This patient’s medical record said she’d given birth twice—in fact, she’d never been pregnant

Dec. 10, 2018

Morgan Gleason has had a lot more experience with the healthcare system than most college students. Nine years ago, she was diagnosed with a rare autoimmune disease called Juvenile Dermatomyositis, which causes symptoms like weak muscles and skin rashes.

Like many patients with a chronic illness, Gleason sees a lot of doctors. So, she and her mother, Amy, who works at a health IT company called CareSync, always make it a point to request her medical records after a visit so they can store a copy of all her records in one place.

Two years ago, Gleason requested her records after visiting a women’s health clinic in Florida. To her surprise, she found a note in the record saying she’d had two children. One was apparently still living, and the other had died shortly after she gave birth.

According to the chart, which she provided to CNBC, Gleason would had to have given birth to the first child at age 13 for the dates to line up.

In fact, Gleason had never been pregnant.

It wasn’t the first mistake. In a different record, Gleason had spotted a diagnosis of diabetes shouldn’t have been there. She had looked into it after a doctor had gone off script by peppering her with questions about her blood sugar.

Ross Koppel, a leading academic in the world of health IT, estimates that about 70% of records have wrong information.

Most errors are irrelevant to health outcomes—for instance, a record might state that a patient hurt her finger on Thursday, when it was in fact, Friday.

But mistakes can be harmful or even fatal if they lead to a misdiagnosis, a failure to recognize an allergy or a wrong dose of a medication. A Johns Hopkins study found that more than 250,000 people in the U.S. die every year from medical mistakes, making it the third-leading cause of death after heart disease and cancer. Other studies have found the numbers to be higher than 400,000.

There are also cases of mistaken identity. In the United States, unlike in other developed nations, such as the United Kingdom and many of the Nordic countries, there’s no unique patient identifier number linked to a single centralized record. That makes it a challenge for doctors to ensure that they’ve pulled up the record of the right patient if they happen to have a common name.

To rectify that, Koppel always encourages nurses and doctors to take photos of their patients and clip them to the record, so they can at least ensure that they’re talking to the right person.

CNBC has the full story

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