As a Houston, Texas medical malpractice lawyer, I speak with people every day about how things in their health care went wrong. One of the things that I always look out for is trends on how things fall through the cracks.
I have noticed that one area where there is an increased risk of a mistake is when health care is provided at different facilities. Two examples immediately come to mind.
I gave a continuing legal education speech to a group of lawyers yesterday about HIPAA, which is a patient privacy law that came into being because medical records were being converted to highly-portable electronic formats.
While I do not think that many people put a lot of thought to it, I believe that, generally, they think that, in this electronic age, doctors and nurses can quickly and easily obtain medical records from different facilities.
Emergency rooms, medical records, and radiology studies
I have a case where a patient had to go to the emergency room a number of days in a row for the same problem. On the first day, this person went to a freestanding emergency room. On the second two days, the patient went to the same hospital emergency room.
On the first day, the freestanding emergency room physician ordered a head CT scan, which came back completely normal. As the health condition persisted into the next day, the patient went to a nearby hospital emergency room. When a provider in the emergency room was about to order a CT scan, the patient’s spouse informed her that a head CT had been done the previous day. The new provider canceled the order and said that she would get that study instead.
Unfortunately, getting the previous day’s study fell through the cracks and, instead, the patient was discharged.
The next day the patient returned to the hospital emergency room with the same symptoms, only worse. This time, the emergency room physician ordered a head CT scan, which came back with an abnormality, yet was still a misdiagnosis. Our expert reviewed the CT scan and contends that the neuroradiologist missed an acute, life-threatening cerebrovascular event.
If the hospital had obtained the prior CT study from the freestanding emergency room, then the neuroradiologist would have had it for comparison purposes and would have likely interpreted it correctly. Instead, the patient ended up getting discharged, for the third day in a row, and later that evening had a devastating cerebrovascular event that changed his life forever.
To avoid this type of situation, I recommend a few things. One is to consider having all of your care for a certain condition at a particular hospital, so all of your radiology studies and medical records will be available to the healthcare providers. If that is not possible, a second option is to obtain a printed copy of your medical records and a CD containing any radiology studies before being discharged from the facility. That way, if you have to go to another hospital or facility, you can bring this important information with you.
The hospital system potential exception
One potential exception to my observation that medical records and radiology studies may not be available between different facilities applies when two hospitals are in the same system.
I have found that, typically, one hospital in a system can seamlessly access medical records generated by another hospital in the same system. For example, think about the Memorial Hermann, Houston Methodist, and CHI St. Luke’s hospital systems. Quite often at these hospitals that are part of the system, patients will be presented with a special consent form to allow their medical records to be shared with providers within their own system.
Another way that patients can unwittingly increase their risk is by having their prescriptions filled at different facilities. I have not heard of pharmacies, doctors, nurses, or hospitals talking about this to patients, so I think that it is important for me to share with you.
If you have all of your prescriptions fulfilled by one pharmacy, or even one pharmacy chain, then your medication and prescription history will typically be available to the pharmacist when they look at new prescriptions to be filled.
From a patient safety perspective, this is very important because pharmacy computer systems will automatically inform the pharmacist about Food & Drug Administration (FDA) and manufacturer warnings and contraindications for the new prescription medication. In other words, there may be something about your health or prescription history that makes a new medication potentially dangerous for you.
In these situations, the standard of care requires pharmacists to contact prescribing healthcare providers to make sure that they are aware of the warning or contraindication. In addition, pharmacy staff must offer counseling to customers about their prescription medications.
To improve your pharmacy and medication safety, I recommend using the same pharmacy or chain (whether CVS, Walgreens, or another chain) and always taking advantage of the opportunity to receive counseling from the pharmacist.
We are here to help
If you or a loved one has been seriously injured as a result of medical or pharmacy malpractice, call the experienced attorneys at Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.
Robert Painter is a medical malpractice and wrongful death attorney at Painter Law Firm PLLC, in Houston, Texas. He is a frequent writer and speaker on topics relating to medical malpractice and healthcare. He was previously editor-in-chief of The Houston Lawyer magazine, and currently serves on the editorial board of the Texas Law Journal.