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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12487
Experience:  Emergency Medicine and Family Practice for over 26 years
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I get prescribed 5mg of oxycodone to take as needed for shoulder

Customer Question

I get prescribed 5mg of oxycodone to take as needed for shoulder and back pain from a psychiatrist as well as other controlled medications. I went to see a pain management group doctor for muscle relaxers, and disclosed all of the controlled medications that I was taking. I signed a form saying that I wouldn't receive narcotics on my initial consultation from another physician.
When I saw one of the pain management group's doctor for my first visit, I disclosed all of the medications I was taking, and filled out a form answering "yes" that I receive controlled medciations from another doctor. This first pain management doctor said that it was okay to still get the oxycodone, and prescribed to me Norco 10-325 and Zanuflex 2mg. I knew that I just shouldn't take th oxycodone and the Norco at the same time, and this doctor said different pain meds affect different parts of body more effectively than others. She then quit the pain medical group after I had three visits with her in 2011.
I continued going to the same pain medical group, thinking it was okay to still get the oxycodone since I was disclosing it at every appointment and being recorded in the groups electronic medical records. This continued throughout 2012 and their other doctors continued prescribing the Norco and the Zanuflex.
I then get in told in Feb. 2013 that I broke a rule on the form I signed, which was getting a narcotic from another doctor. The main doctor of this medical group claimed that I only told them once in 2011 about the oxycodone.
I went online and checked my medical records, and in fact, she was wrong and the nurse had been recording my oxcycodone use throughout 2012. The doctors were just being negligent in this group and not checking my medical list. The main doctor said I would need to find another pain management doctor, even though her nurse and office manager showed her that I had been disclosing my usage and it was her mistake for prescribing me Norco.
Anyway, I wanted to see my electronic medical notes and from the 2013 visit that incorrectly states that I only took oxycodone once in 2011. The main doctor said she would think about adding an addedum to the medical record notes of disclosure of oxycodone and honesty. She has done nothing.
I want my medical errors corrected before I see my new pain management doctor so he knows my correct history. This other doctor won't do anything.
How can I get her to change her negligent errors of not noticing that I disclosed taking oxycodone in 2012? What Board or Agency can I report her to? I will need to seek pain management soon for my back and shoulder pain again, and will stop taking the oxycodone.
Thank you!
Submitted: 1 year ago.
Category: Medical
Expert:  Family Physician replied 1 year ago.
The HIPAA privacy regulations are the relevant rules in this regards. Among other things, the regulations do allow a process to request an amendment to your medical records.
http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html

The amendment procedure is technically rather complex. The provider ultimately does not have to make the change, however the fact that you requested the change, his or her denial and the reasons for not making the change would need to be included in your medical record if the provider did not make the change. Here is the complete text of the HIPAA privacy regulations (which is much more information that you probably ever wanted) that would include the portions regarding amendments.
http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/adminsimpregtext.pdf

You can file a complaint with HHS regarding a HIPAA regulation issue (such as not complying with the amendment request correctly)
http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html

I hope this information has been helpful.
Customer: replied 1 year ago.

If the old pain management doctor refuses to add the addedum that she didn't notice in 2012 that on my list of medications I take was oxycodone, what is a good way to present this to my new pain management doctor?


 


The first doctor was negligent and not reading her nurses' notes and that I kept checking-off that I was receiving controlled meds from another doctor. The new doctor is going to want to see my records...what do I say so that he believes me? Go online with him to my old, patient portal and show the oxycodone use recorded in 2012 even though the old doc states in 2013 I never mentioned it except once in 2011?


Thank you again, and also, is there really anything wrong with taking Norco and oxycodone in the same period as long as you don't take them together, and take them on different days for varying pain in different parts of the body?

Expert:  Family Physician replied 1 year ago.
Since the nurses notes would have included this information - I believe a copy of those records would be adequate to explain this to a new physician.

As for taking both medications at the same time - as long as BOTH prescribing doctors (or one doctor prescribing both medications) is aware of the use of both medications and the directions on use are clear - this is not really problematic.
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12487
Experience: Emergency Medicine and Family Practice for over 26 years
Family Physician and 3 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

The nurses only reported my oxycodone use on their group practice's web site.


I am going to try and print it. If I can't, I hope the new pain management doctor has access to go online and access my 2012 medication lists.


 


What is the HHS agency? I know what HIPAA is...should I warn the first doctor that I'm going to report her and her medical errors, or just go ahead and do it?


 


Will she receive some kind of penalty for not amending her incorrect medical notes in 2013? It's almost April and this occurred in February!


 


You've been great! Thanks!

Expert:  Family Physician replied 1 year ago.
HHS - the Department of Health & Human Services. This is the agency that is responsible for enforcement of the HIPAA regulations.

They do not regulate or deal with medical errors. You would be reporting their failure to correct errors in the medical record. If they honor your request, and include something in the medical record to correct the documentation - then there really is no need to file a complaint.

You would have to have made a formal request for correction of the medical record (I believe in writing), and then there is a time frame for the provider to respond to your request.
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12487
Experience: Emergency Medicine and Family Practice for over 26 years
Family Physician and 3 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

I just wanted to let you know how helpful you were in finding the right web links about amendments to file my medical errors against the pain management doctor since February (who still has my file open on her desk, according to her staff). I spent hours trying to find the right information online! If I weren't on disability right now, I would give you a huge bonus!!
I emailed her staff and her with the links and information about HHS and HIPAA amendment laws and timelines, and told them I want something by the end of this week. It's almost April now and this was back in February that the doctor was going to add the adendment.


The only thing I'm afraid of is if the new doctor thinks I'm a nut for taking both Norco and Oxycodone, but each drug affects my body pains differently. I never took them on the same day. I'm sure he'll request my file before seeing me, but I need a pain management doctor for my back.


I hope the first doctor responds by the end of the week. If not, I'll go through the complaint system. And I'm not the kind of person that likes to do this at all, but she basically accused me of non-disclosure and non-compliance even though everyone on her staff had my medication list, and still prescribed Norco.


Thank you again for linking me to the exact locations; I never would have found it without you!

Expert:  Family Physician replied 1 year ago.
Thank you for the follow up... I'm glad I could help
Customer: replied 1 year ago.

Now I received this:



Thank you for your inquiry to the U.S. Department of Health and Human Services, Office for Civil Rights. Please note that a health care provider is not required to agree to an amendment if they deem that the information is correct. However, the health care provider should have informed you of your rights under the Privacy Rule. Please see Section 164.526, Amendment of protected health information.



If you have not been advised of your rights, you may wish to file a complaint using the attached complaint form package.


I am so confused....

Expert:  Family Physician replied 1 year ago.

The provider does not need to agree to the amendment, however, they do have to respond in writing to your request explaining the reason why they will not amend the record and your request, their denial of the request and your response to the denial I believe all must be included in your medical record. Even if they don't amend the record, they have to include your request etc.

 

Here is an excellent policy from University of Arkansas based on this requirement. It is more understandable in some senses that the text of the HIPAA privacy regulations.

http://uams.edu/AdminGuide/Win03132.html

 

Family Physician, Doctor
Category: Medical
Satisfied Customers: 12487
Experience: Emergency Medicine and Family Practice for over 26 years
Family Physician and 3 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

Are you located in Southern California? I wish you could be my primary care physician...I have Blue Cross HMO (Monarch).
Do you think there are good, quality physicians in Kaiser?


thanks

Expert:  Family Physician replied 1 year ago.
No - I am not from California

Yes - I do believe that there are good physicians in Kaiser - sometimes it takes some effort to find one that fits your needs and particular personality.

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