Thank you for using rssforward.com! This service has been made possible by all our customers. In order to provide a sustainable, best of the breed RSS to Email experience, we've chosen to keep this as a paid subscription service. If you are satisfied with your free trial, please sign-up today. Subscriptions without a plan would soon be removed. Thank you!
At my Sept. 24, 2100 post "UPMC and the Sweet death that wasn't very sweet: How EMRs can detract from a clear narrative, and facilitate spoliation and obfuscation of evidence" I wrote a detailed summary of a civil complaint regarding possible chart alteration from a court docket that included EMR metadata, making EMR metadata visible to laypeople for the first time that I am aware.A new docket has appeared in that case entitled "Interrogatories to Defendant" from Attorney/physician Deborah Maliver dated Sept. 27, 2011. This is publicly downloadable from the Pittsburgh Prothonotary Office Civil Docket site at this link, case #GD-09-019407, document #55, or at my cached version at this link (PDF).
It brings up questions of even greater concern to me as a physician, those of mysterious drug orders for powerful sedatives such as propofol, fentanyl and etomidate. Apparently the metadata makes it difficult to account for what could be questioned as "over-generous" dispensing of those drugs.
(This is ironic, since the trial of the doctor who administered this drug to deceased singer Michael Jackson has itself just gotten underway.)
Here is the first interrogatory request listing numerous drugs:
Question 1. Request for full metadata on these drugs (click to enlarge)See Exhibit "A" from the new Interrogatory docket below, as produced in discovery earlier, and download the new Interrogatory in its entirety to see the questions asked about the other metadata:
Exhibit "A". McKesson drug cabinet dispenser audit trail. Five 100-ml vials of propofol in a row from May 14-May 15? Lorazepam (ativan), propofol and etomidate on May 15-16 at a time when a patient had a deteriorating respiratory status? (These drugs suppress the respiratory drive.) Click to enlarge.Question 4 is particularly disturbing:
(click to enlarge)Apparently none of these drugs appeared in the eMAR system, the electronic medication administration record. Where did they go?
One would hope a highly computerized medical center could keep track of its inventory of drugs of powerful potential for abuse with 100% certainty.
This is of concern to me as a former Occupational Medicine physician (in the transit industry) and a physician in general. I've seen drug abuses result in train wrecks - literally. Drug abuses/failure to be able to track disposition in a hospital would represent a prima facie public health menace.
There are also questions about whether users of the EMR signed in or used the accounts of other individuals, which is another weakness of the EMR. No handwriting to evaluate...
-- SS
--
Source: http://hcrenewal.blogspot.com/2011/09/was-michael-jackson-upmc-patient-at.html
~
Manage subscription | Powered by rssforward.com
Thank you for using rssforward.com! This service has been made possible by all our customers. In order to provide a sustainable, best of the breed RSS to Email experience, we've chosen to keep this as a paid subscription service. If you are satisfied with your free trial, please sign-up today. Subscriptions without a plan would soon be removed. Thank you!
At my Sept. 24, 2100 post "UPMC and the Sweet death that wasn't very sweet: How EMRs can detract from a clear narrative, and facilitate spoliation and obfuscation of evidence" I wrote a detailed summary of a civil complaint regarding possible chart alteration from a court docket that included EMR metadata, making EMR metadata visible to laypeople for the first time that I am aware.A new docket has appeared in that case entitled "Interrogatories to Defendant" from Attorney/physician Deborah Maliver dated Sept. 27, 2011. This is publicly downloadable from the Pittsburgh Prothonotary Office Civil Docket site at this link, case #GD-09-019407, document #55, or at my cached version at this link (PDF).
It brings up questions of even greater concern to me as a physician, those of mysterious drug orders for powerful sedatives such as propofol, fentanyl and etomidate. Apparently the metadata makes it difficult to account for what could be questioned as "over-generous" dispensing of those drugs.
(This is ironic, since the trial of the doctor who administered this drug to deceased singer Michael Jackson has itself just gotten underway.)
Here is the first interrogatory request listing numerous drugs:
Question 1. Request for full metadata on these drugs (click to enlarge)See Exhibit "A" from the new Interrogatory docket below, as produced in discovery earlier, and download the new Interrogatory in its entirety to see the questions asked about the other metadata:
Exhibit "A". McKesson drug cabinet dispenser audit trail. Five 100-ml vials of propofol in a row from May 14-May 15? Lorazepam (ativan), propofol and etomidate on May 15-16 at a time when a patient had a deteriorating respiratory status? (These drugs suppress the respiratory drive.) Click to enlarge.Question 4 is particularly disturbing:
(click to enlarge)Apparently none of these drugs appeared in the eMAR system, the electronic medication administration record. Where did they go?
One would hope a highly computerized medical center could keep track of its inventory of drugs of powerful potential for abuse with 100% certainty.
This is of concern to me as a former Occupational Medicine physician (in the transit industry) and a physician in general. I've seen drug abuses result in train wrecks - literally. Drug abuses/failure to be able to track disposition in a hospital would represent a prima facie public health menace.
There are also questions about whether users of the EMR signed in or used the accounts of other individuals, which is another weakness of the EMR. No handwriting to evaluate...
-- SS
--
Source: http://hcrenewal.blogspot.com/2011/09/was-michael-jackson-upmc-patient-at.html
~
Manage subscription | Powered by rssforward.com
0 comments:
Post a Comment