A Tale of the Supply Chain

This Began in August 2021

Shortly after my visit to the hospital while browsing the internet I came across an article about a Phillips Respironics recall of CPAP machines. Through a series of phone calls and research I discovered that my CPAP machine had bee recalled.

What did this mean?

I had started noticing that when I first started the machine at night the air was stuffy. While initial recommendations were that I should continue using my machine I decided caution was the best course and stopped.

My first concern was why was the machine recalled? This was not a simple question to answer and took several weeks to put together the following is what I discovered:

• In order to quiet the motor, Phillips had covered the motor with a foam pad.
• Overtime this pad would dry out.
• This drying process was quickened by using an automated cleaning system such as SoClean, which I used daily.
• Eventual small foam particles would enter into the air pathways leading to my mask.
• Hence, I was breathing little foam particles.

My decision to stop using my CPAP machine was sound.

So now what?

My first step was to get in touch with my sleep specialist and make an appointment. My appointment was made for September 28th. This was my 1st year using an Advantage as opposed to a Supplemental plan.

The simple difference in plans is with the supplemental plan:

• There are no copays.
• No referrals required, I just went to whichever Dr or Specialist was supported by the plan
• The supplemental plan requires an additional $300 plus monthly payment.

With the advantage plan.

• There is a minimal copay for most visits. For my hospital stay the copay was $120.
• My primary physician must refer me to most specialists.
• I save $300 a month.

Now for this $300+ month saving, my primary care physician must refer me to each specialist. So prior to September 28th I had to call my primary care doctors office for an insurance referral. This went without a hitch.

My visit with my Sleep Specialist

Was short. I explained the situation, by now the Dr was well aware of the recall and the procedures necessary. We had a brief discussion of my experiences to that point and my decision that I was not going to use the current CPAP.

He put in an order for the CPAP and indicated that I should have a machine by November. I requested a machine other than Phillips.

We made an appointment for December to review the sleep results of the new machine.

I went home and waited, and waited, and waited until December.

Prior to the December appointment I called my sleep specialist to reschedule. I knew demand was high and supply chain issues are throughout the economy.

My next step was to determine where the replacement. I called my insurance agent to determine where my order was in the chain of events. They had no record.

I called my sleep specialist and determined that the actual machine is ordered by my primary care physician.

I actually had a periodic appointment with my primary care physician, so I had this conversation face-to-face. It went something like this. We’ll look into it. Over the next week or so, I was able to determine and order had been placed, but with a supplier not covered by insurance plan.

I got back to my primary care physician and finally got the machine order properly. I confirmed this with the supplier and went back into the wait mode.

The supplier interface.

I’ll admit I make things worse, because I now do not answer my phone if I do not recognize the phone number. Overtime, for most things, this works well. When I’m expecting a delivery I change this mode until the delivery actually occurs.

In early February, I decided it was time to push the process again. I started by calling the number I had in my cellphone. As it turns out this number was for the supplier not covered by the insurance plan. I went back to my primary care physician to get the correct phone number, which I placed into my contact list.

I called and was directed to the respiratory department. They had my machine and we made an appointment for the following Monday for delivery. Monday came and after the schedule window I again called the supplier.

Apparently, they had tried to get in touch with me to reschedule. We rescheduled for Thursday.

Old dogs, new tricks.

Over the last couple of months, I replaced my cellphone with the newest version. One of the changes was my Voicemail App. Seems the new application does not supply a hint that someone called and left a message.

I checked the app and found a voicemail from the supplier, shortly after I made the Monday appointment asking me to call. The call was not from the suppliers office, but from the delivery persons personal phone. The supplier is not actually from Palm Beach County, but from Broward County with a different area code.

This Old dog had not answered the phone because he didn’t recognize the number. Hadn’t heard the voicemail because he didn’t know he had one. I’m still not certain how to fix this, but I’ll try to check for voicemails every now and then.

Thursday delivery.

Was a little late, but occurred without further issues. I used the machine for the first time that night. I track my sleep using a Fitbit. One of the tracked measurements is estimated oxygen variation. For the first time since August, the oxygen variation was normal the whole night.

Lessons Learned.

I’ve know for a long time that I’m responsible for my health care. This includes follow ups with orders and such. Patience is always a virtue, but to track progress one needs to know who to call.

I found this whole process cumbersome. It centers on the primary care physician and not on the specialist. I would think that once a referral occurs, that the specialist’s office would be responsible for orders, supplier selection and equipment acquisition. The more people involved the more expensive the whole process becomes.

But that’s just me, what do I know.

This old dog is still learning

And the new machine is manufactured by Phillips. I’m not sending it back and starting again.