My Kaiser Oakland Nightmare With Dr. Felice O'Ryan

[LyraM45]

I've been blogging my story through my jaw surgery process, but saw this board and figured it might be a good idea to leave my story here too in case anybody else is a future Kaiser Oakland and/or Dr. O'Ryan patient.

I'll try to make this short and get to the point (and apologies if I don't, since this is definitely not a short story!), and if you are interested in hearing my full story, you are welcome to check out my blog that I'll link to at the bottom of the post.  I started ortho in spring of 2013 and got referred to Dr. O'Ryan for my overbite and gummy smile.  I heard great things about her and got multiple referrals from a couple of Bay Area orthodontists I consulted with.  Even after my nightmare of a case, the professionals I am seeing now for revision surgery to fix everything still can not believe I am a product of her work.  She is definitely well regarded in the area.   

I only had an initial consult, and then a two week pre op appointment.  This is pretty standard for Kaiser.  Speaking of Kaiser, you get what you pay for in my opinion.  Now that I have seen what other max/fac care is like outside of Kaiser, it's night and day.  You really are just another number with them, and the care is minimal; very treat em' and street em' approach.  Anyway, I am a super informed patient as well as a scientist who understands all of the technical aspects of this procedure.  I did my research, and wanted to know all the details of my case.  Dr. O'Ryan would never share details with me, despite multiple requests.  In particular, I wanted measurements and a surgical plan.  She would just respond with something general like, "I'm going to move your lower jaw forward, your upper jaw impacted up and forward a smidge."  Finally my orthodontist, after sensing my unease with this, consoled me and reminded me about how he's done a ton of cases with her and this is just how it works.  Relax and trust them.  I did, and proceeded with surgery.

My surgery was riddled with numerous surgical errors.  I went in with a simple overbite/overjet and gummy smile, and came out severely yawed, twisted, canted, asymmetrical (both in the bite and physically looking at my face), with an overbite on one side (still class II over all, both dental and skeletal), and an anterior open bite.  I came out worse than what I went in to fix.  Is that a problem?  Sure, but I understand mistakes happen.  Not every case comes out right.  Where my nightmare begins is the care (or lack there of) post op.  It was evident around 3 weeks post op that something was wrong, but Dr. O'Ryan just kept giving me the thumbs up and saying everything was great.  I finally pushed the issue, and she finally admits to just the cant of about 2-3mm down on the right side of my upper jaw.  I told her that I was not upset, and that I more than understood that mistakes happen, but I just needed to know that we were in this together and we were going to figure out X was wrong and Y was going to be done to fix it.  I got rushed out of her office, and to make a long story short, I never heard from her again.  I tried multiple times through Kaiser and through direct emails to her to get an appointment to get examined and find out what else was wrong (because I could feel that there was definitely more off), but she just kept telling me to work with my orthodontist and she would be in touch.  She was never in touch.  This was a crucial period in time as I was 4 weeks post op, prior to any bony fusion of the osteotomies, and they could have gone in to fix everything without a total revision that would rebreak my jaw and cause a separate long healing period. 

From 4-8 weeks post op, I was in the dark.  My orthodontist did not step up for me for whatever reason (possibly covering up for the surgical mistakes and didn't want to throw a long time co-worker of sorts under the bus?), and by 8 weeks I wanted answers.  10 weeks post op I was able to go for my first appointment for a second opinion with Dr. Gunson.  I saw a few other leading names for jaw surgery, as well as a few other more local mom and pop surgeons.  All of their opinions were unanimous, and none of them could understand how I came out so crooked and twisted and not have Dr. O'Ryan step up to fix it after I was so understanding.  I sent Dr. O'Ryan Dr. Gunsons records and he offered to even talk with her, but I heard nothing from her still.  It wasn't until I logged a complaint against her with Kaiser that she reached out to my orthodontist and said she would talk about the records that Gunson sent and get with me.  This was now 4 months post op, and 3 months since the appointment where she rushed me out of her office and she wouldn't see me after.  At that point, I was done with her and was pursuing another team to handle my revision.

So, I went in with an 8mm overbite/overjet and a gummy smile with no asymmetry or other significant issues.  Now I am canted 2-3mm down on the top jaw, have a 6mm overbite, both jaws are yawed (twisted) with the bottom being yawed so severely that it has physically disfigured my face and caused obvious asymmetry, midlines off 2-3mm, anterior open bite, and I still have a gummy smile.  I found out after the fact that my upper jaw was moved forward a whopping 4mm (and was only supposed to come forward a "smidge" since it was already too far forward and prominent in my class II case), and because of that my lips can't close without strain, cramping, and visible dimples around my mouth and chin.  I felt like I had a chimp face from day 1, and found out it's because my top jaw should not have come forward at all (if anything, backwards is where it should have gone) and she did 4mm advancement with no notice to me either pre op or post op.  I am now in braces again and scheduled at the end of this year to have a total revision to try and fix all of Dr. O'Ryans mistakes.  Some of them are permanent, like the disfiguring of my jaw where it's been yawed out and now bulges out on the left side of my face.  Again, all of the surgical errors can me chalked up to "crap happens," but the care I received post op was not only below the standard, but it was down right immoral.  You don't leave a patient hanging high and dry when they need you the most.  If you make a mistake, it needs to be fixed instead of running away and pretending like it never happened and your patient isn't a human being that exists and needs you.  I was VERY understanding, so it was an even bigger let down that this is how she handled my case.  I know there are patients who have gotten their work done with her and things have come out great, and the same could happen to you in the future (for any future patient of hers reading this), but this is my story.  This is what she did to me, and this is the professionalism she showed when the going got tough.  I know I wouldn't want somebody operating on me who is going to leave you hanging high and dry if it doesn't go well.  Mistakes happen.  We can't expect perfection 100% of the time from these doctors who are not gods.  But, what we can ask is that they are willing to work with you to make it right and put in their best effort to abide their oath and do their fiduciary responsibility when it comes to the patient.  I didn't get any of this from her, and it's almost criminal.  I feel violated, and my trust for any treating doctor for me in any area is now shattered, and it probably will remain so for the rest of my life.  I am out thousands of dollars and 1-2 months of leave without pay from my job, but the thing that cost me the most was a piece of myself emotionally.  Fine, she messed up my jaws more than they were messed up already, but the emotional damage she has done to me through all of this is irreparable, even after a successful revision surgery to fix all of the impacts from her mistakes.  I would hate to see another person go through that with her, so for this reason I have to share my honest report on what happened to me. 

I tried to keep this short, but it's a long story!  If anybody is interested in reading up on the course of events from day 1, feel free to read my blog. 

Thanks, and good luck with your jaw journeys everybody!

http://confessionsofametalmouth.weebly.com/


Picture:  2 weeks pre op pictured on top, and the bite on the bottom is about 5 weeks post op. 

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[mirepjanic15]

thanks for sharing. I am very, very sad for you, yet i am sure you will fix this.

I hope and wish you the best, thanks for sharing

[LyraM45]

Thanks    I hope I can get this fixed too.  My new team seems to be really involved, paying a lot more attention to detail vs. my first team that did not, and I feel like they genuinely care and feel really awful that I am in the position I am in and had the experience that I had.  I'm not expecting perfection out of this revision, as the mistakes are so bad that this is going to be extremely challenging for them to get it 100% dead on corrected, but I am hoping it can improve the state I am in now (which is worst than my original pre op state I went in to fix!) and hopefully get me out of some of the pain/discomfort that came with being left so crooked and twisted.

Revision is slated for Dec/Jan at the end of this year.  Counting the days!

[Modigliani]

What an absolute b*tch your surgeon is, not only did she (or the rookie?) screw up what should have been a routine surgery, she completely mismanaged you afterwards. It's f*cking appalling but unfortunately all too common, so many of these clowns let their giant egos get in the way of their ethics.

Thank you for sharing your story, I know how painful it is but naming and shaming these butchers is often the only come back we have.

[PloskoPlus]

I'm really sorry this happened.  What I don't understand is why she didn't quietly offer you a revision at no cost.  Given her volume of work, this would've been a minor hit to her income, instead of a huge reputation hit. Unless she is not that good and fears screwing up even more.

[LyraM45]

Modigliani-- It is sad that this happened, and it's sad it happens quite often in many areas of surgical practice.  As for the screw up possibly being the rookie, that is a theory on the table.  There were two residents working with her the day I was operated on.  I didn't know either of them.  The one took charge of the case right off the bat, he's the one who wrote my long operative report, told my family how I was, took me to post op care, did my exam and discharge from the hospital the next day.  My surgeon was basically hands off, so I assumed from day 1 that he pretty much did my case.  This was before I suspected anything was wrong.  After all of this has come to light, it made even more sense, and totally makes sense in terms of why would a good surgeon would distance herself so quickly from a mistake like this.  Part of dealing with my surgical outcome would have been admitting that not only did she not do the surgery, but I suspect that maybe she didn't even stay to check the work before these guys finished me up.  I've had multiple surgeons that I have seen for revision consult tell me they don't think she did the work, as they are very familiar with her work.  They said my work is so sloppy and awful that it couldn't possibly be the work of a good surgeon like my primary surgeon.  So, 2+2=4 for me here, but I will never know the truth there unfortunately.

PloskoPlus-- I got operated on with Kaiser.  For my surgeon to do a revision on me, it would cost her nothing.  This is not a private practice.  She is just one surgeon within a huge HMO, and it would have zero financial impact on her. 

[LyraM45]

Ha!  I joke and say that all the time.  "This chick must have been drunk or something!" lol.   Honestly, her drunk work probably still would have been better than what I believe is the sloppy work of her resident.

[LyraM45]

If you haven't seen the 1 year post op post, check it out here:  http://confessionsofametalmouth.weebly.com/blog/1-year-post-op  I go over some of the more physical things like where I am at at 1 year post op with the numbness and all.  In general, I have not really gotten any additional feeling back in the last 5-6 months.  I was numb across my right side up to my lower eye lid immediately post op, but my left side came out just fine.  I got the feeling back in the upper half of my face really quick within 4-6 weeks post op.  My lower lip and chin took a couple more months to feel any difference there.  I would say by 6 months post op, that is what I've been left with.  It's a strip right down the right half of my lower lip and chin.  The gums across this area are also numb, tingly, and weird feeling.  Conversely, I have a few spots (especially around my upper right K9) that are hyper sensitive.  Both things I've learned to live with and oddly enough (maybe because of all the other things that have happened that make the numbness such a small issue in comparison) I am not losing sleep over the thought of additional numbness during the next surgery.  It sucks, but there is nothing I will be able to do about it at this point. 

[sunshineb]

I am so sorry this happened to you. I wish the best for you.
I am having surgery with Felice O'Ryan and will definitely update everyone about it.
My orthodontic has had several clients that needed jaw surgery and they did it at Kaiser with great results, I met one
girl at his office once.
 
I also wanted to note to people reading this that I believe just as your doctors mentioned, that it was an error on the "resident's" part, perhaps.
Usually a main doctor will operate with a resident, it's optional, people can ask for only main doctors to be there, so everyone take note.

I was told by my orthodontic and research I did here and there that Felice O'Ryan is actually one of the best doctors in the country,
and that Kaiser is highly experienced in this type of surgery.
I wanted to mention this as well because I know so many people do it at Kaiser with great results, and
it can be so scary for people reading bad experiences that might be a small percentage as it happens with any procedure.
So people should look at both sides.

Nonetheless, it's important for people to be aware of their options and to understand all the risks as with any procedure.

Thank you for sharing your experience and I hope it resolves as you wish. 

[LyraM45]

Thanks for the well wishes.  I am actually going in for my full revision tomorrow.  I am hoping it can all be sorted out this time.

RE: resident.  I knew she worked with residents.  I actually signed paperwork before my surgery stating that she would be the one doing the surgery and the residents would be observing/assisting. If it was a resident error, then it's still no excuse for how she treated me after when things went terribly wrong.  No excuse at all. 

Research is important.  Sounds like you did a lot of the same research I did.  I also met one of my ortho's patients who had their surgery with her.  Every ortho consult I went on had brought Dr. O'Ryan up as one of the best.  The ortho I settled on had her at the top of the list, so that is who I went with for surgery.  The fact is, every doctor can make a mistake.  Whether it was the resident or her, it was ultimately her responsibility to step up and take care of me after, and she did the complete opposite.  We can't ask for perfect results.  Facts are they don't always happen and it's unfair to expect perfection.  But what we can expect is that they step up and abide by their oath and do what is right to make the situation better if they can.  To stand by their patient when they need them the most.  Because she did not, that is where she becomes a disgrace in my eyes.  I was never upset at the fact that I was botched and that there were copious surgical errors.  I was upset with the treatment (or lack of) after, which I think if fair and more than warranted. 

Out of my research and all of the patients I have talked to, I found most are happy with Dr. O'Ryan.  I have found a few people in my shoes who ended up with wonky results and all she did was try to talk her way out of them and try to make it like it was all OK and nothing was wrong.  One of them even went for a second opinion with Dr. Gunson after I urged them to (after looking at their xrays and pictures of their results and it was obvious it wasn't right and she was telling them it was all OK like she did with me) and he said they were not right and required a full revision.  So, since my surgery and talking to a few of her patients, not only does she have a proven track record of not stepping up to fix things if they don't go right, she has a proven track record of not admitting or alerting you if it's off in anyway, so you should remain on your toes after your operation to look out for yourself there.  I was catastrophically off.  Not a little bit off, but so much off that none of the surgeons or professionals I have seen can believe I was even discharged from the hospital like I was, let alone continually smoothed over and passed off post op despite both me and my ortho telling her things weren't right.  I hope you don't end up in that position and I hope that your surgery goes perfect so you don't end up in that position.  While chances are your results will be good (overall chances with any surgeon for this procedure are that you'll be OK), seems like the chances are not as great that you'll receive the best care if your results aren't good. 

People reading blogs and stories about surgery should read them with caution.  9 times out of 10, people posting online are doing it because they had issues.  I would like to think I am a rare case, because my blog has been going since day 1, even before I got my braces on.  So, it's a completely unbiased story, telling it how it's happened since day 1.  I wanted it to be a perfect fairy tale story, but unfortunately it was not.  So, all we can do as patients is hear these stories, take them in, evaluate it with the risk vs. reward you have to think about, and decide to do what is best for you.  Unfortunately, having surgery with Kaiser and Felice O'Ryan was not what was best for me. With any surgeon you're going to have to roll the dice.  A main risk is an undesirable outcome.  But hopefully you have a surgeon who is willing to work with you and try to make it better if you do in fact have an undesirable outcome.  It's the basic standard of care......and I didn't get that.

Good luck with the rest of your ortho and surgery!  If you ever need anything down the road with regards to Kaiser/Dr. O'Ryan, feel free to send me an email off of my blog or PM here.   I hope that you don't, but unfortunately I have already been counsel to several other patients of hers since my surgery.  So if you end up there, you know where to find me.  www.confessionsofametalmouth.com 

[LyraM45]

Another quick reply ahead of my revision surgery tomorrow-- I am hoping we can at least make what I've been left with better.  My surgical plan looks solid.  The ortho appears to be done much better ahead of surgery this time.  My surgeon and ortho have been in much better contact and planning a lot more than my first surgery.  I've gotten so much more care and attention to detail this time around.  I've been sent for so many more scans, shown 3D modeling, 3D planning, had everything shown and explained to me in detail.  I never got that with Kaiser, and I definitely needed it.....well, no, I DESERVED it this time.  I am so twisted and canted that they aren't sure they'll be able to get it 100% perfect, but even if my surgeon can do half of what he's hoping to do, I think I'll get some relief from this awful bite and jaw positioning I've been left with.

Through all of my MRI/CAT/Xray's, I've found out I've seen some joint damage from the way my bite was left. I've lost bone on my top jaw, and some of the bone on my bottom jaw did not heal fully.  They are bringing some grafting material in to fix me up just in case its needed.  I also found out my septum was deviated pretty significantly, so they are going to try to center that more but more than likely I'll need another procedure down the road to fix that.  If they can't fix it in revision, I might also need another jaw surgery down the road to fix the facial deformity I have on my left form the first surgery when they set my lower jaw all bowed out and new bone has healed over that creating the bulge that sticks out the side of my lower jaw.  But for now, looking at setting my upper jaw back 2-3mm where it was to begin with before the first surgery (and should have stayed there-- it was never in my plan to have a 3-4mm advancement the first time given I had an overbite to begin with), untwist it in the yaw direction, shift the midlines back over 2-3mm center, and take my right side up 2.5mm to level out the cant I was left with.  Lower jaw brought forward 3-4mm (where it was supposed to come total during the first surgery), untwist it and center the midlines, and level out the cant on the lower too.  My surgeon has a lot on his plate to try and fix this mess, but I am really hoping he can manage at least most of it to give me some relief, because I can't live with my bite like this. 

Attaching files in multiple posts since I'm limited to a certain size for each. 

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[LyraM45]

Pre op pictures.

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[LyraM45]

3D surgical plan

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[LyraM45]

3D surgical plan

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[LyraM45]

Proposed movements

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