Reporting medical errors to patient.

[amandalm711]

Do you legally have to tell a patient if you accedentally give them an overdose of a drug and the patient has a seizure as a result of the overdose?

[mazy]

I truly hope that you are not really asking the question that you could cause grave harm to a patient and then not report it.

The policy would be for you to report it to your supervisor and then the supervisor would do a follow up investigation and report it to the patient/POA and then follow up with you. Depending on your response, your facility would set up a disciplinary course of action for you.

That would involve either re-educating, counseling, or if you feel that it should not be reported or that you should not be held accountable, possibly termination.

Everyone makes mistakes. The appropriate response is to accept responsibility for it, learn from it, and not make the mistake again.

[Double-Helix, BSN, RN]

YOU may not have to notify the patient personally, but yes the patient has to be notified by someone. It's usually a supervisor or someone from hospital administration.

Think of it this way: How would you feel if someone gave you (or your family member) an overdose of medication and you had a seizure? How would you feel if nobody told you what had happened or why you had the seizure, but instead covered up the mistake? You would never know why you had the seizure and might live in fear that it would happen again.

So, no. It is not legal for hospitals to lie to patients about medication errors. It is not legal for health care professionals to lie and withhold medical information from patients. Patient's have a right to know the truth about their medical records, their health, and their care.

[amandalm711]

I'm sorry I should of said I am a nursing student. I know ethically you should tell the patient, I need to know exact legislation that says you have to legally report it to the patient.

[melmarie23, MSN, RN]

yes, report it. To your supervisor, file an incident report and also inform the MD as well as the pt.

[Double-Helix, BSN, RN]

If you want exact legislation, you're better off searching a website for federal laws regarding patient right's. Most of us know the laws as they apply to our practice, but can't tell you statute numbers.

Is this for homework?

[nurseprnRN, BSN, RN]

i'm not aware of any legislation requiring disclosure per se. on the contrary, for many, many years hospitals have been told by their risk managers and attorneys that they should never let on that they know anything about any adverse effect (unless it's easily discerned by lay persons, like an instrument left inside at surgery, a wrong-side surgery, or a test that was ordered for someone else; and then, they should not discuss it with the patient/family...so let the lawsuits begin). and since most legislatures are populated largely by attorneys, i'm not expecting that they would advocate for such legislation.

however, more recent studies have indicated that when the adverse event is disclosed to the patient by the hospital (not necessarily by the nurse or physician, but they are usually involved in the meeting) as soon as it is discovered, an apology given, an explanation of how the mistake has resulted in a change in whatever made it occur, and any reparations made (for instance, if the error resulted in extra days in the hospital, this care is not billed), most people accept that and no legal action is forthcoming.

while i am sure this upsets the lawyers, it's good news for those who believe in people's basic good nature. i mean, if somebody came to you and apologized, said "i screwed up, i'll make it up to you, and i'll do my very best to be sure it will never happen again," wouldn't that be enough? turns out, for most folks, it is. in this increasingly litigious world, that's heartening.

[Meriwhen, ASN, BSN, MSN, RN]

Legally: check your state/country laws to see if you are mandated to report a medication error to the patient.

Ethically: damn right you should tell them. Whether it's you or the MD or someone else delivering the news, the patient has the right to know.

As far as fearing a lawsuit by telling them...the odds are high that the mistake is going to come out one way or another. If you were the patient, which would make you feel angrier: if your nurse/MD came up to you and told you that you received the wrong med? Or if you found out after the fact that you got the wrong med but the nurse/MD was hiding/lying/didn't tell you about it?

[HouTx, BSN, MSN, EdD]

A lot of organizations (mine included) are opting for a much more open environment in which the patient & family are provided with honest and timely information about any mistakes that have been made. However, this type of communication should be made by people who are trained in how to deliver the information and engage in the follow up conversations that will be needed. My organization has special training courses for physicians and other staff who are responsible for these discussions.

Basically, you would report the incident - along with all necessary paperwork, physician notification, etc.-- and this triggers the involvement of a trained person who manages this function for your area. Usually this is the clinical manager. She/he would take the lead to inform the patient. Many times, the nurse who made the error will be included in the patient notification so that the patient & family can receive a direct apology. As it turns out, that is what most patients want.... someone to say they're sincerely sorry and assure them that it won't happen again.

[Double-Helix, BSN, RN]

The patient legally has a right to a copy of their medical records. Documentation regarding the medication error and the adverse effects would be in the chart. If that information was not included in the chart, it is falsifying documentation, which is illegal.

[Vespertinas]

I'm sorry I should of said I am a nursing student. I know ethically you should tell the patient, I need to know exact legislation that says you have to legally report it to the patient.

You're a nursing student and you want us to find you the exact legislation for a hypothetical situation?

Why don't you just say thank you for your help?

[applewhitern, BSN, RN]

Just a question: how would you know for sure the overdose caused the seizure?