On July 12, Jill, who suffered so

On July 12, Jill, who suffered so many years with neck surgeries, life-threatening infections, systemic sclerosis, and an ever-evolving number of physical symptoms requiring medical care—often poor—developed severe pain in the left side of her head while at work. She was not speaking coherently and eventually lost consciousness for a few moments. She was taken to her physician’s office by a coworker. Jill’s physician ordered some tests at the hospital’s outpatient imaging center to rule out a transient ischemic attack (TIA). A medical assistant at the imaging center explained to Jill that her tests could not be scheduled until July 14. Dan drove his wife Jill to her appointment. They arrived early on July 14 for her imaging test. On their arrival at the imaging center, Dan dropped Jill off at the front entrance while he searched for a parking space. Meanwhile Jill went into the center and handed her prescription to Carol, a medical assistant at the front desk. Carol said to Jill, “I am sorry, but we cannot perform your test. Your doctor faxed us an unsigned and undated order sheet. It is confusing as to what imaging studies he wants. He checked a box on the physician’s order sheet indicating that he wanted a CT scan of the head. In addition, there was a handwritten note on the form indicating that your physician wants an MRI to rule out TIA. We are not sure if he wants one or both tests. You will have to get clarification from the physician as to exactly what procedure he wants.” Dan, after having parked his wife’s car, arrived at the front desk, and saw his wife somewhat distressed. Carol explained the problem to Dan. He asked Carol, “Could you please contact the physician and ask him to clarify and fax back to the center what tests he wants?” Carol replied, “We are very busy; however, you can use our phone and ask the physician to clarify his order and have him fax us a new order.” Jill interrupted, appearing somewhat agitated, and asked, “What is your fax number?” Carol (pointing to a wall) replied, “It is posted there on the wall by the phone. You can use that phone.” Carol suggested to Jill that she complete the patient intake paperwork while Dan contacted Jill’s physician. Dan was able to get a new faxed order. As they waited for Jill to be called for her tests, with her eyes tearing up, she turned to Dan and said, “This is how my last 6 years of life have been … with so many health issues and hopelessly fighting to stay alive. What would I do without you?” 1. Do you believe Jill should have been tested without clarification? What could have been the outcome? 2. What ethical and legal violations did both the physician and medical assistant, Carol make? 3. After fully understanding where things went wrong, would this be an incident that needed to be reported and if so, who should this be reported to? SCIENCE HEALTH SCIENCE NURSING HCM 330

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