Liability

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The hospital can be sued for not complying with HIPAA, but that's got nothing to do with what happened here (nobody's privacy got breached, did it?).

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The HIPAA issue deals with private information on an insecure public netork... though it is a seperate issue.

The real issue is why this information was stored in such a bad manner... most likely it was from either the execs trying to cut corners or someone in administration just doing a bad job. In any case, they clearly didn't secure the information according to best practices and are responsible accordingly.

The doctor may have given a standard treatment to the patient who had an exotic allergy. the doctor assumed that no allergy as mentioned in the record, so one must not exist. Since the doctor worked with the information they had and were clearly not just attempting to cut corners the DA wouldn't even attempt to hold them accountable.

cheers,

catch

PS. There is no mention of Administration informing the doctor of the situation.

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from the original post
Mallory drops patient database

5. Patient dies from allergic reaction to meds after Doctor can't access patient records.

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That to me clearly states that the doctor tried to access the patient's records (to, among other things, check for allergies).

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Originally posted by catch
the doctor assumed that no allergy as mentioned in the record, so one must not exist

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What record? There wasn't any - or at least it was not accessible. Assuming that there are no allergies because there aren't any mentioned in the records would be a perfectly acceptable defense. Assuming that there are no allergies because there are no records (which is exactly the case here) is a one-way ticket to jail - you bet the DA will attempt to hold the doctor accountable.

Hmmm, interesting.....................

Naturally I am looking at this from a UK perspective, as it is the only one I know :)

1. catch by administrators, I meant the hospital administrators. Our laws hold them responsible for the professional actions of their employees/agents. The only situation where the IT guys would carry the can alone, was if they failed to implement policy and directives in such a way that the administrators could not reasonably be expected to know. For example: deliberate lying. They would, however, share the blame because as supposed professionals, they should have known better.

2. There is no mention of whether the records actually had details of the allergy. If they had, it would have been marked on the patients clipboard/chart over here, along with the prescribed medications. If a patient is admitted, and no records are available (as in this case) the doctor is entitled to assume no allergies exist. Over here, people with those sort of allergies have a "medicalert" medallion or bracelet...............if they were not wearing it, then the coroner would return "misadventure". The doctor would not be liable.

Over here a doctor is expected to treat the sick, and if there are no records, he goes with what he's got. That approach is fully supported by our laws.

:)

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That to me clearly states that the doctor tried to access the patient's records (to, among other things, check for allergies).

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Since no record was present, the doctor likely pulled a NULL, not an access denied or other such error. So of the doctor looked up allergies for Mr.X and got a null, then he'd assume no allergies exist.

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What record? There wasn't any - or at least it was not accessible. Assuming that there are no allergies because there aren't any mentioned in the records would be a perfectly acceptable defense. Assuming that there are no allergies because there are no records (which is exactly the case here) is a one-way ticket to jail - you bet the DA will attempt to hold the doctor accountable.

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So if the patient had an immediate need for treatment the doctor should sit on his hands? Better yet, why not just shut down the hospital and kick everyone who's records were lost out?

It is administrations job, through record keeping to inform the doctor of any pre-existing conditions which would require a deviation from normal treatment, their failure to do so leaves the doctor no recourse but to proceed with normal treament.

cheers,

catch

It clearly says "can't access patient records" - if you want to keep turning that into something it doesn't say just so you can be right all the time, that's up to you. It doesn't say "pulled the patient's record and didn't see anything".

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Better yet, why not just shut down the hospital and kick everyone who's records were lost out?

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Let me turn that irrational comparison around, and say: why not just amputate every patient's right leg? That's only a step away from administering drugs that, in certain people, cause allergic reactions, to a patient whose allergic record you're unable to pull.

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If a patient is admitted, and no records are available (as in this case) the doctor is entitled to assume no allergies exist.

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Arguably, yes. On the other hand: it's, again, not like "no records are available". It's that the doctor "can't access patient records". The difference is night and day...

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Originally posted here by catch
Since no record was present, the doctor likely pulled a NULL, not an access denied or other such error. So of the doctor looked up allergies for Mr.X and got a null, then he'd assume no allergies exist.

So if the patient had an immediate need for treatment the doctor should sit on his hands? Better yet, why not just shut down the hospital and kick everyone who's records were lost out?

It is administrations job, through record keeping to inform the doctor of any pre-existing conditions which would require a deviation from normal treatment, their failure to do so leaves the doctor no recourse but to proceed with normal treament.

catch

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I saw this on Venom ER on Animal Planet.... a kid was struck by a diamond back and they didn't know anything about her history because she was life-flighted in. Venom ER, where records don't matter! Assuming to save a life with antivenom.

Negative, I'm sorry, but you're just wrong on this subject.

It doesn't matter if no records exist, if the records couldn't been accessed, or if the records had been corrupted. The simple fact is that the doctor did not violate any information made avilible to them. As far as the doctor is concerned, nothing else matters.

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Let me turn that irrational comparison around, and say: why not just amputate every patient's right leg? That's only a step away from administering drugs that, in certain people, cause allergic reactions, to a patient whose allergic record you're unable to pull.

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It's not an irrational comparison, you're saying that if doctors can't access records, they cannot treat the patients without risking criminal charges, hence it makes sense to close the hospital. Amputating a leg is a very drastic measure, and typically not called for. As far as what people could have allergic reactions to... that could be anything... could be latex, could be ANY drug that exists... in fact it could be anything at all that the client could come in contact with. So long as the doctor follows what would be a reasonable treatment process, they will not be responsible for any deaths.

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Arguably, yes. On the other hand: it's, again, not like "no records are available". It's that the doctor "can't access patient records". The difference is night and day...

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No it isn't... the fact that the doctor DID NOT VIOLATE THE INFORMATION AVAILIBLE. Nothing else matters.

cheers,

catch

edited for typos

"A patient who’d sought treatment at a hospital clinic was given co-trimoxazole (trimethoprim-sulfamethoxazole, Bactrim), a sulfa drug. She was allergic to sulfa drugs, however, a fact noted in her written record but not on the computer-generated record the resident reviewed before prescribing the drug."

"The judge found the hospital liable and awarded the patient’s family $200,000 (the doctor had settled out of court for $230,000)"

http://www.nso.com/case/cases_area_i...&area=Hospital


-Maestr0

Maestr0 what you are describing there is a clerical error, and would be the responsibility of the hospital over here, as well.

The doctor would be held blameless, as he acted to the best of his ability using the available information.

Anyways, if you have a life threatening allergy you should be looking at this:

http://www.medicalert.org/home/Homegradient.aspx

Check out the "emblems" tab ;)

I find it slightly strange that catch would be absolutely correct over here, but I strongly suspect that Negative would be correct in the US, or at least in many states?

I wonder how long before the defence starts pulling "contributory negligence"...................as in "you didn't provide your records on a USB storage device"?

:eek:

This is totally different...

The hospital had access to the allergy information, but didn't provide this information to the patient (via the print out) and this error wasn't caught as the result of neglect.

Even in this case the doctor didn't go to jail.

cheers,

catch
PS.

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I find it slightly strange that catch would be absolutely correct over here, but I strongly suspect that Negative would be correct in the US, or at least in many states?

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Fortunately negative isn't correct, if doctors could be held criminall responsible for information not provided to them... emergency procedures would just stop. i know that I sure they hell wouldn't touch a patient if I thought there was even the slightest possibilty that I might not have comprehensive information on the patient and even following best practices might land me in prison.