A 49 year old female with history of Type 1 Diabetes Mellitus, kidney transplant and recent diagnosis of breast cancer with spinal metastatic disease.

A 49 year old female with history of Type 1 Diabetes Mellitus, kidney transplant and recent diagnosis of breast cancer with spinal metastatic disease. She was discharged home on 9/3. On 9/6 she presented to a different healthcare facility with fevers and was transferred to the primary healthcare facility on 9/8. Records from secondary facility stated that the patient had a low-grade fever and blood cultures were positive for gram positive cocci and gram negative rods. Transfer medications of note, included Vancomycin and Gentamicin. Upon arrival the patient was afebrile. The physician reviewed the records sent with the patient but did not note the gram negative blood cultures in the history and physical and did not continue the gram negative antibiotic coverage. The hospitalization was prolonged and required surgical intervention due to the infection at the previous surgical site. Critical thinking: 1.) Would medication reconciliation have avoided this error from occurring? If so, how?

2.) Who do you feel are expected to reconcile medications for external transfer patients at a healthcare facility? Support your answer with facts.

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