Mutual Matters

The Importance of an Accurate Problem List for Patient Safety and Care

Posted by Bill Kanich, MD on Dec 1, 2016 2:00:00 PM

Case Study

Mr. Washington was a 58-year-old male who went to see Dr. Lincoln in January 2005 for a physical exam. The patient had a history of hypertension and hyperlipdemia controlled on an ACE Inhibitor and a statin. Upon a review of sMMIC_female doctor_clipboard.jpgystems, the patient complained of bright red blood per rectum when he had a bowel movement. The physical exam was unremarkable and the patient’s stool guaiac was negative. The notes suggested a gastrointestinal referral for a colonoscopy. There was no separate referral form for a colonoscopy, however, which was required by the patient’s insurance. The patient’s lab tests were unremarkable except for a mild anemia, (HCT of 36).

The patient returned three times (over the next year and a half) for respiratory infections and intercurrent illnesses. The colonoscopy and bleeding were never mentioned in any of these visits. In July 2006, Mr. Washington presented to the ER with abdominal pain, fever, nausea and vomiting. The patient was admitted and underwent an exploratory laparotomy which revealed widespread cancer of the colon. He was eventually found to have stage IV cancer and was treated with chemotherapy. The patient expired in January 2007 and a lawsuit was filed.

Discussion

There are multiple areas of weakness in defending the care of Dr. Lincoln. Find out more about accurate problem lists and patient safety by clicking below. 

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Topics: Hospital Management, Patient Safety, Practice Management