Medication Moexipril: Case Summary

Covered entities should always ensure they are adhering to all federal, state, and local laws. Covered entities contracting with pharmacies to dispense 340B drugs should be aware of the federal anti-kickback statute and the way in which such requirements could apply to their arrangements with contract pharmacies. Cases of suspected violations of the anti-kickback statute should be directly referred to the Office of the Inspector General (OIG) who oversees this provision. The OIG can be reached at: Online:http://oig.hhs.gov/fraud/report-fraud/report-fraud-form.aspx Phone: 1-800-HHS-TIPS (1-800-447-8477) Fax: 1-800-223-8164

Dr. Pugnale withdrew an ampule of fentanyl under patient Brook Tamisia during an emergent delivery case on 6/28/17 or 6/29/17. According to Dr. Pugnale, the fentanyl was taken out under patient Brooks Tamisia and administered to Lewis Jordan; a discrepancy report is being created today because there is no fentanyl record under Books Tamisia. I Paged MD on 6/30/17 and on 7/3/17, there has been no response. Furthermore, Brookes Tamisia was not on Dr. Pugnale’s Omnicell narcotic report generated for 6/28/17 and 6/29/17. The billing office has been

Mrs. Carroll stated on today’s date, she noticed her husband, James Carroll, was missing some medication. She advised the medication that appeared to be missing was listed as Fentanyl Transdermal, methadone 10 MG, and Morphine Sulfate. She stated the last time she seen the medications was approximately 3 days ago. She continued to state only immediately family was inside the residence the last few days. She also stated she can’t pin point anyone because she did not see anyone take the medication.

medications on the unapproved list. The patient will be responsible for the charges of the

The reporting party (RP) stated she was recently terminated due to leaving residents alone in the facility and discussing missing narcotic medications. The RP stated on at least two occasion residents' medication became missing. According to the RP a female resident (name unknown) who passed away shortly before Thanksgiving was missing her "Norco." Additional a resident named Richard was missing his evening dose of "Lorazepam." Subsequently the RP discussed the missing medications with the Nurse and Executive Director; however, the missing medications were not reported to CCL. The RP stated that the medication staff are not properly trained in assisting residents with their medications. According to the RP many prescription medications have

was informed that she never picked up her medicines and her Dr in California can't send controlled substance prescriptions across state lines. However, her SPD caseworker Joshua

different from that which they had on record, but all the other certificates and credentials checked out, including the Drug Enforcement Agency (DEA) ID number, doctor licenses, and pharmaceutical certificates. In this incident, a malicious hacker had compromised the medical center’s credentials and was attempting to take out a large line of credit with the pharmacy to purchase drugs. The pharmacy’s act of calling the medical center to double check the order saved them from losing $500,000 in prescription drugs, and saved the medical center $500,000 being withdrawn from their account (Center for internet security, 2017).

The error was found after the vaccine was given and Ms. Lee had left the offices. The Ms. Dhabolt was going to enter the vaccination record into the online systems and the system wouldn’t allow it. The system flagged the entry because the Lot number on the vaccine did not match the pediatric Lot numbers. Both Dr. Gifford and the office manager, Christine Wilson was immediately contacted by Ms. Dhabolt and informed of the error.

The physician and pharmacist must write a report to the state’s health services department if medication is dispensed.

The purpose of this paper is to bring forth awareness when it comes to patients and medication errors and further educates health care professionals on the importance of communication especially during transition of care. According to Williams and Ashrcoft (2013) “ An estimated median of 19.1 % of total opportunities for error in hospitals.” Although not all medication errors occur during transition it is the time most prevalent for these errors to occur. As per Johnson, Guirguis, and Grace (2015) “An estimated 60% of all medication errors occur during transition of care. The National Transitions of Care Coalition defines a transition of care as the movement of patients between healthcare locations, providers, or different levels of care within the same location as their conditions and care needs change, [and] frequently involves multiple persons, including the patient, the family member or other caregiver(s), nurse(s), social worker(s), case manager(s), pharmacist(s), physician(s), and other providers.”

Medication Reconciliation is defined by the Joint Commission as the process of checking and rechecking a patient’s current medication list to the patient’s orders. Within a MedRec program, three steps must be followed to ensure patients have the correct medications at admission and discharge: Verification, Clarification, and Reconciliation (Greenwald et al., 2010; Ruggiero et al,. 2015). MedRec should not occur once, but multiple times especially when a patient moves from department to department. The more a patient moves, the more liable they are for a medication error due to poor communication. MedRec is done for the simple reason of catching those medication errors and correcting them before they can do any harm (The Joint Commission, 2006). Medication errors effect nearly 1.5 million people who enter the hospital setting in the USA. At least every patient has one medication discrepancy between admission and discharge, which leads to rehospitalizations due to hospital-setting medication errors (Institute of Medicine as cited by Wilson et al,. 2015). With nurses at the forefront of a patient’s medication regime, pressure is put on them to provide the necessary education and safety to prevent medication related rehospitalizations. Included in the causes for medication errors is miscommunication between departments taking care of the same patient (Allison et al., 2015). Many medication errors are preventable by the implementation of electronic orders. The use of electronic

I had placed my order over the phone with Bono’s. I advise the phone rep that I wanted to order 2 orders of their three meat combo. Each combo comes with two sides so I had inform the first order I would like double green beans and the second order make it double fries. I also order a sweet tea and a Pepsi. The representative advised it would be 10 minutes. I waited 10 minutes from the time I called to go pick up my order. Once I arrived at their location. Gave them my name, the representative inform she could not locate my order by the name. Immediately she asks what I ordered. I inform her; she realized that she had given my order to the previous customer. She apologizes and informed me the other representative had given the order to the

3. Medication errors, handoff process and information quality. Chiru, Alina M; Baxter, Ryan. Business Process Management Journal 19.2, (2003): 2011-2016

Please Note: On the acquirer’s note page 2 of 5, the following responses by the merchant are inaccurate of what occurred at the time service rendered:

Goal three by the National Patient Safety Goal for 2014 is to use medicines safely. Many errors occur regularly with medications which is why communication is so important with the doctors, nurses and patients. One process that Joint Commission requires in accredited HCO’s is medication reconciliation “creating the most accurate list possible off all medications a patient is taking, including drug name, dosage, frequency, and route, and comparing that list against the physician’s admission, transfer, and/or discharge orders with the goal of providing correct medications to the patients at all transition points within the hospital (Finkelman & Kenner, 2012, p. 388)”. Ensuring medication reconciliation to the patient, health providers and any new consults that are