What were the consequences of a failure to report?

View the scenario called “critical decision making for providers”


Healthcare providers need to be able to make critical decisions. These decisions could have serious consequences for the patients and organization as well as other stakeholders. The paper examines the case of Mike, a laboratory technician, who did not report abnormal lab findings, which led to severe consequences. The paper analyzes the consequences of Mike’s failure to report, including its impact on patient safety, litigation risk, organization’s quality metrics, and workload of other hospital departments. Furthermore, the paper outlines the steps that can be taken by Mike’s manager to address the issue with him and ensure that other staff members do not repeat the same mistakes.


Mike is a lab technician who has been working in the hospital’s laboratory for five years. One day, he performs a test on a patient’s blood sample and discovers that the patient has an abnormal level of potassium in their blood. Mike suspects the abnormal result could be due to lab errors and refuses to tell the doctor. After being discharged from the hospital, however, the patient experiences cardiac arrest and then dies a week later. It is later discovered that the patient’s abnormal potassium level was the cause of their death.

Reported Failure: The Consequences

Mike’s decision not to report the abnormal potassium level had severe consequences. Firstly, it compromised patient safety, as the physician was not aware of the abnormal lab result and was unable to take appropriate action to prevent the patient’s death. Secondly, it increased the risk of litigation for the hospital, as the patient’s family may sue the hospital for medical malpractice. Thirdly, it negatively impacted the organization’s quality metrics, as the hospital’s reputation may be damaged if the incident is made public. It also increased workload for other departments in the hospital, who may need to face the aftermath of the incident (such as legal action and increased media attention).

How to Address the Problem

As Mike’s manager, it is important to address the issue with him to ensure that he understands the severity of his actions and to prevent other staff members from making the same mistakes. These are the steps you can take:

  1. Perform a performance assessment: Mike’s manager needs to conduct a review to determine why Mike failed to report an abnormal laboratory result. Managers can use this to determine underlying problems, like lack of training, confusing policies or communication obstacles.
  2. Education and Training: Mike should be taught and trained by his manager based on their performance review. This should include a review of the hospital’s policies and procedures on lab reporting.
  3. Monitor and audit: A manager should establish monitoring and auditing to make sure that laboratory results are accurately reported and updated on a timely basis. It will allow you to spot potential problems early, and help prevent future incidents.
  4. Promote a culture for reporting: A manager must encourage employees to report unusual lab results or other incidents. You can do this by giving feedback to employees who report incidents, and by encouraging staff to not be afraid to report them.


Abnormal lab results not being reported can lead to serious problems for both patients and the company. Healthcare providers must have the ability to make critical decisions and understand the significance of reporting abnormal laboratory results. As demonstrated in the scenario involving Mike, failure to report can compromise patient safety, increase the risk of litigation, damage the organization’s reputation, and increase the workload of other hospital departments. It is important for hospital managers to discuss the problem with employees and establish procedures that foster a culture where reporting is encouraged.

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