Unit Ill-prepared for Labor and Delivery Complications
This case study was made available to MIEC through our partnership with CRICO. It was written by Jennifer Vuu Sanchez, CRICO Description A fetal death was attributed to a failure by the obstetrics team to identify and respond to uterine rupture. Key Lessons Early signs of fetal distress should trigger the decision process re: early intervention Review of, and adherence to, policy/protocol is essential to patient safety The scope of practice requirements for covering physicians should be clear to all providers on the Labor & Delivery Unit Clinical Sequence 1:00 p.m. A 30-year-old gravida 2, para 1 patient with a...
Gaps in Clinical Workup Lead to Young Patient’s Missed Colorectal Cancer
This case study was made available to MIEC through our partnership with CRICO. It was written by Melissa DeMayo, CRICO Description A 33-year-old woman was diagnosed with colon cancer more than two years after her initial complaint of rectal bleeding. Key Lessons Gaps in clinical workup can lead to flaws in medical decision-making. Sub-optimal surgical/invasive procedures can lead to missed diagnoses. Clinical Sequence A 31 -year-old woman with no significant medical history complained of rectal bleeding to her primary care physician, a cardiologist. At this visit, she also described hard stools with hematochezia and possibly hemorrhoids. The cardiologist performed a...
This case study was made available to MIEC through our partnership with CRICO. It was written by Melissa DeMayo, CRICO Description Six days after his initial visit to Urgent Care for ear pain and facial paralysis—and after three CT scans—a 28-year-old man was diagnosed with bacterial meningitis. Key Lessons A patient’s return for care with worsening symptoms should trigger a diagnostic questioning protocol Fragmented patient care increases the need for concurrent communication among providers Clinical Sequence A 28-year-old man presented to Urgent Care with complaints of right ear pain and right-sided facial paralysis. At this visit, impacted ear wax was...
This case study was made available to MIEC through our partnership with CRICO. It was written by Lisa Heard, CRICO Description A patient suffers an infection when a biliary stent that should have been removed after three months is discovered still in place after 12 months. Key Lessons Determination among providers regarding accountability for patient follow-up is essential to prevent gaps in care. The discharging provider must have systems in place to confirm that the subsequent provider received information needed to accurately care for the patient. Information transfer involves physicians, nurses, care managers, office personnel, and information technology staff. Unresolved...
DEA Likely to Further Extend Flexibilities on Controlled Substances and Telehealth Prescribing Beyond 2024
During the first year of the COVID-19 pandemic, the provision of medical care through telehealth increased by 154%, and much of that increase occurred in behavioral health. This trend, combined with COVID risk mitigation strategies and temporary flexibilities in licensure and regulatory requirements, resulted in substantial growth in virtual-only medical practices. In the field of behavioral health, temporary flexibilities allowing telehealth-only prescribing of controlled substances has allowed these practices to flourish by allowing them to treat a full spectrum of conditions through remote-only care. However, as the COVID pandemic ended, an important question arose as to whether telehealth-only prescribing of...
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