Kendra Brown, Registered Health Information Technician, CCS, is the Assistant Director of Health Information Services at Memorial Hospital. Dr. Philip Russell, the chairman of the medical staff committee, enters Kendra's office accompanied by Sue Davidson, the facility risk manager. Sue requests records of all patients in the past two years who have had gastric bypass surgery by Dr. Lester Brown and states that they will be back for them in 20 minutes. Kendra reminds Sue that the department policy for study requests is 24 hours, but Sue tells her that this is an urgent matter. Sue and Kendra are close friends and have both worked at Memorial Hospital for 15 years. Sue confides in Kendra that Dr. Russell needs the records in response to a patient death after surgery, with the family threatening a lawsuit against the facility. She also states that there have been similar incidents with Dr. Brown's patients over the past two years, and Dr. Russell wants to look into the situation and potentially take appropriate action. Kendra lets Sue know that she will pull the records immediately and thanks her for sharing the information with her. She runs the report of Dr. Brown's patients who have had gastric bypass procedures over the past year and pulls the records from the list. Kendra's mother is scheduled to have gastric bypass surgery by Dr. Brown next week, so naturally, she is curious about the reason for Dr. Russell's inquiry. As Kendra pulls the records for Dr. Russell, she briefly examines the documentation on the charts that indicate a complication may have occurred. She is astonished to discover that all except for one of Dr. Brown's patients were either re-admitted with serious complications or had extended stays due to complications from the procedure. She notes that 24 of the 78 patients expired due to complications from the procedure. Because of these findings, Kendra feels the need to warn her mother to reconsider her decision for surgery or to seek another surgeon. Kendra returns to her office and calls her mother. Although not revealing any details of her findings, she tells her mother that she has seen something disturbing at work regarding Dr. Brown's gastric bypass patients. She does include her concern regarding the fact that there have been a significant number of gastric bypass patients who have died after the procedure. Kendra asks her mother if she might reconsider her surgery scheduled for next week or at least seek a different surgeon. Sue overhears Kendra's phone conversation and enters Kendra's office. When Kendra gets off the phone, Sue confronts her about the content of her discussion with her mother. Kendra responds, "I couldn't help but notice a trend in the outcomes of the records I was pulling, especially the number of patients who died after the procedure. Obviously, you are well-aware of what is going on. Wouldn't you do the same thing if your mother were scheduled to have gastric bypass with Dr. Brown?"
1) What are the legal issues?
2) What are the ethical issues?
3) What you consider to be the greatest legal or ethical dilemma in this case and determine the best option for resolution.