Delay in Conveying Patient Results Could Lead to Medical Malpractice

Delay in Conveying Patient Results Could Lead to Medical Malpractice

Even with innovations like EHR-integrated medical transcription services and accurate data entry, issues like communication delays can lead to malpractice.

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Medical malpractice is a major concern for practicing physicians, and can ruin their career and image. Many factors contribute to medical malpractice, and medical data entry error is one of those. Medical transcription outsourcing is a useful option in this regard for medical practices and hospitals and it helps physicians circumvent EHR data entry errors.

The goal of every health provider is to help patients stay healthy. However, poor coordination between physicians can lead to poor quality care and increased healthcare costs. During a hospital stay, patients are often shuttled between multiple departments, which could lead to loss of data or miscommunication that in turn results in inefficient patient care. This type of miscommunication is probably one of the most common factors that lead to dangerous medical mistakes. It is estimated that the number of deaths due to medical errors is more than 250,000 people each year. Medical errors are the third leading cause of death after heart disease and cancer.

Another contributing factor that many physicians and other clinicians overlook is the delay in communicating patient results. Physicians may have their own way of communicating the test results to their patients and ensure that the necessary information reaches the patients at the right time. Delay in giving patients their results could however lead to loss of the message and information. So, how can a delay in communication lead to medical malpractice? A MedScape article highlights this concern with a real-life example.

A 54-year-old woman visited a community health clinic complaining she had headache, back pain and joint pain. At the clinic, a family practitioner assessed benign hypertension, depressive disorder, insomnia, general osteoporosis and lower back pain. The physician prescribed anti-depression pills and asked her to follow up. But during her subsequent visits she complained of anxiety, depression and panic attack.

The next year the family

practitioner referred the patient to a neurologist. The patient described her difficulties and also about loss of appetite, weight loss, tremors in the arms and lower extremities, low energy, shortness of breath, sudden onset of chest pain, constant fear, delusional ideas, and isolation. The neurologist also noted that the patient had daily headache and goiter. So he requested a CT scan to rule out mass lesion and further suggested psychiatric and endocrinology consultation and asked her to follow up after two weeks.

After the CT scan, the radiologist noticed a 4.5-cm left temporal lobe mass that was either a brain tumor or meningioma and suggested an enhanced CT or MRI for further evaluation.

However, the patient did not turn up for her subsequent visit with the neurologist that was scheduled after two weeks; instead she started consulting a family practitioner whom she had consulted several years ago. After a few weeks, she again came to the community clinic

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complaining about her depression and anxiety. The chart of the referring physician did not include the neurologist’s report or CT scan reports.

The patient later returned to the neurologist after 8 months and he documented that the patient's mental status and cranial nerves were intact but did not document anything about the CT scan. After three months, the patient was taken to the ER and a CT scan of the brain showed a large left temporal mass with midline shift and edema. Although the surgeries

provided

were

successful

in

removing

the

lesion,

the

patient

became

incapacitated. She sued the neurologist and the physicians at the community clinic.

Now, here is how this course of events led to the malpractice suit and how the delay in communicating the test results became the villain. 

The neurologist did not document the CT scan results; neither did he advise the patient or her family about the brain lesion



He could not determine whether he sent a dictated consult to the referring physician



He planned to discuss the CT scan results during the patient’s scheduled follow-up visit (as was his usual practice) so that he could talk to the patient in person and review the findings. He didn’t want to convey this kind of information over the telephone



His office staff members had called the patient after she cancelled the appointment.

However, they were not sure if they had called more than once or even if they had actually spoken with the patient.



When the patient came back eight months after the CT scan, the neurologist’s paper chart was not available. Moreover, his computer access to hospital records was down.

This case is a prime example of a physician failing to communicate test results to patients on time – the reason for this physician is consideration of the best setting for discussing significant test results with their patients. Whatever the consideration, there should be an efficient plan to alert the patient of the important test results. When there is delay, it can only increase the chances of the patient not receiving the information because of multiple reasons – computer hitches, unreturned telephone calls, missing charts, or missed appointments. Even with technological innovations such as EHR-integrated medical transcription services and accurate data entry, there are other ways in which a physician can be held liable for malpractice. So, there should be a foolproof plan to inform the

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patients of significant test results. The office staff should keep track of when they call patients, how often they are contacted, and whether they actually spoke with the patient.

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918-221-7809