An 82-Year-Old Man with a History of Advanced Alzheimer Dementia

An 82-year-old man with a history of advanced Alzheimer dementia is brought to the hospital by his daughter, who is his power of attorney and caregiver.  She says that her father is increasingly confused and verbally aggressive.  He is admitted to the hospital and found to have a urinary tract infection.  Intravenous antibiotics are initiated and he appears less disoriented and agitated but remains unable to recall nursing instructions throughout the day and is fairly nonverbal.  Three days into his treatment, the antibiotic order expires and is missed by the physician, nurses, and pharmacy staff.  The patient receives no medication for 2 days before the error is noted and corrected.  There are no consequences to this error other than extension of his hospital stay by 2 days.  Which of the following is the most appropriate course of action?

A) Do not disclose the error as the patient was not harmed
B) Do not disclose the error but arrange for the hospital to not charge for the extra days
C) Inform the daughter and disclose the error with an apology
D) Inform the patient and disclose the error with an apology
E) Say nothing until the incident is discussed with nursing and pharmacy staff

Correct Answer:

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