VA Midwest Health Care Network (VISN 23)

Issue: A Release of Information (ROI) clerk gave the wrong records to Veteran A, Veteran A returned them to the Privacy Officer. Veteran A had access to Veteran B's full name, medical information, Full SSN, address, and DOB. Update: 01/27/12:Veteran B…

Outcome: Referring to HRMS for disciplinary action. Employee required to re-take privacy training.

Issue: A Veteran reported receiving a clinic blood draw list attached to his blood draw appointment letter in the mail. The list included Veterans' names and full SSNs. Update: 01/23/12:The Veteran who received the list reported it and returned it the…

Outcome: To HRMS for disciplinary action and re-take privacy training.

Issue: Veteran A called to report that he had received Veteran B's medication in the mail. Veteran A was not due any medication refills at this time. This prescription refill was processed by the Consolidated Mail Outpatient Pharmacy (CMOP). The medication…

Outcome: CMOP notified that error in mailing labels occurred. Medication sent in error was retrieved and correct medication sent to appropriate Veteran. CMOP is undertaking internal review to determine issue and will correct.…

Issue: A VA Employee lost an inpatient roster with 24 patients information (full name, last 4 of social security number, age, admission date, floor, room, bed, and physician. He cannot recall where he left this paper and it is in essence…

Outcome: PO provided education to the employee. He reported himself. HIPAA notification letters have been sent out.…

Issue: Veteran A called to report they had received Veteran B's medications in the mail. Veteran A returned the medications to the pharmacy on January 6, 2012. Update: 01/10/12:Veteran B will be sent a notification letter due to full name and…

Outcome: PO spoke with Pharmacy regarding this incident. Veteran A returned Veteran B's medication to VA facility. CMOP mailed prescriptions in error. Will continue to monitor for trends.

Issue: The Omaha VAMC sent the Salvation Army a copy of the wrong Veteran's billing information which contained their full name, full social security number, and date of birth. Update: 01/10/12:The Veteran will be sent a letter offering credit protection services…

Outcome: Document on incorrect Veteran was sent back to us and correct Veteran information was sent out. Educated staff.…

Issue: Veteran A reported receiving Veteran B's Non VA Care letter in the mail. The letter contained Veteran B's name, last four digits of the SSN and approval/denial of treatment dates. Veteran A destroyed the information after reporting this to the…

Outcome: Contacted the Non VA care unit to see where the letter came from. Unable to determine.

Issue: Veteran A received Veteran B's medication bottle and vice versa. Medication bottle contained only the type of prescription, Veteran's name, and instructions for use. Update: 01/04/12:Two (2) Veterans will be sent a notification letter.…

Outcome: Both Veterans have been called and both will be returning the mis-mailed medication bottles to the VA Pharmacy. Staff were reeducated.…

Issue: An employee found a print out of a coworker's "view registration data sheet" on a counter unattended. This sheet included sensitive information on this employee such as full name, SSN and DOB. The Privacy Officer is running a log to…

Outcome: The employee's sensitive information was found on a counter accessible by several different departments. The staff that were shown to be in the employee's record don't recall printing anything and leaving it out in the public.…

Issue: Veteran A received Veteran B's information via a mis-mailing. Information contained full name of veteran, full SSN, address and other unknown information that Veteran A was unable to identify. Veteran A saved all items and will be returning information to…

Outcome: The Service Line in which was responsible for sending out this information was contacted to alert them of the incident and how we can prevent this from reoccurring. Recommendation was to double check contents inside of addressed envelopes to ensure…