Altering records: discrediting your best witness.
There is a proper way to make a correction to a medical record. If the correction is entered properly, contemporaneously, has bearing on current patient care, does not embellish or amplify your actions as being correct, and is consistent with other entries in the record it should be sound. Entries that are not properly made can destroy a professional liability defense. Plaintiff's attorneys will look for a reason to allege altered records. It is a plaintiff's attorney's strategy to use such an allegation to make the case less defensible, force a settlement or increase the value of a case through the threat of punitive damages. Do not give them the opportunity.
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Risk Management, MAG Mutual Insurance Company, Atlanta, GA 30305.
D005568:Forms and Records Control / Q000331:legislation & jurisprudence*; D006801:Humans; D016365:Liability, Legal; D008499:Medical Records