Transplant Hepatologist - Winston-salem, NC

"I personally was not a patient of Mr. Rudnick, but my brother unfortunately was during the months of October 2021 - June 2022. Mr. Rudnick unofficially diagnosed my brother with Stage IV PSC (Primary Sclerosing Cholangitis). PSC is a chronic liver disease that can result in death if discovered too late as well as untreated. Dr. Rudnick based his knowledge of this diagnosis primarily on ONE high liver/enzyme count after completing a fibro scan on my brother. Liver fibro scans can also be called Liver Elastography. This basically is a special type of ultrasound that sends a strong pulse into the liver tissue and takes multiple samples of an area in the liver to see how dense (stiff) the tissue is. In theory it's supposed to be a noninvasive tool that will hopefully in the far future help reduce the amount of liver biopsies that are needed because it can help grade how damaged and stiff the liver tissue has gotten. Prior to becoming a patient of Mr. Rudnick, my brother had his Gallbladder removed after experiencing extreme stomach pain. Once your Gallbladder has been removed the bile within the Gallbladder has to go somewhere. Usually the bile ducts will dilate and hold the bile until the intestines need it. My brother's bile ducts however are scarred and narrow so the bile has been sitting in his liver cells, which can cause inflammation. Over time the liver doesn't like being inflamed so therefore the body starts to scar the liver tissue which is formally called Cirrhosis. So, in order to correctly stage the level of Cirrhosis it would have been NECESSARY to have a liver biopsy done with imaging results. As a fibro scan is a wonderful scan, they can be tricky. Technology has come a long way but in order to properly diagnose liver failure APPROPRIATELY you cannot do so without having a needle biopsy performed. The fibro scan is very technologist dependent can be skewed very easily. If someone isn't very educated of this scan or holds their hand differently, or if the patient moves or breathes or even eats it can alter the results. So, while it was a good idea to have this done it was not a best practice by a medical professional to diagnose such a major condition at the stage in which he "thought" his patient, my brother was in. Even if he is in Stage IV Cirrhosis then why were TIPS ad stents and things of that nature not presented to my brother? If this was so severe, then why prolong next best action steps for as long as we were made to wait and are currently STILL waiting. My brother is only 25 years of age. He is married with a two-year-old daughter. In the midst of all of this he has tried and is still trying to work a full-time job that requires manual labor and be a present full-time husband and father. While this would be hard for anyone of any age, this has been that much worse with the time WASTED and lost by Dr. Rudnick's lack of urgency to act on how to best treat and go about his condition. "