A community of 30,000 US Transcriptionist serving Medical Transcription Industry

Be afraid - be very afraid...

Posted: Feb 12, 2013

http://www.mygeartools.com/articles/transcription-outsourcing-leads-to-womans-death-140m-settlement/

while I am not defencing outsourcing - sm

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I would think that this would fall on the doctor for not checking the validity of report.

defending that is!!! - nm

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x

Could have... - anon

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That error could have been made by one of us just as easily. It is not an error inherent to India.

On a side note, my husband is diabetic and takes 100 units of Levemir every evening. 8 units is a very, very low dose.

defending - BlessedB

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I didn't read this linked article as this is old news.

It as 80 units of Levemir that was apparently the problem.

Many people take 80 units of Levemir.

The doctor should have caught the error.

The nurse should have caught the error.

They are two professions with the liability, certainly not the MT.

And the above poster was correct, ANYONE could have made this error. You don't have to be Indian to not be sure if you hear 8 or 80, 15 or 50 -- and when EITHER can be correct it's even worse.

Then it should have blanked for clarification - and not guessed. So MT can be responsible

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Quote from above post, "And the above poster was correct, ANYONE could have made this error. You don't have to be Indian to not be sure if you hear 8 or 80, 15 or 50 -- and when EITHER can be correct it's even worse."

This is what blanks are for...for clarification so that no assumptions are made in these instances. It does start with us folks.

BUT, have you ever listened to something and were - just sure you heard it correctly... sm

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Only to have QA review it and find that you didn't? You don't always know what you don't know. MT might've really thought she heard 80 without question in her mind (hence, no flag). As one other poster said, 80 units is not an unheard of dose where MT would question it, like they might if they heard 8000 units, for example. Even then, MT isn't required to know appropriate dosing for all drugs. We're not MDs or pharmacists. This is why the MD is the one ultimately responsible for the medical content in the report!!

Please . . . that's ridiculous - MumbleJumble

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If we left a blank for everything that was not clear, these reports would look like some sort of Swiss cheese on steroids.

The incoming quality of many dictations is so horrible that it's a miracle anyone can transcribe it.

The blame for this case is weighted - first it goes to the physician who failed to proofread the report before signing, and secondly to the staff who administered the dose without verifying. Since the MT did not administer the medication how can that even be a case for contention?

Cause for contention - Anonymous

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It is a cause for contention because VR incorrectly documented 80 units instead of 8 when it was clearly dictated, several MT witnesses testified to it at the trial. The MT may not ultimately be to blame, but it's concerning that all through the editing and QA process no one heard it correctly. I was an MT for over 30 years and I now work in QA. I've seen quite a few dosage errors that didn't involve analytical thinking on the part of the MT, they were missed because of carelessness or simply placing a decimal point in the wrong place. I've also encountered situations where the provider clearly dictated one medication and the MT/editor transcribed something completely different. If the reports look like swiss cheese on steroids, so be it; at least they'll be brought to someone's attention. The excuse, "I won't do that because I'm not paid enough" doesn't fly, I'm sorry. I'm sure people in other occupations feel the same but they do a good job all the same or their employers fire them. Instead of debating whose fault it was in the Precyse case, it should make MTs more vigilant. The bottom line is that someone died because of a medication dosing error that began at the transcription level, I don't think anyone wants that to happen again.

absolutely agree - plus...

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A US MT could make this mistake. It's a matter of quality assurance on the part of the MTSO.

I agree! - sm

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I don't think that should fall on the MT, PERIOD, no matter what country she or he was from! I think the doctor should have checked over the report AND whatever healthcare professional who gave the medication should have known the proper dosage before giving it. I am also a nurse and I know that if I do not know the dose of something I am supposed to verify, plain and simple. The death was in no way the fault of the MT.

No question, the MT is NOT responsible. - anon

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The doctor is fully responsible for any information he/she provides. They are REQUIRED to sign ALL dictation for accuracy. They sometimes try to bypass that with the whole "dictated but not read" BS but in the end it is them on the line.

There are some die-hard old timer MTs who think the MT should catch mistakes the dictator makes but we get paid close to minimum wage and the doc makes 10 times that. It is NOT our job to ASSUME what the doc SHOULD be saying. Of course, we should be allowed to leave blanks but we get penalized for that. So, if you give me minimum wage and lousy VR and tell me you want verbatim, that is what you will get.

it IS the MTs fault - - sm

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What do you think we are here for ?!?! It is absoultely the respondibility of the MT to correct errors in speech rec, flag for questionable information. When that report leaves your hands it should be ACCURATE. Reports are released for pt care every single day, prior to the doc seeing or signing it -

Nope, MTs do not go to medical school as a general - rule, should not be expected to know... sm

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everything a physician knows. Granted, the MT made the error in this case, but sometimes 8 vs. 80 vs. 18 can be hard to distinguish even for a US MT. It is ultimately the DOCTOR'S responsibility to read and sign his/her reports, bottom line. Regardless of whether it was India or US or BFE, don't peg this on the lowly MT making pennies for all her "vast" knowledge. The MTSO maybe, as they knew quality was trash from overseas, but not the MT herself, probably just struggling to put food on the table making barely livable wage just like all of us are these days! Oh, and remember, that's happening while doctors sit in their cushy luxury houses and drive their new BMWs. Bad, bad precedent to blame the MT, no matter where it was, as this decision could eventually haunt each one of us on any given bad day.

Of course, we are here to do EVERYTHING - PerfectWorld

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. . . We should know everything about medicine without the benefit of medical school, know how to spin poor dictation into golden perfect reports, work for free as instructed, take the blame for every other hand that touched the reports when needed, absolutely, all that is OUR job.

Pffttt! Sorry, my sarcasm was showing. Certainly the job demands you do the best you can do, but perfection is not in that mix by any means. Too many variables that MTs cannot control will always spell disaster.

Old news - Anonymous

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This has been discussed in this forum several times over the last few months. The nurse should not have been taking information from the discharge summary. The doctor was gone and didn't sign off on the report. The speech engine got it wrong and the MT/editor/QA staff didn't catch it, this was a bit like a run away train. The fact that it brought about someone's death is tragic.

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