Complaint Of Improper Charting Of Anesthetic Medications

We recently represented an anesthesiologist who was investigated by OPMC due to a failure to document a patient’s chart. There were two different procedures performed and in neither case was the name or the the amount of the medication charted. The charting was done by a CRNA, not the anesthesiologist and therefore it was tempting to simply say that the charting omissions were the fault of the CRNA and not the responsibility of the anesthesiologist. However, we know from experience that OPMC will not accept that type of defense.

The patient is the patient of the anesthesiologist and he/she has the ultimate responsibility to ensure that the charting is correct and complete. Therefore, during the interview, our client stated that the charting was deficient but that it was his responsibility to correct the omissions. He also said that since this case he has changed his practice to ensure that all anesthesiology reports are complete and accurate.

By taking this position, our client did not try to defend the indefensible and he said he had learned from the experience and improved his patient care. Because of this, OPMC was satisfied with the responses and closed the case without further action.

We at Walker Medical Law feel that it is important to approach these OPMC issues in a way that is looked at as being honest and forthright. By and large, you will not fool an experienced doctor who is conducting the interview for OPMC and if you try to do so you will simply antagonize him/her. This is not helpful to your client. Also, it is important to show how the matter has been a learning experience for the doctor and that he/she has changed his practice to give better care to the patients. This is something that appears to go a long way toward helping the client’s position in the OPMC setting.

Each case is different, but this approach has been used successfully by us on numerous occasions.

This informational video was brought to you by Paul E. Walker, an experienced New York City OPMC & OPD Attorney.