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Would you send report to QA for drug reaction? - Cathy

Posted: Apr 15, 2010

Would you send a report to QA for a discrepancy if there is a major drug reaction indicated in the report? Patient had angioplasty and stenting less than 1 year ago and is on Plavix. Dictator states that he is going to place him on Protonix for GERD. This is a major drug reaction. I don't know if it would be overstepping my bounds as an MT to point this out to the dictator or if it would be appropriate as it is part of my job to look out for discrepancies. Any advice? TIA!

personally, - sm

[ In Reply To ..]
I would not phrase it that way, as potential drug reactions/interactions belong in the pharmacy realm. BUT, if you feel there could be a dictated medication error, I would address it to QA, or better yet if possible, a direct note to client, ie., please verify that I heard dictation correctly for both the drugs Plavix and Protonix. Just my opinion, but I have been at this for a long time. Accuracy for patient care trumps recognition for your knowledge. Directly challenging the physician might fog the issue.

Thank you - Cathy

[ In Reply To ..]
Thanks for your reply. Certainly not seeking recognition for my knowledge here, just trying to look out for the safety of the patient.

I would simply ask my supervisor, - but I know

[ In Reply To ..]
that is not something I see people saying on here very often. Usually if I email her with a question she gets back to me before I send the report back, unless it's a short one; otherwise she would go in and fix/address it herself. I don't ask her questions like that very often, but she certainly doesn't mind when I do. Small company, though...might make a difference.

Not your job - MtMtMt

[ In Reply To ..]
However, if you're able to get the report flagged for review, I would. You might think there are major contraindications but the doctor oftentimes has outweighed the contraindications against the benefits and made his choice.

Agree. The MT is not a doctor and does not always - "know" why the dr. does something. NM

[ In Reply To ..]
x

I agree, not your job - sm

[ In Reply To ..]
I've been an MT over 20 years and I agree that it's not our job to second guess the doctor. Unless where the doctor dictated Plavix and Protonix was unclear, sending the report to QA for that reason would be tantamount to turning you (us/the MT) into QA for the physicians.

Physicians usually have their own system of peer review and IMHO it's not up to us to step into that role.

drug reaction - I would

[ In Reply To ..]
I typed a report once where the doctor prescribed Wellbutrin to a patient with a known seizure disorder. I pointed it out to my supervisor who in turn took all the necessary steps to contact the patient, her treatment team, etc. but by the time those steps were taken the patient died from a major seizure. However, because of my knowledge and being proactive about something I knew shouldn't be, I saved the clinic from a major lawsuit and the doctor was dismissed immediately. Doctors don't know everything and make mistakes. They are humans too and should be questioned when you have the knowledge of something that maybe the doctor overlooked. I don't know why people think doctors are so superior and should never be questioned. I learned my lesson right then and there.

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