The following is a NY Daily News report:

Some staffers at city-run hospitals have practiced a very nonmedical skill – fiction writing.

Doctors, nurses and support staff have made false entries in hospital records to cover up medical screwups, a Daily News investigation found.

Records sometimes lacked crucial data or were missing completely, making a thorough investigation impossible.

Again and again, workers at city-run hospitals faked records to cover up incidents or claimed they couldn’t find data when investigators came knocking.

Between 2004 and September 2008, the state issued 16 citations for incomplete, altered or missing medical records, a News analysis of hundreds of pages of internal documents found.

BELLEVUE HOSPITAL

Records were sometimes ludicrous. At Bellevue, for instance, medical reports listed a psychiatrist performing surgery.

Sometimes, as in the case of patient Alfred Scott, they were anything but funny. Scott showed up at Bellevue Sept. 8, 2005, diagnosed as having suffered a “cardiac event.” A fourth-year med student placed an IV in his left arm.

Problem No. 1: Students are not allowed to administer IVs.

Over the next two days the medical student and several nurses made apparently fictional entries in medical records.

The student claimed Scott’s arm was fine. One nurse wrote that the arm’s skin was “warm to touch.” Another says there were “no signs of inflammation.”

Problem No. 2: Scott’s arm was covered from knuckles to elbow with a material called Kerlix which made examination impossible. When the Kerlix was removed after two days, staffers found Scott’s arm was “blistering,” his left hand “cool to touch and pulseless.”

Investigators concluded “the student likely did not examine the left arm” and that the signs of problems “must have been present during the time that nursing staff documented intact skin and circulation.”

Surgeons determined the IV made Scott’s arm “not salvageable.” Three days after surviving a heart attack, Scott had his left arm amputated at the elbow.

Besides the fictional notes, hospital records make another false claim: that a licensed medical doctor administered the IV.

Scott died four months later. His widow, Gwendolyn, sued, saying the amputation contributed to his death. The hospital was fined $14,000, but the family was not told.

In a statement, the city Health & Hospitals Corp. confirmed “protocol prohibits medical students from starting IVs” and blamed the nurse for “mistakenly” thinking the med student was a resident.

Because of this incident, HHC banned using dressing that obscures an IV site and required nurses to check IVs every day.

WOODHULL HOSPITAL

The hospital turned over “corrected” records when investigators showed up to look into a March 2007 incident in which a 3-month-old infant died.

The infant arrived at Woodhull March 25 with difficulty breathing and spiking a temperature of 102. At the time the hospital relied on a doctor who specialized in cardiac care for children, but that weekend, the doctor was out of town.

Two pediatric residents who weren’t supposed to examine critical care patients without direct supervision did the exam. They recommended continuous nebulizer treatments, but they did not give this information to the attending physician.

The attending first learned this eight hours after the child arrived, when he examined the infant for the first time and recommended “close observation.”

After this, the report notes, the infant began suffering “severe respiratory distress,” and by 8 p.m. the hospital finally contacted the pediatric heart specialist.

That doctor recommended transferring the child to another hospital because he was out of town. At 2:15 a.m. the next day the child was transferred “with spastic tremors of face and arms.” The child died within 24 hours of the transfer.

Though hospitals are supposed to report incidents like this within 24 hours, the state did not learn of this incident for a month.

Investigators found the hospital’s medical files did not identify an attending physician on duty when the infant was there. The next day, the hospital produced a “corrected” record naming the doctor on duty.

The hospital insists it always had adequate doctors on hand but was cited for numerous violations, including failing to report the incident in a timely manner. It was fined $10,000.

JACOBI MEDICAL CENTER

In many cases, problems included simply losing medical records and failing to properly track patient care and status.

Jacobi Medical Center in the Bronx was cited on five separate occasions for these problems, records show.

On April 8, 2004, a woman delivered a stillborn infant at Jacobi. The state found key sections of her medical records missing.

The citation said the missing records made it impossible for the facility to properly review the care the mother was given prior to the stillborn birth.

HHC called this a case of “misplaced paper” that was eventually found.

In some cases, HHC hospitals take their time about investigating incidents.

Records show a Harlem Hospital Center patient died after staff failed to properly respond to repeated episodes of severe bleeding. Staff did not investigate the cause of the bleeding until at least 10 days after the problem began and had still not completed it when the patient died less than three weeks later.

(LINK to NY Daily News article)