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Complaint Department Complaints, Malpractice Reports & Medical Examiner Cases. JUDIE CLARK Director. Complaint Department Staff. Sherry Hyder, Complaint Summary Coordinator Amy Ingram, Complaint Coordinator Carol Puryear, Malpractice/ME Coordinator. Our Mission Statement.

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Complaint department complaints malpractice reports medical examiner cases
Complaint Department Complaints, Malpractice Reports & Medical Examiner Cases

JUDIE CLARK

Director


Complaint department staff
Complaint Department Staff

  • Sherry Hyder, Complaint Summary Coordinator

  • Amy Ingram, Complaint Coordinator

  • Carol Puryear, Malpractice/ME Coordinator


Our mission statement
Our Mission Statement

Fair complaint resolution

as a service to the public and medical professionals


What we do
What we do….

  • Talk, talk, talk, listen, listen, listen(to educate the public and licensees)

  • Process written complaints

  • Process malpractice payment reports

  • Process medical examiner reports

  • Verify Licensee Information Page related to all malpractice payments (new addition!!!)


A day in the life of complaints
A Day in the “Life of Complaints”

  • We average 45-60 complaint calls per day

  • Complaints can be filed by requesting a complaint form or filed via the web site

  • All complaints are reviewed upon receipt and handled as “paper investigations” or referred to Investigations for “field investigations”

  • Complaints are mailed to licensee for their review and a written explanation to the Board.


Malpractice info
Malpractice Info

  • Payment reports are provided by the insurance company as per statute

  • Licensee also provides payment information via renewal or licensee information update

  • Explanation of settlement is required from licensee and requested from plaintiff’s attorney


Medical examiner reports
Medical Examiner Reports

  • Reports are provided to the Board from the Office of the Chief Medical Examiner when there is a suspicion that the death could be related to a NC licensee. We receive about 25 reports per year.

  • Obtain medical records from hospital to determine appropriate licensee to respond

  • Explanation requested from licensee regarding their involvement in the care/death of the patient


The review process
The Review Process

  • The review process averages 6 months

  • When the response/records are received, the Office of Medical Director (OMD) reviews the complaints, Malp and ME reports and makes a recommendation to the Senior Staff.

  • Senior Staff (SS) meets two to three times per month to review all cases.


The review process continued
The Review Process (continued)

  • AAI complaints are closed at the Senior Staff level (average 65 per month)

  • Complaints with recommendations of a PLOC are reported to the Review Committee

  • Complaints with recommendations of II, PubLOC, Charges, etc. are reported to the Disciplinary Committee

  • All Malp & ME cases are reported to the Disciplinary Committee


Recent statutory changes
Recent Statutory Changes

  • Licensees are required to report malpractice payments to the Board within 60 days of settlement

  • The Board is required to complete the initial review process within 6 months or provide written explanation to licensee


Past statutory changes
Past Statutory Changes

  • Complainants may be provided a copy of the physician’s response to their complaint. Copies are provided based on established criteria.

  • Complainants are now informed when the licensee receives a private letter of concern.


Annual processes
Annual Processes

  • Query NPDB (National Practitioner Data Bank) and cross reference malpractice payments with our database. Follow-up with licensee when applicable

  • Write insurance companies and remind them of reporting requirements