children-claw-claw_machines-arcades-arcade_games-little_boy-awhn203lWhat passes for news these days is tough to judge. Newsprint on a national basis is a dying (or dead) medium for transmitting information. Our local newspaper has move to a hybrid online-print format where now we can read LOST TODDLER FOUND IN CLAW MACHINE both 3 days after the event when posted on-line after a slow news day and again in print 5 days after the event. Scanning various content sites seems to be the way to get information in an organized fashion, but that is time consuming. My 20-something daughter goes to Reddit, where readers post content and then other readers vote it up or down. In a way simplifying the process (if 2000 other people think it is important it must be) but in a way limiting you to what other 20-somethings think is important (is the fact that a TWENTY-TWO-year-old crew member saved people on the Korean ferry disaster REALLY the most important story of the day?).

Older people tend to watch the news networks. People of a certain age interested in food stamp fraud watch Fox, and folks interested in airplane abductions are going to CNN these days. Big stories tend to get on-site coverage. But a lot of the “little stories,” ones that are of the human interest variety, often contain incomplete information and are simply put out there to reverberate over the internet with no context and no analysis of what happened. Such is the case, I suspect, with the rogue mammogram tech (688 Reddit votes). The story in the CNN/Fox/ world is that this mammogram tech (Rachael Rapraeger) got “behind in her work” and took it upon herself to enter “normal” into 1200 mammogram reports rather than walk the mammograms down the hall to the waiting radiologist. Two women died of their diagnosed-too-late breast cancer. For this Ms. Rapraeger took a plea and will do jail time. Another bad cog in the best health care system in the world machine, thankfully caught before she could do even more harm.

The Macon news offers a little more in-depth coverage today and suggests the story might not be as cut and dried:

  • The tech’s job consisted of performing the mammogram and then either creating a file jacket for a new patient or updating an old file jacket. She was then expected to walk the file with the mammogram film down the hall and give it a radiologist to read
  • The process of creating or updating the file jackets was apparently extremely time consuming for Rapraeger, who chose instead to enter the negative results over a period of months using the radiologist PIN numbers given to her by hospital staff rather than provide the radiologist with the films
  • Immediately after she was terminated, the suite was converted to digital and the machine, hard drive of the computer, and in many cases the films themselves were destroyed.

As a physician with an interest in health system design, neither of these articles answered my questions. If I were the journalist these are the questions I would want the answer to:

  1. Didn’t the radiologist think something was up when day after day he sat in that dark room waiting for mammograms to be delivered to him and none ever came, despite the fact that 15 people a day were walking in and out of the mammogram suite? Did anyone submit the bills for these?
  2. Did the tech really have EVERY radiologist’s PIN/electronic signature (there are about 8 that went to that hospital) and if so, how did she get it? Did these radiologists then bill for the reading? Who else at the hospital has the ability to enter physician specific information over their signature? Did the hospital think this might be a problem?
  3. Didn’t the hospital find it fishy when no positives were being reported out of their system over a period of several years? The positive rate is normally as high as 25% over several years. Are other tests besides mammography showing normal results, but actually not being done at all?
  4. Whose idea was it to destroy the records (and apparently many of the old mammograms) during the renovation?

I suspect folks with an interest in claw machines could ask the same kind of questions (and based on the comments, many would like answers to their claw related questions as well). I just have to wonder if the person who puts the toys in the claw machine is ready to do jail time, because the lowest person in the pecking order at Perry Hospital is about to.