Question

Answer the following Critical Thinking questions from the chapter 13 Study Guide (pages 109 and 110) 1. A patient's chart has been subpoenaed for pending malpractice litigation. In preparing the chart, you discover an error that was made when the results of the laboratory report were incorrectly documented in the chart. You have the original laboratory report. What should you do? 3. Identify the steps you might take in inspecting a patients paper chart before filing reports or other patient information. Or if the clinic uses electronic medical records (EMR) what would you check before scanning a report or other information into their EMR.

Answer 1

Since the patient chart has been subpoenaed for pending malpractice litigation we can only view this if we have legally granted permission. if I have permission to view this then i would bring it to the attention of legal department.

It is already a legal record so it cannot be changed.It can be turned into quality department and notation can be made in the document by including the date of discovery of the incorrect document.

Mostly one should first report it to supervisor and if you are a supervisor then it should be reported to legal department and quality department.Because we cannot alter a original legal document.