April 13, 2012 INCIDENT REPORT

To whom it may concern, Good day! With this letter I would like to report in detail the incident that had happened yesterday, April 12, 2012 (6-2 shift) at Dr. Victor R. Potenciano Medical Center (5th South). I was the nurse-in-charge to patient named Pascual, Jezen, a thirty- one (31) year old, male, who undergone Bilateral Tonsillectomy under general anesthesia admitted at Room 513. He was under the service of the following doctors: Dr. E. Llanes - attending physician (Surgeon), Dr. T. Huerto - anesthesiologist and Dr. Permejo - responsible for his cardio-pulmonary clearance. I received the patient from our endorsement with a may go home order from Dr. Llanes after last dose of dexamethasone (last dose was given on April 12, 2012 at 2 oclock AM), patients bills were still up. Professional fees of doctors were as follows: Dr. E. Llanes - care of of secretary, Dr. T. Huerto - to notify, Dr. Permejo to notify. At around 8 oclock AM just right after we had our routine rounds, I billed down patients account with the following professional fees: Dr. E. Llanes - care of secretary, Dr. T. Huerto - to follow, Dr. Permejo - to follow. At around 8:15 AM, I notified the surgical- resident- on- duty (Dr. Ecle) via phone call about the discharge order. I also asked her to fill out the Philhealth Form (CF3) of the patient since the patient verbalized that they will be using the said health insurance. At around 8:20 AM, I texted Dr. T. Huerto asking for his professional fee to the said patient. While waiting for his reply, I checked for Dr. Permejos contact numbers from 5th South Doctors Directory but I did not find any. I then asked my co-staff nurses if they have any contact number for Dr. Permejo and they gave me his clinics number (local 113). At around 8:30 AM, Dr. Ecle was able to fill out and accomplish patients CF3 form. My other co- staff nurse gave the accomplished form to patients guardian and notified me after I have gone from other patients needs. At around 8:45 AM, I called to Dr. Permejos Clinic but no one answered the phone. I tried to call once again at around 9:00 AM but still there was no one answering. At 9: 30 AM, I received from the patients guardian patients discharge clearance slip from the billing department. I was honestly in doubt of how come the patient got the clearance from the billing department where in fact I noted to patients account that Dr. Huerto and Dr.Permejos professional fees were to follow. My other co-staff nurse told me that the patients guardian verbalized that all their bills including the professional fees of doctors were covered by their health card, so the patient was cleared by the billing department. At 9:45 AM, I got Dr. Huertos text message saying Antayin ko na lang mag-PF si Dr. Llanes. Confident enough that the patient was already cleared to be discharged, I immediately replied saying, Dr. Huerto gud am po ulitOkay na poCovered na daw po lahat ng health card nung patientThank you po! and then he replied, Ok. Tnx. Having in mind that everthing including doctors professional fees will be covered by the patients health card, I didnt ask anymore for Dr. Permejos Professional fee. At around 9:50 AM, I removed patients

heplock since they were about to go already, I discharged patient at around 10: 05 AM with home medications and follow up check up instructions. Knowing that I still have to notify Dr. Permejo about the patients discharge, I called and asked the information department if they have any other contact number of Dr. Permejo. I specifically asked for any mobile number and they gave me this one (09228216914). At around 10:15 AM, I texted the given number saying, Doc Gudam, inform ko lang po kayo na may go home na si patient Pascual, Jezen, 31 y/o male, RM. 513, post tonsillectomy under the service of Dr. Llanes, covered naman po sya ng card nya, Thank you Doc I waited for any reply or acknowledgement but I didnt receive any until 2 oclock PM. I sincerely apologize for my action especially with regards to Dr. Permejo. If there will be any rightful sanction for my action, I will be willing to accept it whole-heartedly. Thank you!

Respectfully Yours, Ma. Rocelia G. Parreo, RN