A patient fails to show for any appointments, likely has a significant injury, his surgeon becomes frustrated and releases him.
This is not infrequent. What is occurring is a combination of: Distrust and Revenge
When he was injured, he believes his employer tried to minimize his complaints and delay treatment. Then when treatment was finally authorized, they sent him to a doctor who they trust to return him to work. He got worse.
Even after seeing a specialist, there was control how much care he received, whether tests would be authorized and whether/when prescriptions would be filled.
Feeling physically trapped and financially strapped, he has become angry.
He now does not trust anyone to whom he is sent by the insurer, and as a result, he is quite vulnerable to being sent someplace perhaps worse.
He mistakenly feels that his lack of recovery will punish his employer whom he (likely accurately) senses does not want him back at work. He feels (again probably accurately) that they intend to fire him so he believes that he can seek his revenge by obstructing anything that anyone attempts to do for him.
Seem self-destructive? Well, it is. But until someone is able to determine exactly what has triggered his anger and distrust, then he will continue to seek revenge in a self-destructive manner.