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Medical Records should be documented with complete and accurate information of patients along with correct administered medications. Tampering or altering medical records is illegal and is a crime punishable with fines and jail time. By doing such, can mislead and can cause harm to patients. But if you are dealing with such accusations or complaints, it is best to seek help from a nurse lawyer.

Such incident happened on or about June 24, 2020, while an RN was employed at a medical facility in Austin, Texas, the RN falsified medical records in that Respondent modified a fall risk score in the medical record of Patient TMC0056418. Respondent initially documented the Morse Fall Risk score to be “50” requiring the bed alarm to be on but changed it to “40” after a fall. Respondent’s conduct resulted in an inaccurate medical record and was likely to injure the patient in that subsequent caregivers would rely on her documentation for further care.

In regards to the incident that happened on or about June 24, 2020, the RN states in the complaint that the medical facility claims that medical records were intentionally falsified in an effort to self-preserve. The RN states this is unequivocally false, while at the same time admitting that there was a mistake made for which she is ultimately responsible. The RN added and states that she was assigned three (3) high acuity patients, two (2) suffering from confusion, and all disoriented. To make matters worse the patients were geographically distant from one another on the floor making it extremely difficult to give them each the attention required. She also states that there absolutely was a mistake made in the charting, but it was a copy and paste error with no malice attached.

As per information received by the Texas Board of Nursing which produced sufficient evidence to prove that the RN violated the 22 TEX. ADMIN. CODE §217.11(1)(A),(1)(B)&(1)(D) and 22 TEX. ADMIN. CODE. The RN was sanctioned and disciplined pursuant to Section 301.452(b)(10)&(13), Texas Occupations Code.

The RN has failed to hire a nurse lawyer for defense which leads to this decision of the Board. If the RN only hired a nurse lawyer, this could have yielded a different outcome.

If ever you have questions about the Texas Board of Nursing disciplinary process. Contact The Law Office of RN License Attorney Yong J. An for a confidential consultation by calling or texting 24/7 at (832) 428-5679 and ask for attorney Yong.