We recently represented a physician in an OPMC investigation which arose out of the IV administration of a potent antibiotic which caused the patient, a diabetic, to go into acute kidney failure. Subsequently, the patient required dialysis on a permanent basis. The issue had been the subject of a medical malpractice lawsuit which was settled during trial. (We did not represent the physician at trial.)
At the interview, OPMC questioned the following areas:
- Why did the physician accept the word of the patient regarding kidney function? The patient told the doctor that kidney function was normal when in fact that information was not accurate and the patient?s primary care physician had the abnormal laboratory results in his record but our client did not obtain those laboratory results;
- Why did the physician give the patient this antibiotic, IV, in the office?
Our client responded to the first question by saying he should not have accepted the patient?s word for the kidney function status even though he had known the patient for years and felt that the patient was an intelligent and accurate historian. The client stated that since this event, 5 years past, he has never accepted the word of a patient regarding test results and has always, 100% of the time, obtained the underlying laboratory results before treating the patient. He told OPMC that he had learned a valuable lesson from this situation and changed his method of practice to ensure patient safety.
As to the second question, the client had literature with him to support the manner in which he administered the antibiotic. However, he again told OPMC that he has not given this medication in the office since this event and never will do so in the future. He stated that while the literature does support this administration in some situations that he had decided that it will be safer for patients if this antibiotic is given only in a hospital setting.
A few weeks after the interview OPMC issued a letter stating that they were closing their file with no further action.
It seems that there is a good lesson to be learned from the facts of this case. If you have done something that turned out very badly and if your method of treatment was questionable, a reasonable course of action with OPMC is to state that you have understood the problem and made changes in your practice to prevent that event from ever happening again in the future. OPMC appears to be very accepting of a physician who can say that, on reflection, his decision making could have been better and that the doctor learned from the event. It is our experience that OPMC will not look kindly on a doctor who attempts to defend the indefensible. On the other hand, OPMC will usually not punish a physician who states that he understands the problem and has made alterations in his method of practice to make patient care safer.