This is an email inquiry that I received about food poisoning followed by my answer:
In the late evening of 10/18/06 my son Nicholas ate a hamburger at a Carl’s Jr. in Orange County, California and within a few hours he became ill with severe abdominal cramps,vomiting, diarrhea, nausea and fever throughout the night. In the morning we took him to his Doctor who after a short examination asked that we immediately take him to the Emergency Clinic at Mission Hospital. Upon admitting him for treatment he was given two IVs and a blood test for which we received a bill of $5,268.89 and a second bill from the attending Physician for an additional $389. What are my optiions? What can I do to get reimbursed for the medical expenses.
The Hospital failed to conduct a simple test to determine that my son’s condition was the result of food poisoning. As a result of this omission, the insurance company for Carl’s Jr. refused our claim to pay your medical
The good news is that your son recovered from the food poisoning and that you have insurance that will cover the medical expenses. The bad news is that the medical personnel did not perform tests to determine the cause of
your son’s illness. Although not mentioned in your email, apparently no one contacted the Orange County Health Department regarding the food poisoning so that they could do their investigation.
It is possible, based upon the information you provided, that your son contracted salmonella poisoning. Salmonella can produce a diarrheal illness. It commonly is transmitted by undercooked meat.
Even if the medical personnel attending your son conducted tests to determine the cause of your son’s illness, which has been assumed to be food poisoning, there would still be the issue of what did he get the food poisoning from. There are tests that the medical personnel could have conducted that would identify the type of food poisoning. With that information, the source could be narrowed.
If your son’s incident had been reported to the county health department, they would have done an investigation. Many times, in situations like yours, the investigation by the health department uncovers food handling violations (which results in a citation) that may have lead to your son’s illness. They may even identify other victims of the food poisoning. The food handling violations and additional victims provide you the evidence needed for a compelling case against the food serving establishment, in this case, Carl’s Jr. Medical personnel are only required to report food poisoning when they believe that there is more than one victim from dfferent families from the same possible source.
1) If there is an unpaid medical bill after your insurance pays what they are obligated for, counter the medical bill with the allegation that the medical personnels’ failure to determine the cause of your son’s illness was negligent and that negligence prevent you from recovering the expenses from Carl’s Jr., so the balance of the medical bill should be waived.
2) With regards to Carl’s Jr., take them to small claims court with the evidence that you do have, basically what you have shared with me and the medical records. Seek the maximum small claims amount, $7,500. If the judge rules in your favor, Carl’s Jr. does not get credit for what your insurance has paid.
3) Even though it is late, report the matter to the Orange County Health
Department, 714-433-6418, www.ochealthinfo.com/regulatory/food/illiness.htm
Good luck. If you have further questions, email or call us.