Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:02/13/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  This service took place on 12/4/2024, and I paid $1,008.00 to a veterinary Dr. D**** at Advanced Internal Medicine for Pets for a recommended procedure. Sadly, my dog **** had to be euthanized less than 36 hours after this procedure. Since then, I have contacted another vet to review ****** medical records as to what happened that tragic day of 12/5/2024, and we have learned that Dr. D**** did not follow protocols for a minimum standard of care. I have sent an email requesting for a full refund of $1008.00, but Dr. D**** has refused to refund my money after she caused me pet **** to bleed internally after this procedure.

  Business Response

  Date: 02/17/2025

  In response to ***** ********* complaint about her pet, ****'s, care.  All services that were charged for were provided.  Dr. D**** discussed, at length, the risks of bleeding with a fine needle aspiration (FNA) procedure prior to doing the procedure. She discussed the risks twice in her conversation with the owner. Knowing the risks the owner consented to the FNA.  If the patient was going to bleed post FNA, it usually occurs immediately post-procedure, not 1-2 days after the FNA.  The cytology results did not rule out a type of cancer whose pathology involves spontaneous bleeding.  Even if the FNA did cause the bleeding, the owner was aware of the risks when she consented to the procedure.  For the FNA, Dr. D**** followed the same protocol she has followed for her 14 years as an internist with thousands of patients, with only two pets bleeding post FNA in her career (owner was informed of these 2 cases in her conversation with Dr. D**** prior to the procedure, also mentioned in Dr. D****** email response).  Dr. D****, *** ********* family veterinarian, and the emergency veterinarian all explained that with the type of cancer **** is suspected to have, spontaneous bleeding occurs as the natural progression of the disease.  Dr. D**** responded to the owner's initial email with regards to her concerns and invited the owner to call to discuss her concerns, *** ******* never responded or called.  We can provide a transcript and/or voice recording of Dr. D****** conversation with the owner describing the risks of the FNA and the owner's consent to the procedure. We can also provide an email from the emergency veterinarian to Dr. D**** relaying the conversation she and the owner had after she saw **** on emergency.  We can also provide additional medical records and communications with regards to this complaint if necessary and if owner releases us to give medical records.  We have sympathy for the owner on the loss of her beloved pet, and understand the need for closure.  Unfortunately ****** disease was terminal. Dr. D**** provided her the knowledge of there being cancer throughout her organs which is what she paid for- a consultation, ultrasound, and FNA with cytology.  Because she received all services charged for, we will not be refunding her but do hope she is able to find help coping with her loss via a grief support group for pet loss.

  Customer Answer

  Date: 02/17/2025

  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, reasons for rejection are included below.

  
  

  
  

  Dr. D**** recommended a fine needle aspiration (FNA) after she discovered a mass on my dog ****** spleen. She said, that she “aspirate spleens many times a week and it is very rare to bleed”. This commented is also quoted in her email communication to me. I questioned the risk twice before the procedure since I was concerned about poking an organ which could bleed and which did bleed the next day. **** may have been slowing bleeding immediately after the procedure, but Dr. D**** failed to administer any coagulation bloodwork test before or after this procedure to see if **** was bleeding internally. And it wasn’t until the next day, when “**** had a moderate amount of free fluid in her abdomen”according to ****** Emergency Hospital. At this hospital, an active abdominal bleeding was confirmed. And since the hemorrhage occurred within 24-48 hours after the splenic FNA, there is a high probability that this procedure triggered the active bleeding which led to **** being euthanized the following day.

   

  I paid for a service that provided substandard care that ultimately led to the death of my pet ****. I never signed any written consent of any known risk factors involved. And if the doctor knew there was a significant risk, then why did she recommend this procedure. Dr. D****** was incompetent for several reasons:

  1. Inappropriate choice of aspiration site of a spleen which is highly prone to bleeding.

  2. Lack of coagulation testing and preventive management.

  3. Procedure performed without sedation increases the risk in involuntary movement causing lacerations in the fragile splenic tissue. One cannot expect an animal to remain motionless when a needle is inserted into their organ.

   

  Finally, as Dr. D**** mentioned cancer as suspected, but never confirmed by the pathology report. And according to Dr. D****, this procedure of the FNA was performed to find out if ****** cells were cancerous. In Dr. D****** email to me, she states, “the aspiration result does NOT have the typical morphology of a hemangiosarcoma. But a hemangiosarcoma or other primary or metastasis are possible differentials”. Therefore, **** did not have a terminal disease as Dr. D**** replied to this BBB complaint. There are so many false inaccuracies and contradictions with Dr. D****** communications. All of these discrepancies are also communicated in the complaint # ********* sent to the **** Veterinary Licensing Board.

   

  These errors and dishonesty confirms the negligent case against Dr. D**** at Advanced Internal Medicine for Pets.

  
  
  
  
  
  Regards,
  
  
  
  ***** *******
  
  

  Business Response

  Date: 02/24/2025

  Hello,

  To respond to the specific complaints:

  From the information I have been provided, we do not know where **** was bleeding from, as she had many masses in her abdomen that could have bled.  Even IF **** bled from the aspiration, it was a known and accepted risk by the owner.  I do aspirate spleens many times a week and it is very rare to bleed- as is evidenced by the fact that IF **** bleed from the aspiration she would be the 3rd dog to bleed after aspiration in over 14 years (1 liver, 2 spleens so only the 2nd spleen in my career to have possible post aspiration bleeding).  By definition this is a rare complication.  If she was uncomfortable with the risk we discussed twice, she should not have approved the aspiration.  I do not know of any specialists who do coagulation profiles prior to aspirating a spleen.  If there are any, it is certainly not a standard of care or even common place.  Every patient, including ****, is checked for bleeding immediately post aspiration prior to discharge.  She did not have any bleeding with the aspiration.

  She paid for a service that was received.  There is no medical procedures without risk.  The risk was discussed and accepted.  Again, we still do not even know if there was bleeding from the FNA but that is irrelevant to her complaints as there was a known and accepted risk that the owner elected to pursue.

  1. The spleen is a common organ to aspirate.

  2. Coagulation testing is not commonly done prior to aspirating a spleen.

  3. **** did not require sedation and did not move during the procedure. We do sedate patients if we are concerned they will move or do move during an aspiration.

   

  ***** has ******* things, and because she is not a veterinarian (nor is ******) she does not understand what she is reading nor the context of what she is finding.  She does not understand which organs or medical circumstances necessitate coagulation panels prior to aspiration.  She does not understand which organs we do not routinely recommend aspirating.  She does not understand which aspirations we routinely sedate for.  If you look at the areas she highlighted and underlined in her "research" (sent to a number of other organizations she has logged complaints with), what she is reading about is: bone marrow aspiration which of course requires sedation; mast cell tumors which is not on the differential list for ****; and a potential complication list of FNA of every part of the body including lungs and other organs not aspirated in ****. I invite ***** to go to vet school, get educated on the vast array of tumors, ultrasound findings, and differences in procedures performed on each organ in the body and then she will understand why her googling has led her down this path of misunderstanding.  Myself or any veterinary specialist she would like to schedule a consultation with would be happy to explain the details of the case if she has questions and would truly like to understand the medical intricacies and is not just trying to get money back.  ****** is not a good medical resource for **** or any other pet's medical care.  I went to college for 4 years, vet school for 4 years, and internship/residency for 4 years.  That is 12 years of higher education followed by 14 years of experience that has led to a deep understanding of veterinary companion animal medicine.  This is a level of education that ****** cannot provide in a few hours as much as we all wish it could.  

  
  Finally, per the aspiration results, cancer IS likely but can only be confirmed by histopathology obtained with biopsy. The FNA was performed to find out if ****** cells were cancerous. As was suspected on the ultrasound the aspiration showed cancer cells.  According to the pathologist the aspiration result does NOT have the typical morphology of a hemangiosarcoma. But a hemangiosarcoma or other primary or metastatic sarcoma are possible differentials.  Meaning the cells were not classic for a hemangiosarcoma but still could be hemangiosarcoma.  Again, without biopsy we do not have a definitive diagnosis, but metastatic cancer is considered most likely based on ultrasound and aspiration results, which is terminal.  Hemangiosarcoma is not the only terminal type of cancer that exists.  All of this again is irrelevant as the owner approved of the FNA after discussing the risks.  There are no inaccuracies or contradictions with Dr. D****** communications.  

   

  Again, we are sorry for ******* loss of her beloved ****.  Cancer sucks.  It really does.  Many owners that have dogs with the type of cancer we suspect **** had, have come home to their dog having passed from internal bleeding without them ever knowing they were even sick.  Or they come home to find them passed out on the ground pale and dying.  The natural course of disease is spontaneous bleeding.  Cancer is the worst.  My job is to help diagnose it, to give pet owners time to process and grieve and understand if there are any treatment options.  I provided her a consultation, ultrasound, and aspiration which is what she paid for.  She elected euthanasia, and we all know that was the right choice given the ultrasound and aspiration findings.  I do wish **** didn't have cancer and was still with her family, but unfortunately I do not get to tell cancer what to do.  I feel empathy for her loss, but I will not refund her money simply because her dog had a terrible disease.  

  Customer Answer

  Date: 03/25/2025

  Unfortunately one can not receive a degree in common sense. And anyone would realize a dog is not going to remain motionless when a needle is entering their organ so therefore, sedation is needed to avoided any complications. 
  

  This incompetent vet Dr. D**** made a mistake and has now attempted to cover up her negligence by communicating false information to an emergency vet at ****** Hospital. ****** Emergency Hospital discharge paper stated that my dog **** had Hemangiosarcoma. According to the pathology report that was post stamped on 12/4/2024 at 13:40 by Dania Villarnovo, it states, “these cells are in low numbers and do not have the typical morphology of a hemangiosarcoma”. **** never had terminal cancer of hemangiosarcoma and unfortunately was euthanized on 12/6/2024 based on Dr. D****** misdiagnosis or misinterpretation along with falsifying a medical report.

  Everyone makes mistakes, and 12 yrs of medical school doctors can also make mistakes, that’s the reason the medical field has to have malpractice insurance.