[Histonet] a question on ethics

[Joe Nocito]

After thinking about this all weekend, one thing that hasn't been mentioned
and should be used as a last resort is CLIA. Every state has a government
agency that overlooks the lab and healthcare.
I worked in a hospital once that a disgruntled employee called in CLIA. We
lost the lab manager and three section supervisors were put on probation.
Not a happy situation, but the tech got what they wanted. The manager fired.

 Joe Nocito, BS, HT(ASCP) QIHC
Histology Manager
Pathology Reference Lab
San Antonio, TX


-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of Jasper,
Thomas G.
Sent: Friday, August 13, 2004 6:19 PM
To: 'histonet <@t> pathology.swmed.edu'
Subject: FW: RE: [Histonet] a question on ethics


Thomas Jasper HT(ASCP) BAS
Anatomic Pathology Coordinator
SMDC Clinical Laboratory
Duluth, MN
tjasper <@t> smdc.org

> -----Original Message-----
> From: Jasper, Thomas G.
> Sent: Friday, August 13, 2004 3:47 PM
> To:   'pathrm35 <@t> adelphia.net'
> Subject:      RE: RE: [Histonet] a question on ethics
>
> Hey Ron,
>
> Have just followed your thread and hopefully I am understanding this
> correctly.  First of all the suggestions made to you by everyone on the
> histonet are right, any or all of them should be implemented.  Sounds to
> me like you are running into a brick wall with a manager (you directly
> report to) that is incompetent.  Therefore, it is extremely difficult for
> you to put these suggestions into place.  Secondly, you were deceived into
> exactly what the position was (is).  This only complicates any effort on
> your part to remedy a dire situation.
> I will reiterate what others have said, something must be done as patients
> are at risk.  This "something" can only be done once the proper authority
> at your institution deems it so.  Whether this comes about from a sentinel
> event (a death), some sort of legal salvo, action from an accrediting
> agency or any combination of the previously mentioned, I am quite certain
> it will happen.  Once it happens it could be very ugly.
> You said your physician (pathologist?) doesn't like to deal with these
> situations.  Hopefully your physician is more comfortable in a court of
> law than he/she is in dealing with your institution's issues.  You must go
> to your MD as someone stated previously he/she is the one on the line.
> Internal QC, QI, QA, PI or whatever your manager wants to call it sounds
> bogus to me.  I doubt your manager understands what a quality concept is.
> How can you apply something you don't understand?
> You may also want to remind your manager, risk management people and
> physician about a little incident that took place up here in Minnesota not
> too long ago.  Two breast cases were mixed up resulting in surgery for a
> patient (that was not required) and a missed diagnosis on another (that
> was required).  This was NOT the fault of the technical staff involved as
> the pathologist mixed the cases up.  Nevertheless, this was a wake-up call
> to MOST path labs in the country.  You are setting yourself up for, or
> already have set yourself up for something along the same lines.
> You may also want to remind the people senior to you that any one of them
> could be the "patient".  How would they feel about that?  Also which
> agency inspects your lab?  CAP? (I doubt it) JCAHO? (seems unlikely).  No
> rap on you Ron but situations like yours are the whole reason responsible
> inspection and auditing takes place.  What goes on at your place should
> NOT be happening.  Fact is stranger than fiction I guess.
> Finally, if I were you I would leave.  Not to bail out on patients, but
> this thing is bigger than you.  The Boy Scouts of America didn't capture
> Saddam Hussein.  That's an extreme comparison but I think it makes the
> point.  I believe you were set up for this whole debacle, you were
> probably viewed as a babe in the woods and ripe for the picking.  Frankly,
> you don't owe these deceptive jackdaws a thing.  The only thing you can
> really do, is defer to higher authority and hang in there until you can
> get away from these toxic people.  Good luck!
>
>
> Thomas Jasper HT(ASCP)BAS
> Anatomic Pathology Coordinator
> SMDC Clinical Laboratory
> Duluth, MN
> tjasper <@t> smdc.org
>
>
> -----Original Message-----
> From: pathrm35 <@t> adelphia.net [mailto:pathrm35 <@t> adelphia.net]
> Sent: Friday, August 13, 2004 12:47 PM
> To: Gary Gill; pam marcum; histonet <@t> lists.utsouthwestern.edu; Joe Nocito
> Cc: histonet <@t> lists.utsouthwestern.edu
> Subject: RE: RE: [Histonet] a question on ethics
>
>
> There is also the issue that this position is not what I was told it would
> be. I also didn't expect to have so many issues such as a tech that can't
> work up to my standards. Also I keep asking myself if it is worth it esp.
> when this isn't turning out to be the job I expected it to be. Lastly, how
> can I work for someone I can't respect or trust?  Any thought on that?
> >
> > From: Gary Gill <garygill <@t> dcla.com>
> > Date: 2004/08/13 Fri PM 01:39:01 EDT
> > To: "'pathrm35 <@t> adelphia.net'" <pathrm35 <@t> adelphia.net>,  pam marcum
> >      <mucram11 <@t> comcast.net>,  histonet <@t> lists.utsouthwestern.edu,  Joe
> Nocito
> >      <jnocito <@t> pathreflab.com>
> > CC: histonet <@t> lists.utsouthwestern.edu
> > Subject: RE: RE: [Histonet] a question on ethics
> >
> > Let your physician know that the person in charge is ultimately
> responsible
> > that the lab is run by the book.  There are right ways and wrong ways to
> do
> > things.  Wrong is indefensible.  Among possible penalties, CMS can shut
> down
> > the lab.  Surely your boss doesn't want to see the lab's name in the
> local
> > newspaper headlines.
> >
> > Gary Gill
> >
> > -----Original Message-----
> > From: pathrm35 <@t> adelphia.net [mailto:pathrm35 <@t> adelphia.net]
> > Sent: Friday, August 13, 2004 12:34 PM
> > To: pam marcum; histonet <@t> lists.utsouthwestern.edu; Joe Nocito
> > Cc: histonet <@t> lists.utsouthwestern.edu
> > Subject: Re: RE: [Histonet] a question on ethics
> >
> >
> > I sent copies of incident reports to RM but my manager wants us to do
> our
> > own internal quality control. How are things suppose to get fixed that
> way?
> > My physician doesn't like to deal with these situations and refers me to
> my
> > manager. I'm running in circles!!! Ron
> > >
> > > From: "pam marcum" <mucram11 <@t> comcast.net>
> > > Date: 2004/08/13 Fri AM 09:11:34 EDT
> > > To: <pathrm35 <@t> adelphia.net>,  <histonet <@t> lists.utsouthwestern.edu>,
> > > "Joe Nocito" <jnocito <@t> pathreflab.com>
> > > Subject: RE: [Histonet] a question on ethics
> > >
> > >
> >
>
>
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