VA Southeast Network (VISN 7)

Issue: A Complaint received from a Veteran who states that his record was inappropriately accessed by a VA employee whom he was formerly dating. The Veteran cannot recall when the record was accessed, but states that the Pharmacy employee has accessed…

Outcome: Veteran record marked sensitive in CPRS. Employee's supervisor notified. Disciplinary action to be recommended in accordance with medical center policy.

Issue: Received phone call from Veterans A mother on 6/17/11. She advised that her son received copies of two Compensation and Pension Examinations on Veteran B. Both veterans had the same name. Her son (Veteran A) received the documents on 6/15/11.…

Outcome: The documents were immediately returned to the Dorn VA Medical Center. The ROI Supervisor has instructed employees to conduct peer reviews of all documents being mailed out to ensure that all Veterans receive the correct PHI.…

Issue: On 06/14/11, the Privacy Officer (PO) was notified by the Associate Chief of Pharmacy Services that Veteran A contacted the Director's Office to inform them that he received Veteran B's medication in the mail. The information exposed included Veteran B's…

Outcome: The employee has been counseled on verifying the correct medications are in the correct packages.

Issue: On 06/02/11, Veteran A received a patient data card and a travel voucher, which was intended for Veteran B. The Travel Clerk collected a number of patient data cards to speed up their work process. She held on to Veteran…

Outcome: Staff is being re-educated on the need to safeguard patient information.

Issue: On 6/7/11, Veteran A received 278 pages of Veteran B's medical records. Both Veterans have the same first, last, and middle name. Veteran A contacted the Chief of Health Information Management Service (HIMS) and informed them of the incident. The…

Outcome: Chief of ROI has re-educated staff on the need to safeguard patient information.

Issue: There was documentation in a Telephone Advice Program (TAP) note dated 05/24/11 that Veteran A claimed that a Life Insurance Company had received documents on Veteran B. The Release of Information Office released copies of medical reports on Veteran A…

Outcome: EMPLOYEES HAVE BEEN RE-EDUCATED ON THE NEED TO SAFEGUARD PATIENT INFORMATION.

Issue: Veteran discharged from Birmingham VAMC on 5/19/11. VA employee accidentally packed another Veteran's medication for him, and he took it home. The veteran discovered he had the wrong medication, called the VAMC , and mailed the medication back to VAMC.…

Outcome: Employee inadvertently packed a medication bottle belonging to the wrong patient. Another patient was being discharged and discovered the error upon his return home when he unpacked his luggage. He contacted the facility and returned the medication bottle via US…

Issue: Birmingham VAMC Clerk scheduled Veteran A's appointments under Veteran B's name/record. The appointment list was printed and given to the Veteran A's sister, so she saw the Veteran B's name, last four, clinic name, and appointment date. Update: 06/06/11:Veteran B…

Outcome: Employee placed appointment information on wrong patient's chart. Employee then provided the wrong patient's information/appointment to the patient. The employee and patient were reviewing the appointments when they realized the patient information belonged to another patient. The employee immediately took…

Issue: A pharmacy package was delivered to the wrong individual. The Veteran no longer resides at the address where the package was delivered. The individual contacted Pharmacy Service staff regarding the misdirected package. The individual who received the package is not…

Outcome: Employees are being re-educated on the need to safeguard patient information, and the importance of being vigilant when disbursing medication via the pharmacy window as well as through the mail.

Issue: The Release of Information (RO)I clerk received notification from the US Postal Service (USPS) that on 05/03/11 "an empty wrapper with your address was found in the mail and it is believed to have been separated from the parcel during…

Outcome: no fault of VA CPS sent anyway.