This database was last updated in December 2015 ago and should only be used as a historical snapshot. More recent data on breaches affecting 500 or more people is available at the U.S. Department of Health and Human Services’ Breach Portal.

Phoenix VA Health Care System

PHOENIX AZ - 644

Mentioned in a privacy incident report created by the U.S. Department of Veterans Affairs on August 8, 2013. Also cited in 102 other reports.


Report ID: PSETS0000093137, U.S. Department of Veterans Affairs

Reported Entity: PHOENIX AZ - 644

Issue:

On 8/1/13, a Pharmacy technician processed an address change for Veteran A. Address change was mistakenly applied to the chart of Veteran B, who has a similar name and last 4 SSN. Veteran B received two packages of medications intended for Veteran A. After realizing the error on the first package, he refused delivery of the second package, and contacted the VA Pharmacy Helpline to report the error. On 8/8/13, a pre-paid return package was sent to Veteran B to recover the first package of medications for Veteran A. Pharmacy contacted Veteran A to obtain information to re-process medication order. Medications for Veteran A were re-processed for in-person pick-up at the facility, at the request of Veteran A. Preliminary investigation indicates root cause was failure to correctly identify patient chart for address change, with name and SSN similarities contributory. Further investigation, recovery, and notifications to ensue.

Outcome:

08/09/13: Veteran A will be sent a letter of notification.

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