Doctors Fail to Follow Up on Lab Tests Indicating Infection

Case Overview

This case involves an elderly male patient that was admitted to the hospital for a suspected UTI related to indwelling catheter use. A urine culture was ordered by a nurse practitioner, however the patient was discharged before the results were reviewed. It was later revealed that the test results were sent to the wing of the hospital in which the patient was staying, however they were not brought to his care providers. A few days after being discharged from the hospital the patient presented to the emergency room with signs of a worsening infection. The patient required multiple surgeries in order to repair damage done by the untreated infection, and continues to suffer from ongoing urinary tract dysfunction.

Questions to the Nursing expert and their responses

How frequently do you treat patients like the one described in this case?

I care for patients with UTIs frequently in the ED, Urgent Care, and through my internal medicine position. In all 3 settings I assess, perform differential diagnoses and order appropriate diagnostic studies which would generally include a UA and, if positive, a urine culture to follow.

In the presence of a patient with suspected UTI, who is usually responsible for following up on the urine culture results?

The person responsible for follow up on the diagnostic tests, including a urine culture is either the provider who ordered the test, another provider of the care team when the ordering provider is not available or another designated provider. The specific person depends on the setting, the resources, and the facility's established procedure for follow up on resulted labs.

About the expert

This expert is double board certified as an Adult Nurse Practitioner and a Family Nurse Practitioner. She is a member of the American Association of Nurse Practitioners, the American Academy of Emergency Nurse Practitioners and the Emergency Nurses Association. This expert has published 8 peer-reviewed journal articles and has done over 20 national presentations. She is the former Department Chair, Health Management & Risk Reduction at Loyola University in Chicago as well as a former Staff Nurse in the Emergency Department at Loyola University Medical Center. She was also a nurse practitioner in the emergency department and internal medicine department at a major medical center. Currently, this expert serves as a nurse practitioner at an urgent care center in Illinois. In addition, this expert serves as an assistant professor at a nursing school in Chicago.

E-033816

Specialties:

Nursing