Friday, September 26, 2008
UC Irvine in Trouble for Falsifying Patient Records
UC Irvine (UCI) Medical Center is being placed under the oversight of the State Department of Public Health because federal inspectors found that doctors were filling out medical records in advance and even putting patient's outcomes in the record before the procedures were done.
A whistle blower complaint preceded an investigation and a 30-page inspection report that listed problems dating back at least three years. They included substandard equipment checks, inadequate record keeping and falsified records by doctors. Anesthesiologists were found to fill out operative reports a day before the surgery was even done.
The Department of Anesthesiology had problems dating back to 2003 when half of the 26 professors signed a letter alleging that "the direction of the department has been radically altered to achieve financial goals at the expense of academic goals." Many of the doctors resigned over the next few years.
After a lengthy search, UCI hired Dr. Zeev Kain, executive vice chairman of anesthesiology at Yale, as chairman of the renamed department of anesthesiology and perioperative care. He began on March 1 and hired six new faculty members and installed a new electronic monitoring system that eliminates the opportunity to fill out records in advance.
Kain said he was brought in to "clean things up" and all staff members have now signed a zero tolerance policy for falsifying records. (amazing that it should even need to be addressed in a signed policy)
It would seem that something is seriously wrong at UCI. They have been involved in a number of large scandals over the last 13 years. They had to shut down their transplant program when Medicare funding was withdrawn after 32 people died awaiting livers in 2004-05. Their doctors turned down organs that were successfully transplanted elsewhere.
They came under fire when the director of the University's Willed Body Program sold parts of cadavers and did unauthorized autopsies.
In 1995 the fertility doctors were accused of stealing patient's eggs and embryos and implanting them in other patients without permission. That program was also shut down.
One of the leaders in the Cardiology Department was found to have no California license and no cardiology credentials. He resigned.
Usually, repeated high-profile scandals such as these indicate serious problems with ethical culture and it starts at the top. There seem to be endemic management problems and too many examples of poor ethical decision making. I am certain there are hundreds of dedicated, well intentioned clinicians at UCI who provide excellent patient care. But I would challenge the Board and Medical Executive Committee to do a thorough house-cleaning and shine the light on management to start a culture change of ethical and open behavior.
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