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My question is not necessarily specific to PAs, as it could apply to all providers, but was wondering how liable one is for old findings in hospital records. As an example:

An elderly patient was admitted for a non-pulmonary issue. She had nearly more than 20 imaging results over the years. A CT chest from 3 yrs ago reported a suspicious pulmonary nodule that PCP was following but patient was lost to follow up. Fortunately it was caught in the inpatient setting. However, I could not help wondering, what if it had not been caught. If a patient is admitted to the hospital, obviously providers should be as thorough as possible when reviewing charts but when patients have years worth of records at times, how liable can a provider be for missing concerning findings from years old reports when it’s not related to their presenting chief complaint?  

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First question would be, what is the harm? "Liability" is a nebulous concept. You basically have to worry about malpractice suits or board actions. It's not clear to me from the initial scenario how an old lung nodule, followed by primary care but lost to follow-up, would create either sort of a problem for the hospital or associated medical professionals who saw this patient for an unrelated condition.

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I guess I just wasn’t sure when a patient is being admitted, could it be argued that the admitting provider was obligated to review previous imaging, even when the chief complaint may not be related. I would hope that if the study is not pertinent to the admitting diagnosis, that it would not create a problem if the provider did not review. 

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welcome to primary care, the hub of all of it

 

yup, old records hide some things that we can get burned by.   I hate EMR's which encourage data dumps and labeling/dx everything - creates info overload......

 

Mostly I go by things I find, and what the patient tells me.

then the recommended screening exams

 

if you don't tell me about a past nodule, and you are not in the Lung CA screen set, I might never see that old report because I am not reading every old record..... but I don't think I am liable for something years ago that I was not told, and was not responsible for at the time, and that there was no rec screening which I did not present to patient, i.e. annual LDCT

 

This is the challenge of pcp fields......

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