There’s trouble on the horizon for Wake Forest Baptist University Medical Center in Winston-Salem, North Carolina, whose lab errors related to the hospital’s pathology testing have led to both misdiagnosis and missed diagnosis—for cancer. And unless the hospital’s proposed action plan solves the problem, Medicare might not stick around to hang.

Image: NC Health News

At Wake Forest Baptist, several patients were mistakenly treated for cancer and at least one other had a missed cancer diagnosis, NC Health News reports. This led to the announcement by Medicare that the hospital “will no longer be able to bill the program for patients admitted unless the agency approves a plan to fix problems related to pathology testing before then.”

NC Health News shares that the hospital has submitted a corrective plan to the Centers for Medicare and Medicaid Services, the agency that oversees the country’s Medicare program. In the meantime, the hospital’s Medicare contract was extended to April 6, which “gives government inspectors more time to complete the required follow-up visit to validate [the] corrective action plan.”

While we’re waiting, let’s backtrack.

What happened?

NC Health News reports:

“‘Last fall, Wake Forest Baptist Medical Center became aware of deficiencies in its pathology quality monitoring process, which led to a change in diagnosis requiring a change in management for 10 of our patients,’ the hospital said in a statement. ‘We promptly notified all patients affected, as well as the physicians who cared for them. We have completed a review of hundreds of similar cases to satisfy ourselves that there are no other patients who have been affected.’”

The decision potentially puts at risk tens, if not hundreds of millions of dollars in annual revenue to the Winston-Salem medical center.

“The errors were reported by hospital employees through the medical center’s Safety Starts Here program and subsequently reported to regulators."

Why is this important?

Well, for one, Medicare is the largest healthcare payer in the country.

“For [Wake Forest Baptist’s] last full fiscal year, which ended June 30, 2017, 27 percent, or about $680.4 million, of the medical center’s $2.52 billion in patient revenue came from Medicare,” NC Health News reports.

The breakup with Medicare would be a big blow to the hospital.

Patients affected

Cancer treatment can include radiation therapy, surgery and chemotherapy, which can themselves negatively affect a patient’s health, NC Health News reports.

According to Modern Healthcare and Becker’s Hospital Review, “The pathology problems at [Wake Forest Baptist] led to problems with cancer diagnoses for four patients, with one patient’s treatment being delayed as a result. Three other patients were falsely diagnosed with cancer and started treatment programs before the error was caught.”

The hospital ‘determined that most, if not all, of the misdiagnoses centered on a single individual who is no longer with Wake Forest Baptist,’ the hospital’s statement says. Wake Forest Baptist said it’s made changes to its lab processes, equipment and training to address the issue.

Lab errors in hospitals

This isn’t the first time lab errors have created trouble for hospitals and medical centers. From a routine blood screening during pregnancy to specimen labeling errors in healthcare facilities, errors in technology and laboratory services are shocking—and hard to believe.

It’s not always inside the lab where things go wrong. Errors in lab work can occur outside the laboratory, as well.

“Close to 75% of mistakes occurred in the pre-analytic stage, which ECRI Institute defined as the time frame in which tests are selected and ordered, specimens are identified and transported, and patients are prepared. These mistakes were more likely to be associated with labels that had the wrong patient's name, the wrong specimen ordered, and incomplete or missing information. The other 22% of mistakes occurred in the post-analytic stage, when results were interpreted, reported or stored. Negative events were associated with either missing results, or a delay in getting results to the staff member who ordered them," Modern Healthcare reports.

“More than thirteen billion tests are performed in over 250,000 certified clinical laboratories each year in the U.S., making it likely everyone will each have at least one test done in their life. These include tests for genetic disorders, lead poisoning and diabetes, and the results routinely guide diagnostic and therapeutic decisions," Scientific American reports.

‘In the United States, some 251,000 deaths per year occur because of errors in medical care. This makes medical errors the third leading cause of death, only after heart disease and cancer.’

We don’t mean to scare you (many medical errors aren’t lethal), but we do hope that sharing these stories brings attention to the news at hand. Here's what you can do: stay informed—read up on the latest related news, and ask your providers questions.

As for Wake Forest Baptist, the question of what a corrective action plan looks like is very much on the minds of North Carolinians.

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