Report: ER doctors get subpoenas for ordering wrong scans

2016 09 07 14 29 02 75 Emergency Entrance 400

Doctors in the emergency room (ER) at Rhode Island Hospital have been served with subpoenas charging them with medical misconduct for incorrectly ordering medical imaging scans, according to a report published January 30 by Politico.

The article claims that ER physicians at the hospital are upset at the tactics of the state Department of Health, especially because many of the doctors have voluntarily reported the errors. The practice could have a chilling effect on the willingness of physicians at the hospital to report their own mistakes.

The subpoenas were sent to at least four ER physicians at Rhode Island Hospital. They pertain to mistakes in ordering x-rays and other imaging procedures for patients, such as ordering a scan on the wrong side of the patient. Politico postulates that some of the mistakes could be due to the complexity of electronic health record (EHR) screens, where a mistaken click can result in an order for the wrong procedure.

The article quotes one of the letters sent to the physicians as accusing doctors of "incompetent, negligible, or willful misconduct in the practice of medicine" including "rendering of medically unnecessary services" that "fail to conform with standards." The letters also promise that the Department of Health will be commencing investigations into the events that have been reported.

But one emergency physician at the hospital has claimed that ER doctors are reporting the incidents to point out difficulties related to order entry in the EHR.

Rhode Island Hospital has been operating under a consent agreement with the Department of Health related to several mistaken imaging procedures that occurred at the facility in 2018, according to the article. These included wrong-patient errors involving a brain CT angiogram, another angiogram, and a mammogram. Another patient underwent a vertebroplasty procedure on the wrong vertebrae.

The consent agreement required Rhode Island Hospital to take a number of steps to improve its procedures for patient identification and verification, including for medical imaging services. It has also been required to take steps to reduce the number of errors in electronic order entry.

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