VA Southeast Network (VISN 7)

Issue: On 05/20/11, the complainant received a copy of her physical therapy consult in the mail. The envelope was not sealed. Complainant states it appears that at one point in time, the envelope had been slightly sealed and it had come…

Outcome: Patient notified Privacy Officer on May 20, 2011 that she had received mail from the Physical Medicine service. The envelope was not properly sealed. Medical documents pertaining to the patient were inside which contained her full SSN and other pertinent…

Issue: On 05/11/11, Veteran A received a reminder by mail of an upcoming Primary Care Clinic appointment. The Veteran was surprised to see a second appointment letter, which was intended for Veteran B included in the same envelope. Veteran A contacted…

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

Issue: Veteran A received a prescription package by UPS which contained a narcotic that was intended for Veteran B. Both Veterans have the same first and last name. The Pharmacist mislabeled the package with the Veteran A's name and address. Veteran…

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

Issue: Veteran A received his medication in a bag at the outpatient pharmacy window. He stood in the pharmacy lobby area reviewing the contents of the bag. He was surprised to find a prescription bottle that was intended for another Veteran…

Outcome: The Supervisor discussed the error with the employees during her morning meeting, and the group was cautioned not to combine bags and to make sure that all batch stickers are properly scanned out at the pickup window. This issue has…

Issue: On 04/26/11, Veteran A received a reminder by mail of an upcoming Compensation and Pension appointment. The Veteran was surprised to see a second appointment letter, which was intended for Veteran B included in the same envelope. The letter contained…

Outcome: Corrective Action: To prevent an incident such as this from recurring, staff is being re-educated on the need to safeguard patient information.…

Issue: On 04/28/11, Veteran A (Social Security Administration employee) received the results of her lab work by mail. There were two additional lab results, which were intended for Veterans B and C, included in the same envelope. The letters contained Veteran…

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

Issue: A Community Based Outpatient Clinic (CBOC) Administrator alerted the alternate Privacy Officer (PO) that a Release of Information (ROI) request had been sent to the wrong patient (Patient A) through the mail. Patient A brought in the package of medical…

Outcome: Chief of section has discussed with staff compliant process for mail out of these documents and has stressed the two-person verification process.

Issue: An Administrative Assistant submitted an application through USA Jobs that included an action required report for the Extended Care clinic group . This report included the full names and social security numbers of 25 Veterans. Information Security has received a…

Outcome: OPM has removed the documents from the website and destroyed the data. It has been recommended that the employee retake their Information Security and Privacy training. The Service Line is pursing administrative action. CRM Ltrs mailed on May 23, 2011.…

Issue: A Community Based Outpatient Clinic (CBOC) employee returned the completed Personal Identity Verification (PIV) applications of all staff at the CBOC in one privacy envelope. The CBOC Nurse Manager told all the employees where the envelope was and she left…

Outcome: Service has requested remote access for staff conducting the workflow. This process has gone to a new electronic process. All employees have been oriented to new process.…

Issue: Veteran A received multiple Veterans' documents in an envelope mailed to him. Veteran A had not requested any copies of his own records. Veteran A is concerned that his information may have been sent to others. The Privacy Officer (PO)…

Outcome: Privacy Officer unable to determine the employee responsible for this breach. Material mailed out in a VAMC envelope with no return mail code. Privacy Officer will continue to stress privacy policies at all staff meetings and New Employee orientation (NEO).…