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CAMDEN CLARK MEDICAL CENTER
MEDICAL SCREENING EXAM
Tag No.: A2406
Based on review of documents, medical records and staff interview, it was determined the hospital failed to ensure an appropriate medical screening examination was conducted on patient #1. This has the potential to negatively affect patient outcomes when the on-call physician does not complete an adequate Medical Screening Examination and a potential lack of treatment when an emergent medical condition is found.
Findings include:
1. Patient #1 is an ED physician who was on duty the night of 9/15-16/12, caring for a patient when he began experiencing numbness and tingling and slurred speech. A telephone interview on 9/17/13 at 0855 revealed ED physician #1 was working in the ED of the sister facility and called the on-call neurologist. He explained to the on-call neurologist the situation of there being no physician in the ED and the need for him to evaluate the patient.
2. During a telephone interview on 9/16/13 at 1900 with ED physician #2, he stated he came to the hospital where Patient #1 was and after assessing the patient, called the on-call neurologist. The on-call neurologist stated he did not need to come in and told him to transfer the patient.
3. The on-call neurologist had the ED physician #1 read the Computerized Tomography (CT) scan to him and told ED physician #1 he did not need to come in and to transfer the patient to another facility. The ED physician #2 then asked the neurologist if he should administer the "Tissue Plaminogen Activator (TPA)" before transfer and the neurologist told him since he hadn't assessed the patient, not to give it. ED physician #2 then contacted the recipient hospital and was asked by the receiving physician to administer the TPA prior to transfer. ED physician #2, then went and spoke with the patient #1, (who is an ED physician) and the patient also requested he receive TPA.
4. A telephone interview was conducted on 9/17/13 at 0920 with the on-call neurologist. He stated in part: "I don't have to come to the hospital to see the patient if I tell the ED to transfer the patient."