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Behind $9 million hospital bill, a strange tale

When Tampa General recently filed a $9.2 million claim against the estate of a penniless woman, it left itself open to criticism. But a look at Hillsborough probate court records offers perspective.

They describe what one court officer described as a "very special case, very difficult." Among other things, it provides a cautionary tale for those deciding on a health-care surrogate.

Tameka Campbell, in her mid-20s when she was admitted to Tampa General, spent five years there only because the hospital could not find any place that would take her. It couldn't get financial help from the state, records show, nor cooperation from Campbell's mother.

The case is a good example of a paradox of the health-care system: A dying patient can be kept alive on a ventilator with a feeding tube almost indefinitely, yet there are few places for such a patient to go for care and often no way to pay for it.

So the patient remains in the most expensive place of all: a hospital.

Health News Florida reported the $9.2 million claim against Campbell's estate on Tuesday, adding that it may be a record for a hospital stay but that no one could be found who keeps track. After that report, the Guinness Book of World Records said it doesn't have a category for the size of hospital bills because they are private. Also, a spokeswoman said, hospital charges are arbitrary, subject to manipulation.

Details of the Campbell case would have remained a secret if her mother, Holly Bennett, and the Tampa General staff had gotten along. But they clashed to the point that the hospital petitioned the court in 2007 to replace Bennett as guardian in the interests of her daughter’s care.

Circuit Judge Susan Sexton decided that Bennett was incapable of looking after her daughter’s interests and appointed a professional guardianship agency.

Bennett appealed the decision to the Second District Court in Lakeland, where a three-judge panel affirmed the decision without comment in May 2008.

Records from the hearings that took place in 2007 and the report that followed, which had been stored in a court records warehouse, became available Wednesday afternoon.

They portray a hospital staff locked in a power struggle with Bennett, whom her daughter had appointed as her health-care surrogate early in her stay.

Campbell, as an uninsured patient without any money, would ordinarily have been covered under Medicaid. But as TGH’s chief social worker Carolyn Soucy testified, the state program doesn’t pay for patients like Campbell who don’t need hospital-level “acute” care and could be kept comfortable in a skilled nursing facility.

Soucy testified that the staff tried more than 150 referrals to other facilities, but all ultimately refused because of the ventilator. “There are only three facilities in the entire state of Florida that will take long-term ventilator patients,” she testified, and none of them had beds available.

The staff found a placement for Campbell in Ohio, Soucy said, but Bennett refused, not wanting her daughter so far away.

Hospital witnesses said they offered to pay for private-duty nurses if Bennett would accept her daughter’s discharge to her home. She said no.

According to a report by a three-member independent panel and court magistrate, witnesses described Bennett’s behavior as increasingly strange. Nurses and doctors said she accused them of trying to murder her daughter and sometimes screamed at them to leave her daughter’s room.

They said they would set up meetings to discuss the case but Bennett wouldn’t show up. Sometimes months went by between Bennett’s visits, they said.

Bennett sent complaints to the state Agency for Health Care Administration, which investigated and concluded that Campbell was getting good quality of care and found only a couple of minor documentation problems.

Bennett “fired” the pulmonologist and palliative care specialist in charge of Campbell’s case, Dr. Vincent Perron from the University of South Florida. Perron, who is in the U.S. Navy Reserves, said Bennett even wrote a letter to the U.S. Navy, accusing him of trying to harm her daughter.

One letter in the file shows that the hospital warned Bennett that she was “firing” so many doctors and nurses that it was becoming increasingly difficult to find someone to care for her daughter.

After Tampa General succeeded in its petition to remove Bennett as guardian, Campbell remained there for two more years, dying on June 18, 2009. The record is not entirely clear on why Campbell was never transferred, apart from the testimony from two years earlier about the difficulty of finding placement.

Presumably, Medicaid continued to refuse coverage, but that isn’t explicitly stated in the record. A spokeswoman for the Agency for Health Care Administration said she couldn’t discuss the case – even after being told that Campbell’s hospital records are part of the court file – because of federal privacy laws.

Similarly, Tampa General spokesman John Dunn said hospital officials had declined to comment. Such reticence is common when a hospital fears being sued.

On June 9, Bennett filed a notice in Circuit Court that she intends to file a wrongful death suit against the hospital. It appears that she is representing herself.

--Carol Gentry, Editor, can be reached at 727-410-3266 or by e-mail.

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.