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Monthly Archives: July 2010
What’s a medical error? Part 1 by Pat Iyer
I was talking to my son and his girlfriend about medical errors and he asked me to define them. Here are some cases we have handled. * the hospitalized patient who was alert, oriented, and ambulatory until the nurse administered … Continue reading
What’s a medical error? Part 2 by Pat Iyer
I was talking to my son and his girlfriend about medical errors and he asked me to define them. Here are some more cases we have handled. * the oncology patient who suffered from a large extravasation of a chemotherapeutic … Continue reading
Why don’t healthcare providers follow the rules? Part 2 by Pat Iyer
Normalization of deviance occurs when a provider, such as a nurse, knowingly disregards a safety practice, like using two patient identifiers to verify patient identity. Repeated deviation from the safe practices tends to “normalize” the risky behavior in the nurse’s … Continue reading
Why don’t healthcare providers follow the rules? Part 1 by Pat Iyer
I’ve been updating a chapter on the roots of patient injury for the fourth edition of Nursing Malpractice. I’ve been thinking about the reasons people don’t follow policies and procedures. Back in the 1980s when I ran a nursing hospital’s … Continue reading
Pat Iyer’s 9 tips on detecting altered medical records Part 5
Examine logs or communication books kept at the nursing station of some nursing homes. I found a note in a nursing home communication book that stated, “When you recopy the nurses’ notes, leave enough room for the night shift to … Continue reading
Posted in Healthcare Risk Management, Legal nurse consulting, Medical errors, Medical malpractice, Medical records, Nursing malpractice, Tampering with evidence, Trial lawyer skills
Tagged altered medical records, altered records, spoliation of evidence, spoliation of medical records, tampering with medical records
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Pat Iyer’s 6 tips on detecting altered medical records part 4
Look for the “too good to be true” pattern of documentation. For example, the patient was steadily losing weight but supposedly consuming 100 percent of his 2000 calories per day diet. Note entries that are self-serving and needlessly explanatory of … Continue reading
Posted in Healthcare Risk Management, Legal nurse consulting, Medical errors, Medical malpractice, Medical records, Nursing malpractice, Tampering with evidence, Trial lawyer skills
Tagged altered medical records, altered records, spoliation of medical records, tampering with medical records
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Pat Iyer’s Dirty Dozen Tips for Detecting Altered Medical Records Part 3
Examine handwriting to see if there are obvious changes in the appearance of the writing within an entry. Another thing to look for is a change in style. If notes are sloppily written and suddenly a page of neatly written … Continue reading
