Electronic Medical Records (or EMRs) have been a thorn in the side of many health care providers for more than a decade. While many health care providers will admit the pros and cons of EMRs, the focus is typically on the flaws of EMRs. On December 31, 2018, the Indiana Court of Appeals addressed a case involving a flaw present in many EMRs, automated charting errors.

The case of Speaks v. Vishnuvardhan Rao (Ind. Ct. App. 2018) was a medical malpractice claim that involved several different issues. However, one of the more novel issues involved a computer charting error regarding a medication that was never prescribed and not provided. 

Specifically, the patient’s medical record contained two references to “SOTRADECOL 3%.” 

However, the patient was never prescribed Sotradecol, and it would have been considered malpractice to provide Sotradecol to the patient. The health care providers sought and obtained summary judgment on the issue concerning Sotradecol even though the legal standard for winning such a motion was heavily tilted towards the non-moving party (i.e. the patient/plaintiff). The Indiana Court of Appeals affirmed the decision in favor of the health care providers and stated:

In light of the evidence and circumstances presented, we conclude the only reasonable inference is that Sotradecol’s presence on Speaks’ computerized vital signs and fluid intake chart was a charting error; Sotradecol was not even a drug available at Porter Hospital on November 19, 2012. Therefore, although we agree that whether Speaks received Sotradecol is a “material” fact because it could affect the outcome of her case, we nevertheless conclude that Speaks has failed in her burden to demonstrate that this issue is “genuine.”  . . . Accordingly, summary judgment in favor of Dr. Rao and Porter Hospital on this issue was appropriate.

The Court of Appeals in Speaks made an important distinction that is important to recognize in the age of EMRs – sometimes computers make mistakes (in the sense the computer program was incorrectly coded by an individual). In the age of EMRs, the adage that the “record speaks for itself” is rarely (if ever) accurate. While the conclusion in Speaks may seem obvious to most people, courts are generally reluctant to grant summary judgment – especially when there is the slightest shred of evidence to support a plaintiff’s claim. That being said, evidence must still be viewed under the lens of reasonableness – not hypothetical possibilities. While it was possible the patient in Speaks received Sotradecol as the chart indicated, such an inference was not reasonable in light of the designated evidence showing a computer error. While health care providers must take care when working with EMRs, it is comforting to know they will not be held liable for computer errors like the one that occurred in Speaks.

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Posted on Mar. 01 2019, by Courtney David Mills