Dr. Michael Iannuzzi, Director
UHCC Adult Medicine
MR Nephrology Dr. Elliott
Dear Dr. Iannuzzi,
I am in receipt of your letter of Sept. 10 regarding the above-captioned matter in which you threaten to terminate my health care because of unspecified “inappropriate behavior.”
My people have been Americans since the mid 1600’s. Perhaps you are unaware that the American way is (1) to presume innocence until proven otherwise; (2) to require a bill of particulars of the alleged wrongful acts; (3) to hear both sides of the story, and (4) to have an impartial judge. You have set yourself as judge based on what one of your doctors told you without regard to my statement of events.
For my side of the story see the enclosed complaint to the NYS Dept. of Health, Office of Professional Medical Conduct.
I will sign your required Patient Bill of Responsibilities after I receive—in writing and signed—an apology from you, and a statement of wrongful medical practice from Elliott.
Meanwhile, I have advised my health care proxy that Elliott is never to attend me, even if I am at risk of death.
New York State Department of Health
Office of Professional Medical Conduct
In April 2014 I was referred for catheter change to the Nephrology Clinic at Upstate Medical Center. I had to wait five months for a new-patient appointment.
At the appointment, Dr. Elliott walked into the treatment room, gave me his name and shook my hand. He then stuck his face close to mine and asked me if I knew who he was. Puzzled by the question, I replied, “A nephrologist.”
Then he asked if I knew where I was.
This was not a standard new-patient appointment; this was a non-psychiatrist beginning the interview with a complete stranger by asking questions intended to elicit orientation to place and person. It was inappropriate, unnecessary and rude. Nevertheless, I replied, “The Nephrology Clinic.”
Dr. Elliott then sat down and stated, “You don’t have diabetes insipidus.”
Stunned, I said, “What?”
Elliott repeated, “You don’t have diabetes insipidus.”
I asked, “On what do you base that decision?”
Elliott replied, “I read your lab work.”
I responded to Elliott’s illegitimate statement by sputtering, “Bu—bu—but, Dr. Moses! This hospital . . . international expert . . . tests!”
Elliott repeated that I do not have diabetes insipidus. I asked him to please open the door so that I could wheel out of the treatment room and away from him.
Back in the 1990’s an internist, a nephrologist and an endocrinologist each independently did testing and arrived at the diagnosis of nephrogenic diabetes insipidus.
Around 1991, I was urinating all the time, consequently I got sent to a primary care physician who ordered a 24-hour urine and blood tests. When the results came back, she told me I had diabetes insipidus. I cheerfully replied, “You can fix it can’t you?”
“Um, no,” she said. “It’s permanent.”
Then I went to a nephrologist, Dr. Green, who admitted me to hospital and did a dehydration test, which consisted of denying me liquids overnight and weighing me every hour all night. I lost ten pounds just from producing large quantities of urine.
A healthy person excretes less than two liters of urine in 24 hours; I was putting out twice that amount just overnight. I had diabetes insipidus. “Diabetes” means large quantities of urine; “mellitus” means sweet-smelling; “insipidus” means odorless and colorless. Diabetes mellitus is a disease of the pancreas; diabetes insipidus is a kidney disease. Diabetes insipidus means that you are basically excreting clear water and not concentrating urine.
My next stop was Dr. Arnold Moses at Upstate Medical Center who is an endocrinologist and an internationally acclaimed expert on diabetes insipidus. He put me in one of his research programs and reported that my 24-hour urine output was 9.6 liters—about five times normal.
Diabetes insipidus comes in three forms: neurogenic, nephrogenic and psychogenic. Neurogenic means that the posterior pituitary gland in the brain is not putting out enough antidiuretic hormone (ADH). Nephrogenic means that the kidneys are receiving the ADH but not responding to it. Psychogenic means you’re crazy, therefore you drink too much, therefore you produce too much urine.
Dr. Moses did some horrific test that simultaneously checked all three types of diabetes insipidus and reported that my diabetes insipidus was exclusively nephrogenic. My kidneys had been damaged by lithium, prescribed by a bad psychiatrist, which is the most frequent cause of diabetes insipidus.
I went on to nearly a quarter of a century of treatment by various endocrinologists, nephrologists and emergency medicine specialists. The treatment was DDAVP—which cost about $10,000 a year—and the diuretic hydrochlorothiazide (HCTZ). About every six months, I would dehydrate into the Emergency Room. Then, in 2001, I stopped taking physician-prescribed pharmaceuticals and I stopped dehydrating.
In the following ten years I had to urinate about every two hours, including all night, and I was dying from lack of sleep so about three years ago Dr. James Tucker, chief of hospitalists at St. Joseph’s Hospital, prescribed an indwelling catheter so I could get some sleep.
And this month Dr. Elliott informed me that I don’t have diabetes insipidus, based on his reading of lab work.
1. There is no relevant lab work extant. No 24-hour urine has been done in this century. Upstate didn’t start computerizing their lab work until long after the last 24-hr urine.
2. Absent a current 24-hour urine, Elliott did not order it or any other tests.
3. Elliott did not interview the patient.
Nevertheless, Elliott made a diagnosis, albeit totally wrong.
4. Several days after the interview, I was notified that Elliott had ordered a renal ultrasound. Both the Mayo Clinic, and me and my 23 years of experience, know that an ultrasound is not an appropriate diagnostic tool for diabetes insipidus.
Dr. William C. (a/k/a W. Clayton) Elliott is grossly incompetent, inappropriate and rude. Please discipline him accordingly. With 37 years of experience, perhaps he has lost his professional acuity and is in need of rapid retirement.