Chillicothe VA Medical Center

Issue: A Community Based Outpatient Clinic (CBOC) clerk mailed medical information to Veteran A. She accidentally put a physician's order belonging to Veteran B in the envelope. Veteran A, who received the order, returned it to the clinic. The order contained…

Outcome: 06/22/14: The Incident Resolution team determined that Veteran B will receive a HIPAA letter of notification.…

Issue: VA Pharmacy mismailed Veteran A's medications to Veteran B. The medication was labeled with the Veteran A's, address, and dosage. Veteran B, who received the medications in error, contacted the VA and returned the medications.…

Outcome: 06/18/14: The Incident Resolution Service Team (IRST) determined that Veteran B will receive a HIPAA letter of notification.…

Issue: Employee was disciplined for accessing a veteran's medical record without having a need to know. Veteran is employee's boyfriend. Employee is contesting the disciplinary action and notified her Congressman. Employee's correspondence to the Congressman included the full name of the…

Outcome: 06/05/14: The Incident Resolution Team has determined that Veteran A will be sent a notification letter.…

Issue: The Consolidated Mail Outpatient Pharmacy (CMOP) mailed one bottle of medication intended for Veteran A to Veteran B. Veteran B contacted VA and the medication was returned to the Medical Center. A new medication was sent to Veteran A.…

Outcome: 06/02/14: The Incident Resolution Service Team has determined that Veteran A will be sent a HIPAA notification letter since his name and medication information was disclosed..…

Issue: A prescription bottle for Veteran A was mailed to Veteran B. Veteran B, who received the medication, recognized it was not her name and brought the medication back to the pharmacy. Veteran B's name and medication information was disclosed.…

Outcome: 05/15/14: The Incident Resolution Team has determined that Veteran A will be sent a notification letter.…

Issue: A VA Clerk faxed 18 pages of a patient's consult to a wrong fax number. The intended recipient was a kidney and hypertension center, however, information was faxed to a home remodeling business. The patient's name, address, date of birth,…

Outcome: 05/07/14: The Incident Resolution Team determined that the patient will receive a letter offering credit protection services since the full SSN was compromised.…

Issue: NCCPAC Clerk mailed documents to Veteran A. One form (instructions for completing an authorization form) was included. This form contained the full name and last 4 SSN of Veteran B.…

Outcome: 04/09/14: The Incident Resolution Team determined that Veteran B will receive a general letter of notification.…

Issue: Release of Information clerk mistakenly labeled an envelope with Veteran B's contact information. As a result, 90 pages of Veteran A's medical and military records were mailed to the Veteran B. Veteran B notified the Release of Information Section right…

Outcome: 04/08/14: The Incident Resolution Team has determined that Veteran A will be sent a letter offering credit protection services.…

Issue: VA employee mailed an authorization for non-VA care to the wrong Veteran. The form contained the diagnosis (reason for authorization) and patient details. The Veteran who received the information in error took it to his Veterans Service Organization (VSO), who…

Outcome: 03/31/14: The Incident Resolution Team has determined that Individual A will be sent a letter offering credit protection services.…

Issue: Pharmacy staff reported that Veteran A's meds were mailed to the home of Veteran B. This was done by the Pharmacy's contracted mail service. When the Veteran received the meds, he took them with him to a care facility. The…

Outcome: 03/20/14: The Incident Resolution Team has determined that Veteran A will be sent a notification letter.…