait (on the aspirate), take her home and to see how she did. You can also state how displeasing you feel his "professionalism" is when he told you at least three different things, regarding the FIP diagnostics and the aspirate not being able to be taken. Lastly, state you feel Sienna was in bad health, her chest and abdomen were rapidly filling with fluid, she should have been considered an emergency and required proper diagnostics and immediate treatment to relieve that fluid, but the vet preferred to "wait and see". Of course, Sienna's condition rapidly declined and had he evaluated those xrays properly (and actually known how to interpret the ECG properly), aspirated and relieved the fluid and stressed to you a heart workup should be the primary course of action, you might have at least known how to proceed.
My confusion starts with his first wanting to rule out heart disease. But for some reason, he jumped to the conclusion of FIP. My questions are, and I don't know if you can answer, but, I'd like to know when the xrays and ECG were taken, before or after the fluid aspirate? Not that it matters, but what I'm getting at is that at some point, when the xrays were taken, he knew there was pleural effusion and an enlarged heart. He could have known there was pleural effusion just by examination, auscultation of the heart and lung sounds (that "crackling" noise one hears on the stethoscope), and feeling a "doughy" abdomen, not firm abdomen. Then at some point an ECG was done, and his findings sure as heck didn't even come close to the second vet's cursory ECG, she knew right away from her ECG that something was wrong. The first vet has some very fundamental interpretation deficits, let alone communication skills with his clients.
Find out what the release form was for. Sometimes it is for bloodwork. Sometimes it is for anesthesia/surgery (due to certain risks). Sometimes it is in conjunction with an estimate of charges. If possible, get a copy of such release form that has your signature. Do you not remember signing a piece of paper for something?
You can't contest a refund of the cytology, since it was printed on the invoice, as well as noted in Sienna's health chart. However, you can certainly state your displeasure at the fact the vet told you that he couldn't do an aspirate due to Sienna being fractious or uncomfortable, yet did it anyway, and didn't tell you. Please refresh my memory, didn't he call you during the day to tell you the fluid analysis indicated high protein or did you LATER learn it was done and learned that by other method?
What you can contest is the vet's competence level when he told you first, that he couldn't do an aspirate because of that erroneous assumption the immune function would attack itself (upon his assumption of FIP). Then, for some reason, he did it anyway, going totally against his erroneous information he told you in the first place. There is a lot amiss here, from what I gather from your posts, he said he couldn't do an aspirate because of that hairbrained idea in his head about the immune function, then said he couldn't do one because Sienna was fractious, then finally did it anyway, I've never known a reputable vet to be so quirky, undecided, wishy-washy and a hem-haw attitude to boot. At any time, did he bother to get your consent for an aspirate? Did he tell you he did so, in a phone call, or ???
Which reminds me, be absolutely certain you inform the board (and Banfield) that this vet told you to first wait (on the aspirate), take her home and to see how she did. You can also state how displeasing you feel his "professionalism" is when he told you at least three different things, regarding the FIP diagnostics and the aspirate not being able to be taken. Lastly, state you feel Sienna was in bad health, her chest and abdomen were rapidly filling with fluid, she should have been considered an emergency and required proper diagnostics and immediate treatment to relieve that fluid, but the vet preferred to "wait and see". Of course, Sienna's condition rapidly declined and had he evaluated those xrays properly (and actually known how to interpret the ECG properly), aspirated and relieved the fluid and stressed to you a heart workup should be the primary course of action, you might have at least known how to proceed.
My confusion starts with his first wanting to rule out heart disease. But for some reason, he jumped to the conclusion of FIP. My questions are, and I don't know if you can answer, but, I'd like to know when the xrays and ECG were taken, before or after the fluid aspirate? Not that it matters, but what I'm getting at is that at some point, when the xrays were taken, he knew there was pleural effusion and an enlarged heart. He could have known there was pleural effusion just by examination, auscultation of the heart and lung sounds (that "crackling" noise one hears on the stethoscope), and feeling a "doughy" abdomen, not firm abdomen. Then at some point an ECG was done, and his findings sure as heck didn't even come close to the second vet's cursory ECG, she knew right away from her ECG that something was wrong. The first vet has some very fundamental interpretation deficits, let alone communication skills with his clients.
Find out what the release form was for. Sometimes it is for bloodwork. Sometimes it is for anesthesia/surgery (due to certain risks). Sometimes it is in conjunction with an estimate of charges. If possible, get a copy of such release form that has your signature. Do you not remember signing a piece of paper for something?
..........Traci
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darksatellites
- Posts: 21
- Joined: Tue Aug 23, 2011 11:32 am
- Location: Oregon
Re: QUESTIONING CAT DIAGNOSED WITH F.I.P....VET/TECHS...help
<b>Please refresh my memory, didn't he call you during the day to tell you the fluid analysis indicated high protein or did you LATER learn it was done and learned that by other method?</b>
He returned my phone call after I called to check in on my cat a few hours after I left so he could do xrays, etc (stuff on the estimate)....
He explained he had found evidence to support his claims of FIP amongst his analysis through whatever means; that wasn't clear, it was a lot of technical jargon at the time, so that's why i had my mother speak to him to make sure one of us had a better understanding. One thing was clear, he stated he was "fairly certain" it was FIP and insinuated that no other tests or analysis were necessary to my mother. The phone call focused on the ECG he said he was "rather good at," and that she was negative for HCM, and her walls were normal... when I called on 9/14 to ask why there was no evidence of an ECG or EKG, he put in his chart "i think this could be related to the fact that i explain her that we run an ECG at the same time that we perform the echocardio. that is not a formal ECG is intended mainly to assess the electrical-mechanical activity."
<b>At any time, did he bother to get your consent for an aspirate? Did he tell you he did so, in a phone call, or ???</b>
No consent. I said I wanted him to do it initially then he said he had to make sure she was able to be sedated so he was going to check on her heart. He didn't give me a status on her heart at all, ever, accept that she was negative for HCM...all the the heart details were only known to me after receiving the records/xrays and when you mentioned something, well, and also the 2nd veterinarian. As far as me knowing anything regarding the heart from the 1st vet, as far as anything BAD; i received nothing. His reason in person for not aspirating was that she was too skittish and might crash, and that if we drained her fluid it would refill more rapidly (which is also documented in his notes on 8/22 @ 2:52 pm, not elaborating into the detail he told me of course, but states "ask about drain the fluid: refill is common and rapid. we will try to clean the wound as simple as possible without stress and anxiety but sienna can crash due the stress." He also mentioned to me something about draining the fluid will affect the globulins, something about globulins, and stripping away fluids that would keep her healthy (encouraging the immune system attacking itself). So he told me he couldn't aspirate, for those reasons, but then was able to take a sample? How is that any different in reasoning?!?! He also definitely told me to WAIT on draining the fluid until it was absolutely necessary (and that I would be able to notice her breathing become even FURTHER labored) and that she wasn't at that point yet.
<b>Find out what the release form was for. Sometimes it is for bloodwork. Sometimes it is for anesthesia/surgery (due to certain risks). Sometimes it is in conjunction with an estimate of charges. If possible, get a copy of such release form that has your signature. Do you not remember signing a piece of paper for something?</b>
The release form wasn't anything that I signed, the Dr. signed it, which may be why there is additional pages in this copy of the health records. I didn't get around to scanning the pages yet, but I will within a few days.
Also, I thought you might find this interesting....it's the Dr's resume. It seems he hasn't been practicing much aside from training and small animals....Was wondering if you had any comments about that?
http://www.slideshare.net/congresoveter ... luis-tello
Thanks again Traci!
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He returned my phone call after I called to check in on my cat a few hours after I left so he could do xrays, etc (stuff on the estimate)....
He explained he had found evidence to support his claims of FIP amongst his analysis through whatever means; that wasn't clear, it was a lot of technical jargon at the time, so that's why i had my mother speak to him to make sure one of us had a better understanding. One thing was clear, he stated he was "fairly certain" it was FIP and insinuated that no other tests or analysis were necessary to my mother. The phone call focused on the ECG he said he was "rather good at," and that she was negative for HCM, and her walls were normal... when I called on 9/14 to ask why there was no evidence of an ECG or EKG, he put in his chart "i think this could be related to the fact that i explain her that we run an ECG at the same time that we perform the echocardio. that is not a formal ECG is intended mainly to assess the electrical-mechanical activity."
<b>At any time, did he bother to get your consent for an aspirate? Did he tell you he did so, in a phone call, or ???</b>
No consent. I said I wanted him to do it initially then he said he had to make sure she was able to be sedated so he was going to check on her heart. He didn't give me a status on her heart at all, ever, accept that she was negative for HCM...all the the heart details were only known to me after receiving the records/xrays and when you mentioned something, well, and also the 2nd veterinarian. As far as me knowing anything regarding the heart from the 1st vet, as far as anything BAD; i received nothing. His reason in person for not aspirating was that she was too skittish and might crash, and that if we drained her fluid it would refill more rapidly (which is also documented in his notes on 8/22 @ 2:52 pm, not elaborating into the detail he told me of course, but states "ask about drain the fluid: refill is common and rapid. we will try to clean the wound as simple as possible without stress and anxiety but sienna can crash due the stress." He also mentioned to me something about draining the fluid will affect the globulins, something about globulins, and stripping away fluids that would keep her healthy (encouraging the immune system attacking itself). So he told me he couldn't aspirate, for those reasons, but then was able to take a sample? How is that any different in reasoning?!?! He also definitely told me to WAIT on draining the fluid until it was absolutely necessary (and that I would be able to notice her breathing become even FURTHER labored) and that she wasn't at that point yet.
<b>Find out what the release form was for. Sometimes it is for bloodwork. Sometimes it is for anesthesia/surgery (due to certain risks). Sometimes it is in conjunction with an estimate of charges. If possible, get a copy of such release form that has your signature. Do you not remember signing a piece of paper for something?</b>
The release form wasn't anything that I signed, the Dr. signed it, which may be why there is additional pages in this copy of the health records. I didn't get around to scanning the pages yet, but I will within a few days.
Also, I thought you might find this interesting....it's the Dr's resume. It seems he hasn't been practicing much aside from training and small animals....Was wondering if you had any comments about that?
http://www.slideshare.net/congresoveter ... luis-tello
Thanks again Traci!
_________________
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darksatellites
- Posts: 21
- Joined: Tue Aug 23, 2011 11:32 am
- Location: Oregon
Oh, one more thing....... this is a complete timeline of my veterinarian experiences on 8/22....if you see anything interesting, please let me know!
9:35-39 call banfield to see if i can take sienna in
9:49-50 call mom to update her
10:12 it is first documented that i arrive at banfield, doctor asks if i would be willing to leave
11:14-18 mom tries calling me to get an update
12:27 internal organ function screen entered into health chart
12:49-52 call banfield to check on the status of my cat
1:11 dr luis tello notes the analysis of fluid, xrays & that a short US exploration had been performed
1:19-25 incoming call from dr luis tello, tells me his prognosis, etc
1:25 dr luis tello documents in his chart he had spoke with me on the phone
1:26-32 called to talk to mom about what dr luis tello said, ask her to call because i was upset
1:33-43 mom calls to talk to dr luis tello
1:43 the very earliest dr tello could've gone to lunch
1:44-52 incoming call from mom, told me what dr luis tello said to her
2:00 I approximately arrive at banfield and dr tello had gone to lunch, i sat and waited in a private room with my friend and my cat, which they brought out from the back for me...i then decided in the interim to call dove lewis pet hospital, during the call dr luis tello arrived back from lunch, and still chewing his food at 2:42 (when I hung up the phone), that would leave it positively assumptive that he took an hour lunch from the time he got off the phone with my mother until he walked in the room
2:35-42 called dove lewis to ask questions regarding diagnosis, dr luis tello walks in room, and i immediately hang up the phone
2:52 dr luis tello notes he had spoke with me again regarding the nature of this condition, leaves the room to go in back, keeps coming in and out when i have more questions, this goes on until 3:27
3:27-31 called mom to give her credit card #
3:28 dr luis tello notes he gave his final recommendations about care
3:31 invoice prints out
3:43-48 i arrive home and call dove lewis back for more questions
9:35-39 call banfield to see if i can take sienna in
9:49-50 call mom to update her
10:12 it is first documented that i arrive at banfield, doctor asks if i would be willing to leave
11:14-18 mom tries calling me to get an update
12:27 internal organ function screen entered into health chart
12:49-52 call banfield to check on the status of my cat
1:11 dr luis tello notes the analysis of fluid, xrays & that a short US exploration had been performed
1:19-25 incoming call from dr luis tello, tells me his prognosis, etc
1:25 dr luis tello documents in his chart he had spoke with me on the phone
1:26-32 called to talk to mom about what dr luis tello said, ask her to call because i was upset
1:33-43 mom calls to talk to dr luis tello
1:43 the very earliest dr tello could've gone to lunch
1:44-52 incoming call from mom, told me what dr luis tello said to her
2:00 I approximately arrive at banfield and dr tello had gone to lunch, i sat and waited in a private room with my friend and my cat, which they brought out from the back for me...i then decided in the interim to call dove lewis pet hospital, during the call dr luis tello arrived back from lunch, and still chewing his food at 2:42 (when I hung up the phone), that would leave it positively assumptive that he took an hour lunch from the time he got off the phone with my mother until he walked in the room
2:35-42 called dove lewis to ask questions regarding diagnosis, dr luis tello walks in room, and i immediately hang up the phone
2:52 dr luis tello notes he had spoke with me again regarding the nature of this condition, leaves the room to go in back, keeps coming in and out when i have more questions, this goes on until 3:27
3:27-31 called mom to give her credit card #
3:28 dr luis tello notes he gave his final recommendations about care
3:31 invoice prints out
3:43-48 i arrive home and call dove lewis back for more questions
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darksatellites
- Posts: 21
- Joined: Tue Aug 23, 2011 11:32 am
- Location: Oregon
Re: QUESTIONING CAT DIAGNOSED WITH F.I.P....VET/TECHS...help
the 10:12 note is supposed to be (leave sienna there), also i pulled up my phone records so these are the exact times and durations....the rest of the info is compiled from the health records.
Re: QUESTIONING CAT DIAGNOSED WITH F.I.P....VET/TECHS...help
His "resume" likely doesn't matter, unless the board decides it is worth looking at and investigating his credentials (there may be little reason to do so, Banfield should have done that before he was hired, I assume they did). It appears he was sufficient in teaching (at one or more teaching hospitals, which for most people, is a high accomplishment). However, there are very large differences between medicine and practicing in Chile compared to the US.
Vets in the US at least are required to learn and practice with large and small animals in school and residency, it is usually the same in other countries. Just because it doesn't list large animals in his resume doesn't mean it wasn't in his required curriculum.
I guess what matters is the length of time in actual practice in the US and/or Banfield, and ultimately his competence level in practicing veterinary medicine under US laws and governing institutions. I think this one incidence with Sienna should be enough for both the board and Banfield to question his competency. Of course, all vets make mistakes at least once in their life, it is unavoidable (I'm not undermining this, no mistake is acceptable), but that's why there are boards, so they can determine competency, accountability, and act accordingly. I do hope both Banfield and the board take this as seriously as it is, and reprimand this vet, in my opinion he deserves everything he has coming to him. Another goal is to prevent this from happening to another innocent pet.
Vets in the US at least are required to learn and practice with large and small animals in school and residency, it is usually the same in other countries. Just because it doesn't list large animals in his resume doesn't mean it wasn't in his required curriculum.
I guess what matters is the length of time in actual practice in the US and/or Banfield, and ultimately his competence level in practicing veterinary medicine under US laws and governing institutions. I think this one incidence with Sienna should be enough for both the board and Banfield to question his competency. Of course, all vets make mistakes at least once in their life, it is unavoidable (I'm not undermining this, no mistake is acceptable), but that's why there are boards, so they can determine competency, accountability, and act accordingly. I do hope both Banfield and the board take this as seriously as it is, and reprimand this vet, in my opinion he deserves everything he has coming to him. Another goal is to prevent this from happening to another innocent pet.
..........Traci