Over the course of the last decade, there has been a fundamental shift in the way hospital medical tests are performed. In the past, most tests were sent to a laboratory, while the doctor and patient waited hours or days for test results. Now, however, many or most tests are done right in the patient’s room, at the patient’s bedside.
This type of testing, known as point-of-care testing, or POCT, have increased the convenience of care tremendously. But, as noted in the most recent special issue of Point of Care: The Journal of Near-Patient Testing & Technology, the increased use of POCT has led to the need for careful attention and care to avoid medical malpractice and protect patients.
The special issue included many perspectives, in the form of editorials, studies, and case reports. The issue contained data on the problems, as well as many procedures and suggestions designed to increase patient safety in the context of point-of-care testing.
For example, James H. Nichols, PhD, Professor of pathology at Tufts University School of Medicine in Boston and medical director of clinical chemistry for Baystate Health in Springfield, Mass., noted that a wide variety of problems, and strategies for overcoming them, have emerged with regard to POCT in recent years.
As POCT use increases, regulation has also increased. In fact, the U.S. Food and Drug Administration is assessing and approving an ever-increasing number of POCT devices. And although industry standards are still few-and-far-between, technical standards are now being developed.
But what is truly needed is a systematic approach to point-of-care testing, including patient identification procedures to ensure that results always reach the patient’s file, and the correct patients file. Also needed are system alerts, and standards for operator training.
Other pitfalls include managing the transition from traditional laboratory tests to point-of-care testing. For example, one article in the special issue described several medical errors which occurred at one hospital when a new POCT technology was adopted. The new test gave differently-scaled results than the old test, which led many to misread normal and abnormal results. Another article described malfunction reports from a POCT device due to a technician’s failure to perform routine control checks.
For some as-yet unknown reason, point-of-care testing still has a higher-than-traditional error rate. One study found that, despite quality checks before each test, a routine POCT blood test had a 2 percent patient-identification error rate.
So how can you protect yourself from medical malpractice associated with point-of-care testing? First and foremost, as with other forms of medical malpractice, being proactive during your hospital stay (or that of a loved one) is your single best strategy. If a point-of-care test is offered, ask your doctor whether error rates are higher than the traditional test. If so, ask whether the results are urgently needed, or if there is time to wait for traditional test results.
And, after every POCT, ask to see the results screen to ensure that the test results have been keyed to the proper patient. Although these strategies will not completely reduce medical errors, they can greatly reduce your odds of being a victim.
For a free consultation with an experienced Chicago medical malpractice lawyer at Passen & Powell, call us at (312) 527-4500.
