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Nurse terminated for meds. error: hospital attempts to deny access to records.

CASE ON POINT: Chapman v. Health & Hospital Corporations, 2005 WL 697435--NY

ISSUE: As a consequence of the new HIPPA law, hospitals, as well as other healthcare providers, are more sensitive than ever about making disclosures regarding patient information. However, in this extraordinary New York case, one hospital, after terminating a nurse because of alleged medication errors, refused to provide her with copies of the patient's medical records so that she might defend herself both as to her licensure as well as the legality of her termination. The New York courts were confronted with the issue of whether the nurse was entitled to copies of the records, which allegedly were evidence of her medications error. Curiously, there was a discrepancy in the records. According to the records, the nurse's error was made thirteen days before the patient was admitted to the hospital! How could that be?

CASE FACTS: Woodhull Medical & Mental Health Center employed Jacqueline Chapman as a Registered Nurse in its Labor and Delivery Unit (LDU). Nurse Chapman was on duty on October 12, 2003. The hospital learned of irregularities in the way certain medication was administered and handled on that date. It terminated Nurse Chapman's employment. Nurse Chapman, in an attempt to challenge the legality' of her termination was engaged in hearings at the state's Office of Labor Relations. Nurse Chapman, in attempting to challenge the validity of her termination by proving that she did not engage in any inappropriate conduct, attempted to obtain copies of the medical records in question. However, the hospital refused to provide copies of the records in question. Nurse Chapman did not prevail at the hearing at the Office of Labor Relations Consequently, it was likely that she would not only lose her job but that she would also lose her license to practice nursing, and as a result her means of earning her livelihood. Nurse Chapman filed a court petition seeking to compel the hospital to produce the medical records in question described in a Subpoena Duces Tecum (SDT) served on the hospital commanding that the hospital produce the records for the administrative hearing. The hospital refused to produce the records arguing, inter alia, that the Health Insurance Portability, and Accountability Act (HIPPA), absent an appropriate authorization from the patient, could not release the patient's records.

COURT'S OPINION: The Supreme Court of New York granted Nurse Chapman's petition. The court ordered, inter alia, that the hospital produce "all of the medical records, including laboratory reports, for the patient alleged to be involved in the misconduct attributed to [Nurse Chapman] and described by [her] ... for the period of October 11 and October 12, 2003." The court further ordered that the hospital redact the material as to "de-identify" the patient in accordance with the law providing for protection to the fullest extent possible. The court further ordered that the nurse be prohibited from using or disclosing the material for any purpose other than in the proceeding for which the information was requested, or subsequent proceedings or litigation.

LEGAL COMMENTARY: The court noted that HIPPA provides severe penalties for wrongful disclosure of individually identifiable health information. A person who knowingly and in violation of HIPPA uses or causes health information relating to individual patients to improper disclosure is subject to penalties described in federal law. Further, HIPPA provides that if the offense is committed with the intent to sell, transfer. or use individually identifiable health information for commercial advantage, personal gain, or malicious harm, fines of not more than $250,000, or prison sentences of not more than 10 years, or both are applicable! The court determined that the hospital's reliance upon HIPPA was totally misplaced. It would be malicious for the hospital to base its decision to terminate the nurse's employment on a patient's records and then refuse to allow the nurse reasonable access to those records to defend herself. The court noted that the hospital went so far as to refuse to even provide a printed consent form, showing that the patient in question may not have been admitted for treatment until 13 days after the alleged misconduct. The court pointed out that if the hospital made an honest error, Nurse Chapman was entitled to inquire into whether that error played a role in her termination. The hospital's own records showed a discrepancy of 13 days from the time that the nurse allegedly made the medication error and the admission date of the patient. Could the nurse have made a medication error thirteen days before the patient's admission?

Meet the Editor & Publisher: A. David Tammelleo, JD, is a nationally recognized authority on health care law. Practicing law for over 40 years, he concentrates in health care law with the Providence, R.I. firm of A. David Tammelleo & Associates. He has presented seminars on medical, nursing and hospital law throughout the United States. In addition to his writings as Editor of Medical Law's, Nursing Law's & Hospital Law's Reagan Reports, his legal articles have been published in the most prestigious health law journals. A prolific writer, his thousands of articles, as well as his achievement as an attorney and lecturer, have won him recognition in Martindale-Hubbell's Bar Register of Preeminent Lawyers, Marquis Who's Who in American Law, and Who's Who in America.
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Title Annotation:Nursing Law Case of the Month
Author:Tammelleo, A. David
Publication:Nursing Law's Regan Report
Date:May 1, 2005
Words:876
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