Delay in Laboratory Services Resulted in Delayed Diagnosis and Treatment
Penalty
Summary
The facility failed to provide timely laboratory services as ordered by a nurse practitioner for a resident with multiple medical conditions, including thyroid disorder, diabetes mellitus, and obesity. The resident, who was severely cognitively impaired and fully dependent on staff for care, experienced a change in condition marked by three episodes of foul-smelling diarrhea. The nurse practitioner ordered laboratory tests, an anti-diarrheal solution, and a registered dietician consult. A physician order was placed to collect a stool specimen, which was collected and stored in the refrigerator. However, the laboratory did not pick up the initial stool specimen, resulting in a delay in obtaining a second specimen. The second specimen was sent out two days later, and the positive result for C. difficile toxins was not received until several days after the initial collection. This delay in laboratory processing led to a delay in confirming the diagnosis and starting the necessary antibiotic treatment. Facility policy required timely provision of laboratory services, but this was not followed in this instance.