Insert Your Full Name
Insert Your Address
Insert Your State & ZIP Code
Insert Phone Number
Insert Email
Insert Date
Insert Recipient’s Name
Insert Recipient’s Designation
Insert Name of Hospital
Insert Address
Insert State & ZIP Code
Insert Phone Number
Insert Email
Dear Sir/Madam,
On March 15, 2022, I brought my mother, [Insert Full Name], to your hospital for
treatment due to her delirium and hallucinations. A CT scan was conducted and she was
diagnosed with a urinary tract infection (UTI). It was suggested that she should stay overnight
for further treatment and observation, to which we all agreed.
On March 16 th , when I came to collect her to find her in a low mood and intended to have
her discharged. I severally asked what happened to her hand but only got answered by the
person seated behind the desk. Precisely, that an x-ray had been ordered. The hospital
recommended physical therapy for her arthritis and prevention of infection and if it was a IV
neglect it would not still be swollen. It was an IV wound and it was infected because the swollen
area was so hot they ordered blood work, and informed me there was no infection in blood
work. They also ordered an ultra sound, EKG, later another EKG ultrasound, and x-ray.
I have lived with my mother and taken care of her medical needs solely. The dementia
for her is short term memory (reason she could not tell me what happened to her hand). Those
who have met her would attest to her liveliness which has been ripped of her by the current
medical condition.
I often need assistance with taking care of her, hence I called St. Joseph Hospital
Emergency Room where all this stemmed from. She suggested I take her to Kaiser for the
doctor there to say it looked like an IV infiltration under the skin and for the amount of fluid
looked like it went undetected, and maybe an infection. He gave her antibiotics. After 7 days on
antibiotics, she was no better. Her condition became worse.

I called the doctor who instructed me to call Dispatch Health. They looked at her hand
and wrist and suggested that she be taken into emergency. On June 11 th , 2022, my mother was
taken to Rose medical due to her arm and they did a scan and found what they said looks like a
brain bleed and concluded she had Covid-19.  They sent her to Swedish Memorial Hospital to
aid her recover from the trauma. The neurologist diagnosed her with a bruise on the brain from
a fall estimated about 2 months prior and the hand is pulled from tendons and ligaments and
from a fall. I got the report of March 15th and 16th from the hospital.
She is in need of a lot of rehabilitation, physical therapy, occupational therapy and
she needs every day health care in her home. I requested the report from Kaiser records which
had everything. The visiting nurse practitioner on July 5th showed me on her phone the
description of her hand /wrist injury. I have enclosed link and video of Mar 15 th , 16 th and 17 th and
later as the fluid continued to move and the use of her hand
The fear of falling has also paralyzed her to the bed. However, she is getting
therapy and on top of everything we have mounting bills from this and unfortunately, home
caregiver is not covered on any of her insurances. We are paying out of pocket for caregiver
and it is mounting up.
I hereby demand that Kaiser Hospital compensates my mother for her pain and ongoing
treatment. I also demand that Kaiser Hospital to pay all bills accrued since March 15, 2022 and
cover her home health care for a year. You risk incurring legal consequences if you fail to
comply with this demand.
I have been authorized to act on behalf of my mother. This letter will act as a final
warning to you to comply with our demand before we pursue legal action against you. At this
time, we are not filing a civil suit against you, as we hope we can resolve this matter without
authoritative involvement. We are not under any circumstances, however, waiving any legal
rights we have presently, or future legal remedies by sending this letter.
I expect to hear back from you in a timely manner of no more than seven (7) days from
the date of this letter. If the demand is not met within this period, I will seek appropriate relief
before a court of competent jurisdiction for full payment of damages plus all costs and interests.

Yours Sincerely,

Insert Your Full Name

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