The following is the original complaint letter that I sent to the Texas State Veterinarian Board:
February 7, 2011
My name is Nettie Dunn and I want to make formal complaint about a Veterinarian. I feel that he was not honest or fair with the information that I was given before and after my dog “Spanky” had surgery in his clinic.
On January 14, 2011 my daughter, Malissa Dunn and I took Spanky into Anchor Road Vet Clinic because he was scratching. Dr. Gary Brackeen gives Spanky allergy shots periodically. Spanky also had a knot on his stomach above is left thigh. Years ago I had brought the knot to Dr. Brackeen’s attention and he said that it was a fatty tumor and we would keep an eye on it. The knot seemed to be getting bigger and I wanted Dr. Brackeen to look at it again. Jessica, Assistant #1 gave Spanky the allergy shot. I had her look at the knot. Assistant #1 said that she would get the doctor to look at it. Dr. Brackeen came in to observe the knot; he touched, squeezed and felt around on it. He asks if “she” had been spayed twice and I said that “he” had been neutered. I felt that Spanky being male was obvious from the location of the tumor. Dr. Brackeen told his Assistant #1 to schedule Spanky for surgery to remove the knot and he left the room. The surgery was scheduled for the following Monday morning January 17, 2011. Assistant #1 then told me if it was a fatty tumor Dr. Brackeen would remove it and if it was anything else Dr. Brackeen would send it off to a lab to be diagnosed.
On Monday morning January 17th my daughter took Spanky in for his surgery. I called that day after lunch to check on Spanky and Assistant #1 said that Spanky was fine. Assistant #1 said the knot was just a fatty tumor, the doctor had removed it all and I need not to worry. Assistant #1 said that I could pick Spanky up after 4:00pm. My daughter went to pick Spanky up and Assistant #1 told my daughter that the older dogs sometime take longer to get over the anesthetic and it could take up to 24 hours before Spanky was over the effects. There was a piece of gauze sticking out of the wound about an inch long and Assistant #1 said it was left inside Spanky to help cauterize the area after surgery. We were given some antibiotics to give Spanky every 12 hours. That evening when I arrived home from work I saw that the gauze was dripping with blood, we watched Spanky and I thought he was bleeding more than he should be.
At around 8:00pm my daughter called Dr. Brackeen’s office and his daughter answered the phone. Dr. Brackeen did not come to the phone and Dr. Brackeen’s daughter relayed to him our concerns of Spanky bleeding and Dr. Brackeen told his daughter that we should wrap Spanky with an ace bandage and gauze. Dr. Brackeen said if we needed to bring Spanky in then we should do it before it got too late. At 9:30pm Spanky was still bleeding quite a bit and seemed to be in a lot of pain when we moved him. I then called the office and Dr. Brackeen did not come to the phone but said to bring Spanky in. His daughter asked how long it would be before we could get there. I told her that I could be there in 5 minutes. Dr. Brackeen’s clinic is in his home and I really did not want to bother him but I was worried about Spanky.
When we got there Dr. Brackeen’s daughter met us at the door and we went in and set Spanky on the clinic table. My daughter held Spanky up and Dr. Brackeen didn’t even touch Spanky, he looked at him and said “take him home he is fine” waving his hands in a motion as to say “get out of here”. I told Dr. Brackeen that I thought Spanky was bleeding too much and Dr. Brackeen said that “he has tons of blood and he is not going to die anytime soon”. I apologized for coming by so late and felt like I had been a bother, but I was very worried about Spanky.
The next day, Tuesday January 18th, I called to schedule Spanky an appointment to have his staples removed. I spoke with Desiree, Assistant #2 and she asked how Spanky was doing. I told her that he still was not feeling good. She asked if he was drinking water and going out to use the restroom. I told Assistant #2 that Spanky was doing both but we were making him get up and where ever we set him at he would urinate as if he could not hold his bladder. I also told her that we had to hold the water bowl for him. She scheduled me to bring Spanky back on Friday January 21st.
The following day, January 19, 2011, Spanky was still not moving around and still bleeding. We were putting Spanky on towels, blankets and changing them out about every 4 hours. That evening I moved Spanky into my bedroom next to my bed because I progressively worried more and more about him. I started getting more concerned when I could not get Spanky to drink water. I decided to take Spanky outside to see if he would walk and I put him in the front yard. Spanky tried to walk to me but kept falling down. I felt terrible and I was so worried about Spanky. I wanted to call Dr. Brackeen, but it was around 11:00 pm and Dr. Brackeen made me feel so stupid on Monday night when I took Spanky in, I really didn’t want to bother Dr. Brackeen again. This is where I wish I could have changed all of my decisions. I did not call and I told myself if Spanky was not better in the morning I would take him in to Dr. Brackeen first thing. I wish that I would have had a backup plan, I wish I had known who to call, I wish I would have DONE SOMETHING. Throughout the night I set on the floor with Spanky and held him while he was shaking, I told Spanky how much I loved him, and told him how sorry I was for putting him through an unnecessary surgery. If ONLY I had known.
I waited as long as I could and at 4:30am I called Dr. Brackeen I was crying when Dr. Brackeen answered, I told Dr. Brackeen that I was afraid that Spanky would not make it much longer and asked if I could bring Spanky in. Dr. Brackeen said that he was still asleep and there would be no one there to help him until 7:00 am. He asked me if I thought Spanky could make it until then. I said I did not know….what could I say?
I sat on the couch with Spanky wrapped him in a blanket. I told him that I was so sorry over and over and over. At 6:45am I left my house to take him over to the clinic. I stood outside and waited on the clinic to open. I could see lights on inside but I stood outside until Assistant #2 pulled up in her car and she let me in. When we walked in Dr. Brackeen and his daughter were awake. I could not understand why Dr. Brackeen had told me 2 ½ hours earlier that no one was there to help him. Before I ever set Spanky down on the table Dr. Brackeen said “You know he is full of cancer.” I nearly fell to the ground in shock. I said “No, no one told me that” Dr. Brackeen said that Spanky’s whole body was filled with cancer and I just started crying. Dr. Brackeen walked into the clinic and had Assistant #2 hold Spanky on the table and he removed gauze from Spanky’s stomach. Dr. Brackeen said that it was a tough surgery for an old dog to go through, still in shock from the cancer I didn’t know what to say. Assistant #2 asked Dr. Brackeen what he wanted to do and he said that they would keep Spanky and watch him. I left the clinic and felt so helpless.
As you can imagine, I kept questioning myself. Had I known that it was a tough surgery would I have even put Spanky through it? I thought it was a common surgery. And Spanky being “old”, he was only 7 years old – I considered him still a young dog. Then the CANCER????? Assistant #1 had told me on Monday that it was a fatty tumor and it all was removed and there was nothing to worry about.
Now I’m afraid I’ve made another mistake, I left Spanky there. I watched Assistant #2 put Spanky in a kennel in the back and I had a terrible feeling in the pit of my stomach. When I went home I waited until 10:00 am to call and check on Spanky. Assistant #2 answered the phone and I asked how Spanky was doing, she said that Dr. Brackeen wanted to talk to me. I knew then that something had gone wrong. Dr. Brackeen got on the phone and told me that they “lost him, he put up a hard fight and was a tough old boy”. Dr. Brackeen said that he was bagging Spanky up to put him in the freezer and I could come by that evening to talk. Spanky not only was a dog he was a member of my family and I was so upset. Lost him??? Bagging him up to put him in the freezer???
Both of my daughters, Malissa and Carissa, and I stayed in bed all day. We were dreading having to go to the clinic but I had questions for Dr. Brackeen. When we arrived Dr. Brackeen was leaving the clinic. We met Dr. Brackeen as he was going out the door. Standing in the waiting area Dr. Brackeen hugged me and said that he was sorry. I told Dr. Brackeen that I did not understand and I had questions. Dr. Brackeen said that he had questions too. I asked how Assistant #1 could tell me that Spanky only had a fatty tumor and you tell me that Spanky had cancer. Dr. Brackeen said that the cancer was wrapped up in Spanky’s body and he removed as much as possible and that he could not tell what was going on inside Spanky. Carissa asked Dr. Brackeen when we were first told that Spanky had cancer and Dr. Brackeen said that it was noted in the chart several years ago. Carissa then asked Dr. Brackeen what would have happened if we had not removed the knot and Dr. Brackeen said “I don’t know, my crystal ball broke yesterday”. I then told Dr. Brackeen that we were not trying to blame him all I wanted was answers. Dr. Brackeen said very defensively “oh no, you can’t blame me for this”. I asked Dr. Brackeen why no one told me that the surgery was tough and he said that it was tough on some dogs and not others and Spanky’s age was a factor. Again, I didn’t know that Spanky was old. Dr. Brackeen then told Assistant #1 that he needed to get the kids to taekwondo and left. Assistant #1 was standing in the next room listening to everything that Dr. Brackeen said. I was crying when Dr. Brackeen left. Assistant #1 said that she could not say anything until Dr. Brackeen left; she said that she would get in trouble if Dr. Brackeen heard her.
When Dr. Brackeen drove off Assistant #1 told us that when she came into the clinic that morning Spanky had already passed. Assistant #1 said that Assistant #2 was angry because Dr. Brackeen would not get off the couch to help Spanky. We asked Assistant #1 if Dr. Brackeen left Spanky in the kennel and didn’t do anything and she said “yes”. I could not believe it. Assistant #1 said that Assistant #2 had told Dr. Brackeen that Spanky needed fluids and Dr. Brackeen said that they were just going to watch Spanky. Assistant #1 said that Assistant #2 kept going back to check on Spanky. All I can do is pray that Spanky was not alone when he died. Spanky was such a baby and he got scared easily.
I just can’t quit thinking that Spanky probably thought that I deserted him. After asking and educating myself I feel guilty because I did not rush Spanky to an emergency clinic in Houston. Houston is only an hour drive from my home. But through all the stress and worry I didn’t even think of that. I wish Dr. Brackeen would have given me that option. And while we are talking about options, if I had known that Spanky was going to be left alone in the kennel to die I would have never left Spanky there. Even if I had taken Spanky with me and he died on the way to an emergency room at least Spanky would have been with his family and not in some metal kennel all alone. Assistant #1 also said that Dr. Brackeen has become lazy lately and they can’t get him off the couch to look at the patients. Assistant #1 said this is the second animal this week that Dr. Brackeen would not get off the couch to help and ended in death.
I feel like Dr. Brackeen let me down and I let Spanky down.
I do not want to get the girls in the office in trouble they have always been kind and caring to us and all of our babies. On Friday January 21, 2011, I had an appointment for Spanky to have the staples removed. I kept the appointment and went in, Assistant #2 was working and she said that she and Assistant #1 have gotten to the point that they hate their jobs. The job was not fun anymore and they were left with explaining to people what went wrong with their pets. Assistant #2 said that she thought the surgery went well and she felt like Spanky’s little body just could not handle the anesthetic. Assistant #2 said that Spanky did not have cancer and she didn’t know why Dr. Brackeen would even say that. Assistant #2 said the knot was a fatty tumor Dr. Brackeen removed it all. Deceit is the word that comes to mind or is it misrepresentation? I have thought about it every day since it happen. I don’t understand why Dr. Brackeen would have ever said that Spanky had cancer.
I hope that someone at your office can help me get the answers. That day I told Assistant #2 that I wanted all of my dogs’ records and I would never bring another one of my family members to Dr. Brackeen again. I trusted Dr. Brackeen with someone that was very important to me and now I don’t have Spanky anymore. I am so hurt. I do not feel that Dr. Brackeen was honest, and he was not fair, not courteous, considerate or compassionate to me, Spanky or my family.
Other questions I have, on Spanky’s chart it says nothing about us being told years ago that the knot could be cancer, nothing about us bringing Spanky in on Monday night when I thought he was bleeding too much, nothing about me bringing Spanky in on Thursday morning, and nothing about Spanky dying.
This has been devastating to me and my family, Spanky was mine, he was my first baby and I have found out that I loved Spanky more than I could have ever imagined. I lost Spanky too soon and I blame Dr. Brackeen with Anchor Road Vet Clinic for my loss. I do not want anyone else to lose their animal/pet/family member in the same manner and just letting this go and not saying anything would absolutely be the wrong thing to do.
Should Dr. Brackeen have done something to make sure that Spanky could make it through the surgery? Should Dr. Brackeen have helped me find the proper medical care to save Spanky? Should Dr. Brackeen be allowed to continue this type of behavior? Should another pet suffer and die the way that Spanky did? Again, after research and educating myself should Dr. Brackeen have done blood work or at least taken Spanky’s temperature? Nothing is noted on Spanky’s chart and I never saw any of this done. Isn’t there a standard of care that Spanky deserved?
Please help me.
My name is Nettie Dunn and I want to make formal complaint about a Veterinarian. I feel that he was not honest or fair with the information that I was given before and after my dog “Spanky” had surgery in his clinic.
On January 14, 2011 my daughter, Malissa Dunn and I took Spanky into Anchor Road Vet Clinic because he was scratching. Dr. Gary Brackeen gives Spanky allergy shots periodically. Spanky also had a knot on his stomach above is left thigh. Years ago I had brought the knot to Dr. Brackeen’s attention and he said that it was a fatty tumor and we would keep an eye on it. The knot seemed to be getting bigger and I wanted Dr. Brackeen to look at it again. Jessica, Assistant #1 gave Spanky the allergy shot. I had her look at the knot. Assistant #1 said that she would get the doctor to look at it. Dr. Brackeen came in to observe the knot; he touched, squeezed and felt around on it. He asks if “she” had been spayed twice and I said that “he” had been neutered. I felt that Spanky being male was obvious from the location of the tumor. Dr. Brackeen told his Assistant #1 to schedule Spanky for surgery to remove the knot and he left the room. The surgery was scheduled for the following Monday morning January 17, 2011. Assistant #1 then told me if it was a fatty tumor Dr. Brackeen would remove it and if it was anything else Dr. Brackeen would send it off to a lab to be diagnosed.
On Monday morning January 17th my daughter took Spanky in for his surgery. I called that day after lunch to check on Spanky and Assistant #1 said that Spanky was fine. Assistant #1 said the knot was just a fatty tumor, the doctor had removed it all and I need not to worry. Assistant #1 said that I could pick Spanky up after 4:00pm. My daughter went to pick Spanky up and Assistant #1 told my daughter that the older dogs sometime take longer to get over the anesthetic and it could take up to 24 hours before Spanky was over the effects. There was a piece of gauze sticking out of the wound about an inch long and Assistant #1 said it was left inside Spanky to help cauterize the area after surgery. We were given some antibiotics to give Spanky every 12 hours. That evening when I arrived home from work I saw that the gauze was dripping with blood, we watched Spanky and I thought he was bleeding more than he should be.
At around 8:00pm my daughter called Dr. Brackeen’s office and his daughter answered the phone. Dr. Brackeen did not come to the phone and Dr. Brackeen’s daughter relayed to him our concerns of Spanky bleeding and Dr. Brackeen told his daughter that we should wrap Spanky with an ace bandage and gauze. Dr. Brackeen said if we needed to bring Spanky in then we should do it before it got too late. At 9:30pm Spanky was still bleeding quite a bit and seemed to be in a lot of pain when we moved him. I then called the office and Dr. Brackeen did not come to the phone but said to bring Spanky in. His daughter asked how long it would be before we could get there. I told her that I could be there in 5 minutes. Dr. Brackeen’s clinic is in his home and I really did not want to bother him but I was worried about Spanky.
When we got there Dr. Brackeen’s daughter met us at the door and we went in and set Spanky on the clinic table. My daughter held Spanky up and Dr. Brackeen didn’t even touch Spanky, he looked at him and said “take him home he is fine” waving his hands in a motion as to say “get out of here”. I told Dr. Brackeen that I thought Spanky was bleeding too much and Dr. Brackeen said that “he has tons of blood and he is not going to die anytime soon”. I apologized for coming by so late and felt like I had been a bother, but I was very worried about Spanky.
The next day, Tuesday January 18th, I called to schedule Spanky an appointment to have his staples removed. I spoke with Desiree, Assistant #2 and she asked how Spanky was doing. I told her that he still was not feeling good. She asked if he was drinking water and going out to use the restroom. I told Assistant #2 that Spanky was doing both but we were making him get up and where ever we set him at he would urinate as if he could not hold his bladder. I also told her that we had to hold the water bowl for him. She scheduled me to bring Spanky back on Friday January 21st.
The following day, January 19, 2011, Spanky was still not moving around and still bleeding. We were putting Spanky on towels, blankets and changing them out about every 4 hours. That evening I moved Spanky into my bedroom next to my bed because I progressively worried more and more about him. I started getting more concerned when I could not get Spanky to drink water. I decided to take Spanky outside to see if he would walk and I put him in the front yard. Spanky tried to walk to me but kept falling down. I felt terrible and I was so worried about Spanky. I wanted to call Dr. Brackeen, but it was around 11:00 pm and Dr. Brackeen made me feel so stupid on Monday night when I took Spanky in, I really didn’t want to bother Dr. Brackeen again. This is where I wish I could have changed all of my decisions. I did not call and I told myself if Spanky was not better in the morning I would take him in to Dr. Brackeen first thing. I wish that I would have had a backup plan, I wish I had known who to call, I wish I would have DONE SOMETHING. Throughout the night I set on the floor with Spanky and held him while he was shaking, I told Spanky how much I loved him, and told him how sorry I was for putting him through an unnecessary surgery. If ONLY I had known.
I waited as long as I could and at 4:30am I called Dr. Brackeen I was crying when Dr. Brackeen answered, I told Dr. Brackeen that I was afraid that Spanky would not make it much longer and asked if I could bring Spanky in. Dr. Brackeen said that he was still asleep and there would be no one there to help him until 7:00 am. He asked me if I thought Spanky could make it until then. I said I did not know….what could I say?
I sat on the couch with Spanky wrapped him in a blanket. I told him that I was so sorry over and over and over. At 6:45am I left my house to take him over to the clinic. I stood outside and waited on the clinic to open. I could see lights on inside but I stood outside until Assistant #2 pulled up in her car and she let me in. When we walked in Dr. Brackeen and his daughter were awake. I could not understand why Dr. Brackeen had told me 2 ½ hours earlier that no one was there to help him. Before I ever set Spanky down on the table Dr. Brackeen said “You know he is full of cancer.” I nearly fell to the ground in shock. I said “No, no one told me that” Dr. Brackeen said that Spanky’s whole body was filled with cancer and I just started crying. Dr. Brackeen walked into the clinic and had Assistant #2 hold Spanky on the table and he removed gauze from Spanky’s stomach. Dr. Brackeen said that it was a tough surgery for an old dog to go through, still in shock from the cancer I didn’t know what to say. Assistant #2 asked Dr. Brackeen what he wanted to do and he said that they would keep Spanky and watch him. I left the clinic and felt so helpless.
As you can imagine, I kept questioning myself. Had I known that it was a tough surgery would I have even put Spanky through it? I thought it was a common surgery. And Spanky being “old”, he was only 7 years old – I considered him still a young dog. Then the CANCER????? Assistant #1 had told me on Monday that it was a fatty tumor and it all was removed and there was nothing to worry about.
Now I’m afraid I’ve made another mistake, I left Spanky there. I watched Assistant #2 put Spanky in a kennel in the back and I had a terrible feeling in the pit of my stomach. When I went home I waited until 10:00 am to call and check on Spanky. Assistant #2 answered the phone and I asked how Spanky was doing, she said that Dr. Brackeen wanted to talk to me. I knew then that something had gone wrong. Dr. Brackeen got on the phone and told me that they “lost him, he put up a hard fight and was a tough old boy”. Dr. Brackeen said that he was bagging Spanky up to put him in the freezer and I could come by that evening to talk. Spanky not only was a dog he was a member of my family and I was so upset. Lost him??? Bagging him up to put him in the freezer???
Both of my daughters, Malissa and Carissa, and I stayed in bed all day. We were dreading having to go to the clinic but I had questions for Dr. Brackeen. When we arrived Dr. Brackeen was leaving the clinic. We met Dr. Brackeen as he was going out the door. Standing in the waiting area Dr. Brackeen hugged me and said that he was sorry. I told Dr. Brackeen that I did not understand and I had questions. Dr. Brackeen said that he had questions too. I asked how Assistant #1 could tell me that Spanky only had a fatty tumor and you tell me that Spanky had cancer. Dr. Brackeen said that the cancer was wrapped up in Spanky’s body and he removed as much as possible and that he could not tell what was going on inside Spanky. Carissa asked Dr. Brackeen when we were first told that Spanky had cancer and Dr. Brackeen said that it was noted in the chart several years ago. Carissa then asked Dr. Brackeen what would have happened if we had not removed the knot and Dr. Brackeen said “I don’t know, my crystal ball broke yesterday”. I then told Dr. Brackeen that we were not trying to blame him all I wanted was answers. Dr. Brackeen said very defensively “oh no, you can’t blame me for this”. I asked Dr. Brackeen why no one told me that the surgery was tough and he said that it was tough on some dogs and not others and Spanky’s age was a factor. Again, I didn’t know that Spanky was old. Dr. Brackeen then told Assistant #1 that he needed to get the kids to taekwondo and left. Assistant #1 was standing in the next room listening to everything that Dr. Brackeen said. I was crying when Dr. Brackeen left. Assistant #1 said that she could not say anything until Dr. Brackeen left; she said that she would get in trouble if Dr. Brackeen heard her.
When Dr. Brackeen drove off Assistant #1 told us that when she came into the clinic that morning Spanky had already passed. Assistant #1 said that Assistant #2 was angry because Dr. Brackeen would not get off the couch to help Spanky. We asked Assistant #1 if Dr. Brackeen left Spanky in the kennel and didn’t do anything and she said “yes”. I could not believe it. Assistant #1 said that Assistant #2 had told Dr. Brackeen that Spanky needed fluids and Dr. Brackeen said that they were just going to watch Spanky. Assistant #1 said that Assistant #2 kept going back to check on Spanky. All I can do is pray that Spanky was not alone when he died. Spanky was such a baby and he got scared easily.
I just can’t quit thinking that Spanky probably thought that I deserted him. After asking and educating myself I feel guilty because I did not rush Spanky to an emergency clinic in Houston. Houston is only an hour drive from my home. But through all the stress and worry I didn’t even think of that. I wish Dr. Brackeen would have given me that option. And while we are talking about options, if I had known that Spanky was going to be left alone in the kennel to die I would have never left Spanky there. Even if I had taken Spanky with me and he died on the way to an emergency room at least Spanky would have been with his family and not in some metal kennel all alone. Assistant #1 also said that Dr. Brackeen has become lazy lately and they can’t get him off the couch to look at the patients. Assistant #1 said this is the second animal this week that Dr. Brackeen would not get off the couch to help and ended in death.
I feel like Dr. Brackeen let me down and I let Spanky down.
I do not want to get the girls in the office in trouble they have always been kind and caring to us and all of our babies. On Friday January 21, 2011, I had an appointment for Spanky to have the staples removed. I kept the appointment and went in, Assistant #2 was working and she said that she and Assistant #1 have gotten to the point that they hate their jobs. The job was not fun anymore and they were left with explaining to people what went wrong with their pets. Assistant #2 said that she thought the surgery went well and she felt like Spanky’s little body just could not handle the anesthetic. Assistant #2 said that Spanky did not have cancer and she didn’t know why Dr. Brackeen would even say that. Assistant #2 said the knot was a fatty tumor Dr. Brackeen removed it all. Deceit is the word that comes to mind or is it misrepresentation? I have thought about it every day since it happen. I don’t understand why Dr. Brackeen would have ever said that Spanky had cancer.
I hope that someone at your office can help me get the answers. That day I told Assistant #2 that I wanted all of my dogs’ records and I would never bring another one of my family members to Dr. Brackeen again. I trusted Dr. Brackeen with someone that was very important to me and now I don’t have Spanky anymore. I am so hurt. I do not feel that Dr. Brackeen was honest, and he was not fair, not courteous, considerate or compassionate to me, Spanky or my family.
Other questions I have, on Spanky’s chart it says nothing about us being told years ago that the knot could be cancer, nothing about us bringing Spanky in on Monday night when I thought he was bleeding too much, nothing about me bringing Spanky in on Thursday morning, and nothing about Spanky dying.
This has been devastating to me and my family, Spanky was mine, he was my first baby and I have found out that I loved Spanky more than I could have ever imagined. I lost Spanky too soon and I blame Dr. Brackeen with Anchor Road Vet Clinic for my loss. I do not want anyone else to lose their animal/pet/family member in the same manner and just letting this go and not saying anything would absolutely be the wrong thing to do.
Should Dr. Brackeen have done something to make sure that Spanky could make it through the surgery? Should Dr. Brackeen have helped me find the proper medical care to save Spanky? Should Dr. Brackeen be allowed to continue this type of behavior? Should another pet suffer and die the way that Spanky did? Again, after research and educating myself should Dr. Brackeen have done blood work or at least taken Spanky’s temperature? Nothing is noted on Spanky’s chart and I never saw any of this done. Isn’t there a standard of care that Spanky deserved?
Please help me.