WWYD? Medical Profession related

[tinatark]

So this friend of mine has a 17 year old daughter, who started getting the Depo (birth control) shot a little while back - she last went for it in April. Today, my friend called the doctor to arrange for the July shot (you get it every 3 months) and they said she didn't get that in April - she got the first of her Gardisil series!

The doctor is apologizing - the records say she was there for the Depo, but got the Gardasil (the vaccination for cervical cancer).

There obviously some medical liability, as far as professional licensing, goes - she is in a real dilemma because this is her pediatrician, and if she reports the RN to the med. board she wouldn't feel comfortable bringing her other kids there. She has been happy with this doctor, should she just accept the apology, continue the series and move ahead?

BTW, she had planned to "talk" to the doctor about the Gardasil, but never asked for it. I am not sure what medical releases she signed during the appointment.

I really think this is a major screw up and should be reported to the medical board, but would like some other opinions!

 

[happygirl]

I would have to say something to the board. What if was something deadly they gave her??

 

[luvmy3]

i would have to say something to the board. What if was something deadly they gave her??

mte

 

[Judy from Boise]

I would think this was a human error. At the most I would ask the MD if he did a root cause analysis to see if the RN was "set -up" for the error through a faulty system.

 

[C.Ann]

And what if she's pregnant? Sounds like a bad situation all the way around.. An apology certainly isn't sufficient, but I'm not sure what else can be done..

 

[chloelovesdisney]

They are very, very lucky that there wasn't an accidental pregnancy. Did the 17 year old go by herself for the shot, and what discussion did she and the nurse have? It seems like a very strange to mistake. Maybe the teenager didn't want the birth control shot.

 

[HERSEY]

I always had to sign the chart when they gave me my shot for the Depo and they had the tag from the bottle. I always look what I'm signing

 

[minniebeth]

In my opinion, it's not saying much for the doctor's office if the mother is afraid of retribution if she reports it. (As in the care of her other children...) As honest mistakes happen it is also the right for a patient to report it. A doctor's office should understand that.

 

[LuvOrlando]

-

 

[donald&daisy]

I would report it. This is malpractice. She could also probably sue for battery as she was subjected to medical treatment she did not consent to and it was not an emergency. This is a big deal and I would be very upset. As a PP mentioned there could have easily been an accidental pregnancy.

ETA- I suppose it would depend on how violated the patient/parent feels. My best recommendation would be to speak with Dr. and see how he explains the situation. If he has identified the problem that caused the mix up, etc. I think I was initially very shocked at the idea that she went around for 3 months w/o the birth control she thought she had. That would disturb me a lot so I would want to know the Dr. had taken every possible, reasonable precaution so that would not happen again.

 

[DawnCt1]

Medication errors happen every day in hospitals across the country. Typically, when they are caught, because not all errors are detected, even by the person making the error, an injury/incident report is made out and kept on file. I don't know what the process is in a private practice, but clearly this isn't something that would be reported to the medical board, but perhaps the Dept of Consumer protection/nursing licensure dept. Is it a serious error? The DD hasn't suffered any injury. She isn't pregnant that we know of, so if one did sue, what would they recover? She was given a safe vaccine with no ill effects. The physician informed the parent of the mistake and apologized. Should the nurse loose her job? I think she should be reprimanded but, as a nurse, she is no doubt reprimanding herself more than her immediate boss or the state could ever do. Most nurses take their mistakes very seriously.

 

[Handbag Lady]

Since the doctor called with the mistake themself and didn't try to hide it or act like something is being covered up, I wouldn't be so quick to report them to anyone.

Mistakes do happen and I'm sure the doctor and the nurse feel awful as it is.

I would just suggest calling back and have another conversation about what steps are being taken so that this doesn't happen again.

They do need to earn the trust of their patients back, but I personally believe they took a big step in that by admitting it and then informing everyone involved.

And then, perhaps a lesson should be instilled in the child to maybe be more aware of what is being done to them. Clearly this isn't her fault, obviously, but perhaps if they are more observant of labels or to have conversations with their healthcare providers about what is going on as it is going on, it might help to assure HER of future doctor visits.

 

[DawnCt1]

Since the doctor called with the mistake themself and didn't try to hide it or act like something is being covered up, I wouldn't be so quick to report them to anyone.

Mistakes do happen and I'm sure the doctor and the nurse feel awful as it is.

I would just suggest calling back and have another conversation about what steps are being taken so that this doesn't happen again.

They do need to earn the trust of their patients back, but I personally believe they took a big step in that by admitting it and then informing everyone involved.

And then, perhaps a lesson should be instilled in the child to maybe be more aware of what is being done to them. Clearly this isn't her fault, obviously, but perhaps if they are more observant of labels or to have conversations with their healthcare providers about what is going on as it is going on, it might help to assure HER of future doctor visits.

A very reasoned, well measured response!

 

[DawnCt1]

In my opinion, it's not saying much for the doctor's office if the mother is afraid of retribution if she reports it. (As in the care of her other children...) As honest mistakes happen it is also the right for a patient to report it. A doctor's office should understand that.

On the other hand, a physician who has a parent that sues over the care of one of her children, has every right, and would no doubt advise that mother to find another physician to care for her other children. The physician did report it; to the parent and the patient. I don't see the need to take it further in the absence of harm or injury, of which there is none.

 

[Muushka]

Since the doctor called with the mistake themself and didn't try to hide it or act like something is being covered up, I wouldn't be so quick to report them to anyone.

Mistakes do happen and I'm sure the doctor and the nurse feel awful as it is.

I would just suggest calling back and have another conversation about what steps are being taken so that this doesn't happen again.

They do need to earn the trust of their patients back, but I personally believe they took a big step in that by admitting it and then informing everyone involved.

And then, perhaps a lesson should be instilled in the child to maybe be more aware of what is being done to them. Clearly this isn't her fault, obviously, but perhaps if they are more observant of labels or to have conversations with their healthcare providers about what is going on as it is going on, it might help to assure HER of future doctor visits.

As a medical professional, yes, mistakes do happen. I agree with the quoted poster, it took a lot for them to admit to the mistake. It is the ones who make the mistakes and don't admit are the ones you need to worry about. If there is no pregnancy, I would look at it as a 'no harm no foul'.

I would forgive the error. I am certain that the nurse is beating herself up much more than any nursing board could. And I'll be that is the last time she will make that error.


If there is a pregnancy, that is a whole other issue. Let us know and we will tackle that issue if necessary! Hopefully everything is fine.

 

[tinatark]

Weird, I posted again that she went in and is not pregnant. That post is missing!

Not sure if she signed a log or anything when she got the shot in April - this is a pediatrician's office, so I assume the depo shot isn't a common one there.

She talked to the pediatrician in the office today - the nurse who gave the shot is not in today, but the doctor assured her that this is a 20+ year nurse and she will feel worse than either of them feel.

My feeling is that the incident needs to be documented, whether it is done within the office or with the overseer of the nurse's license.

The funny thing is, when they were there in April, the nurse was adament that the daughter's shot records were still on the "Florida" form, when they had moved to Georgia around 3 years ago. Guess she should have been more concerned with her task at hand!

 

[Muushka]

If the doc knows about it, it is documented in the office.

I am glad the girl did not get pregnant.

 

[DawnCt1]

Weird, I posted again that she went in and is not pregnant. That post is missing!

Not sure if she signed a log or anything when she got the shot in April - this is a pediatrician's office, so I assume the depo shot isn't a common one there.

She talked to the pediatrician in the office today - the nurse who gave the shot is not in today, but the doctor assured her that this is a 20+ year nurse and she will feel worse than either of them feel.

My feeling is that the incident needs to be documented, whether it is done within the office or with the overseer of the nurse's license.

The funny thing is, when they were there in April, the nurse was adament that the daughter's shot records were still on the "Florida" form, when they had moved to Georgia around 3 years ago. Guess she should have been more concerned with her task at hand!

Have no doubt, the incident is well documented within the office. To report the incident to the state, the patient's parent would need to file a formal complaint with the state. I think that would be unnecessary and over the top since there is no adverse outcome here and as you aptly pointed out, the nurse feels worse than anyone. Perhaps the medical chart was separated into two parts. I could envision an office manager not realizing that there was already a record and creating another when the file came from Georgia and the two files didn't get merged. Depo isn't a typical pediatric medication, and as a previous poster pointed out that 17 is plenty old enough to question what she is receiving, particularly if she is having sex and depending upon birth control. Depo is best given in the gluteus (butt) because it is oily and would hurt more in the deltoid (arm). Gardisil is a small amount of a non oily substance so I am surprised that the patient didn't notice the difference immediately. Not that Depo can't be given in the arm but it hurts and it takes longer to inject.

 

[Disney Doll]

Medication errors happen every day in hospitals across the country. Typically, when they are caught, because not all errors are detected, even by the person making the error, an injury/incident report is made out and kept on file. I don't know what the process is in a private practice, but clearly this isn't something that would be reported to the medical board, but perhaps the Dept of Consumer protection/nursing licensure dept. Is it a serious error? The DD hasn't suffered any injury. She isn't pregnant that we know of, so if one did sue, what would they recover? She was given a safe vaccine with no ill effects. The physician informed the parent of the mistake and apologized. Should the nurse loose her job? I think she should be reprimanded but, as a nurse, she is no doubt reprimanding herself more than her immediate boss or the state could ever do. Most nurses take their mistakes very seriously.

I agree with this.

 

[Disney Doll]

Since the doctor called with the mistake themself and didn't try to hide it or act like something is being covered up, I wouldn't be so quick to report them to anyone.

Mistakes do happen and I'm sure the doctor and the nurse feel awful as it is.

I would just suggest calling back and have another conversation about what steps are being taken so that this doesn't happen again.

They do need to earn the trust of their patients back, but I personally believe they took a big step in that by admitting it and then informing everyone involved.

And then, perhaps a lesson should be instilled in the child to maybe be more aware of what is being done to them. Clearly this isn't her fault, obviously, but perhaps if they are more observant of labels or to have conversations with their healthcare providers about what is going on as it is going on, it might help to assure HER of future doctor visits.

I agree with this as well and may I add that I am amazed at the number of people who would go right to reporting and suing for what sounds like a mistake. The doctor and office was honest. They are human, they will make mistakes.

Believe me when I tell you that medical people don't go to work every day thinking "Let's see who I can harm today". It is the single biggest fear a medical person has...that they are going to make an error that is going to harm someone.

If my child didn't suffer any ill effects from not receiving the Depo shot or from receiving the Gardasil shot, I'd probably talk to the MD to see what steps were taken to insure that this wouldn't happen again and leave it at that. From the OP, it sounds like the office was honest, remorseful and apologetic. Is suing or making someone lose their license going to solve anything?

And people wonder why there's a nursing shortage....