Be wary of participation in RO-ILS and other patient saftey organizations (PSO)

[Gfunk6]

RO-ILS = Radiation Oncology - Incident Learning System
info: RO-ILS- American Society for Radiation Oncology (ASTRO)

TL;DR - this is a vehicle that is meant to allow physicians to share adverse outcomes with other physicians (in a HIPAA compliant manner). The objective is to improve treatment quality/safety so that all can learn from the mistakes of one without having to repeat said errors.

However, the Supreme Court of Florida has ruled that such information is NOT privileged/shielded in medical practice suits. Therefore if you mess up and try to share your experience with others so that they don't do the same in an effort to have a frank and open discussion, you are putting yourself at legal risk.

Supreme Court turns down medical records case

The US Supreme Court declined to hear an appeal. So for those of you participating in RO-ILS or other PSOs, beware!

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[medgator]

No good deed goes unpunished

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[RadOncDoc21]

This is why I never make mistakes.

 

[Gfunk6]

This is why I never make mistakes.

If only everyone could follow your example . . .

 

[RadOncDoc21]

If only everyone could follow your example . . .

You know what else can save you money?

 

[scarbrtj]

This brings up, in my mind, an incident from the past, and a question, and a desire for opinions from others.

When I was a med student I was rotating with a rad onc who was treating a woman with a painful breast ca met in her humerus. He was planning for 20 Gy/5 fx, but somehow there was a mistake by the physicist or dosimetrist that she got 4 Gy from an AP field and 4 Gy from a PA field for a total dose of 8 Gy in one day. That was unplanned of course. The rad onc as I recall was super scared and freaked out and went to talk to the patient in hushed tones basically in the context of explaining an error and explaining that she would only be getting one treatment instead of five. This was around 1996 when 8 Gy/1 fx, a fine standard now, was considered (probably) malpractice. At least that's impression I got as a med student: 8 Gy in one fraction was nigh malpractice.

When I was a resident I was seeing a woman about one month out from definitive XRT for NSCLC. The post-tx CT showed a shrinkage of a RUL lesion and growth of RML lesion. I went back and looked at the contouring and planning (by the previous resident on the service) and discovered that she had only contoured the RUL lesion and that's all that was treated (70 Gy/35 fx). The RML lesion was not treated; of course, it had grown in the interim (this was around 1999, before daily CBCTs etc etc). I went back to my attending and showed him the plan, outcome, etc. And of course he was gobsmacked. He instructed me to not go in with him to discuss things with the patient. I never found out what happened to her, nor what she was told (mistake or no mistake etc.). I do know she was not chosen for de novo radiation to the RML lesion; it was pretty close to the RUL lesion, and re-irradiation was very rare obviously back in those days.

Radiation is an intangible, invisible therapy. It is one field of medicine where a "mistake" can be much more obvious to the doctor than the patient. A "mistake" can be more subjective, e.g. the former instance I mentioned. Or it can be less subjective, e.g. the latter instance.

Truly, as someone said, the best option is never make a mistake!

 

[Gfunk6]

Truly, as someone said, the best option is never make a mistake!

Joshua: A strange game. The only winning move is not to play.

 

[Brim]

So what's your question? Is it an intangible, invisible one?

This brings up, in my mind, an incident from the past, and a question, and a desire for opinions from others.